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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 304371159
Report Date: 05/09/2024
Date Signed: 05/09/2024 01:56:56 PM


Document Has Been Signed on 05/09/2024 01:56 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE COUNTY CC RO, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868



FACILITY NAME:OLAM JEWISH MONTESSORI OF BETH JACOBFACILITY NUMBER:
304371159
ADMINISTRATOR:PINTO, LYNNEFACILITY TYPE:
830
ADDRESS:3880 MICHELSONTELEPHONE:
(949) 786-5230
CITY:IRVINESTATE: CAZIP CODE:
92612
CAPACITY:12CENSUS: 11DATE:
05/09/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
12:00 PM
MET WITH:Director, Lynne PintoTIME COMPLETED:
02:15 PM
NARRATIVE
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Licensing Program Analysts (LPAs), Cindy Nguyen and Cynthia Sun conducted an onsite inspection for the purpose of an annual random. LPAs and director toured the facility inside and outside and the floor and yard plan were verified. Census was taken in individual classrooms. The overall census observed was 4 staff and 11 infant children. During the inspection it was determined the facility is operating within its licensed capacity and within compliance of staffing ratios. Facility hours are 8:00 a.m.- 6:00 p.m., Monday through Friday. A review of the Facility Personnel Report Summary on this date indicates all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions.

During the inspection of the indoor activity space, LPAs did not observe any items which could pose a danger to children (poisons, detergents, cleaning compounds, medications or hazardous items). All storage containers for solid waste, including moveable bins, have tight fitting covers that are kept on, and are in good repair. Bottles brought by the infant’s authorized representative are labeled with the infant’s name and current date. Infant changing tables are placed within arm’s reach of a sink. The facility has age-appropriate furniture and equipment including but no limited to, cribs, mats, changing table and feeding chairs. A baby walker was not observed during today’s visit. Floors, equipment, and furniture were clean and were observed to be in good repair and free of sharp edges.

Children's records were reviewed, and there was a separate, complete and current record for each child. LPAs observed and reviewed LIC 9227 Individual Infant Sleeping Plan in children’s files. In the areas reviewed the children’s files were found to be in full compliance. Sign in/out procedure was reviewed for compliance. The person who signs the child in and out uses their full legal signature and records the time of the day.

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SUPERVISOR'S NAME: Thuy HoTELEPHONE: (714) 287-8515
LICENSING EVALUATOR NAME: Cynthia SunTELEPHONE: 714-703-3599
LICENSING EVALUATOR SIGNATURE:
DATE: 05/09/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/09/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
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Document Has Been Signed on 05/09/2024 01:56 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE COUNTY CC RO, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868


FACILITY NAME: OLAM JEWISH MONTESSORI OF BETH JACOB
FACILITY NUMBER: 304371159

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/09/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
HSC
1597.16(a)(1)
Lead Testing
(1) A licensed child day care center, as defined in Section 1596.76, that is located in a building that was constructed before January 1, 2010, shall have its drinking water tested for lead contamination levels on or after January 1, 2020, but no later than January 1, 2023, and every five years after the date of the initial test.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on interview and record review, the Director did not comply with the Section cited above. LPAs were not able to verify if Lead Testing was completed on website: State Water Resource System. Director was unable to access Lead Testing documentation during today's inspection, which posses/posed a potential health, safety or pesonal rights risk to persons in care.
POC Due Date: 05/31/2024
Plan of Correction
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Director stated she will provide a copy of the Lead Sampling Test to Licensing office on due date.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME: Thuy HoTELEPHONE: (714) 287-8515
LICENSING EVALUATOR NAME: Cynthia SunTELEPHONE: 714-300-3599
LICENSING EVALUATOR SIGNATURE:
DATE: 05/09/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/09/2024
LIC809 (FAS) - (06/04)
Page: 2 of 4


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE COUNTY CC RO, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
FACILITY NAME: OLAM JEWISH MONTESSORI OF BETH JACOB
FACILITY NUMBER: 304371159
VISIT DATE: 05/09/2024
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LPAs reviewed storage of medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice)/ (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm

The outdoor activity space was inspected for compliance. The playground was enclosed by a fence at least four feet in height. The surface of the outdoor activity space was well maintained and free of hazards. There was no climbing equipment observed on the playground. Drinking water in the outdoor activity space is provided by children’s water bottles. The outdoor equipment and toys were in good repair and free of sharp edges. There are no bodies of water present at the facility. The facility grounds were safe, sanitary and in good repair. LPAs were not able to verify if Lead Testing was completed online website: State Water Resource System. Director was unable to access Lead Testing documentation during today’s inspection.

The Director was informed that Licensing Quarterly Updates are available at www.ccld.ca.gov and may request to be added to an email list to receive a Quarterly Update from www.ccld.ca.gov and select Receive Important Updates link.

LPAs provided Guardian Information and website info: https://www.cdss.ca.gov/inforesources/cdss-programs/community-care-licensing/caregiver-background-check/guardian

An electronic copy of the 2016 “A Child Care Providers Guide to Safe Sleep” was provided to the director.

English: https//www.cdph.ca.gov/programs/SIDS/Documents/SIDSchildcaresafesleep.pdf

AAP: https://www.healthychildren.org/English/ages-stages/baby/sleep/Pages/A-Parents-Guide-to-Safe-Sleep.asp

NIH: https://safetosleep.nichd.nih.gov/safesleepbasics/environment/room/text_alternative

Safe to Sleep Campaign: https://safetosleep.nichd.nih.gov/materials

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SUPERVISOR'S NAME: Thuy HoTELEPHONE: (714) 287-8515
LICENSING EVALUATOR NAME: Cynthia SunTELEPHONE: 714-703-3599
LICENSING EVALUATOR SIGNATURE:

DATE: 05/09/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/09/2024
LIC809 (FAS) - (06/04)
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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE COUNTY CC RO, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
FACILITY NAME: OLAM JEWISH MONTESSORI OF BETH JACOB
FACILITY NUMBER: 304371159
VISIT DATE: 05/09/2024
NARRATIVE
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· Always place infants on their backs for sleeping

· Use only a tight-fitting sheet on the crib or play yard mattress

· Do not hang any items from the crib or above the crib

· Keep all items, including blankets, out of the crib or play yard

· Pacifiers may be used as long as they do not have items attached to them

· Infants should not be swaddled or have any items covering them while sleeping

· The temperature of the room should be comfortable enough for an adult to wear a t-shirt and not be too hot or too cold

Based on LPAs observations, record review and interview the following violation was observed and are being cited in accordance with Health Safety Code 1957.16(a)(1) Lead Testing is being cited on the attached LIC 809D.

An Inspection and exit interview were completed with director. The report was reviewed and discussed. Appeal Rights and deficiencies were discussed. The facility representative was provided a copy of their appeal rights (LIC 9058) and their signature on this form acknowledges receipt of these rights. All appeals must be in writing and received by the Regional Office within 15 business days.

The facility representative was informed that the “Notice of Site Visit” must be posted for 30 consecutive days. The “Notice of Site Visit” must be posted on or adjacent to the door. Failure to post will result in Civil Penalties of $100.00.

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SUPERVISOR'S NAME: Thuy HoTELEPHONE: (714) 287-8515
LICENSING EVALUATOR NAME: Cynthia SunTELEPHONE: 714-703-3599
LICENSING EVALUATOR SIGNATURE:

DATE: 05/09/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/09/2024
LIC809 (FAS) - (06/04)
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