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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 304371465
Report Date: 09/20/2024
Date Signed: 09/24/2024 11:03:16 AM

Document Has Been Signed on 09/24/2024 11:03 AM - 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:SMILES MONTESSORI CHILDCAREFACILITY NUMBER:
304371465
ADMINISTRATOR/
DIRECTOR:		AHN, SUNG JAFACILITY TYPE:
830
ADDRESS:2261 NORTH ORANGE OLIVE ROADTELEPHONE:
(714) 283-2857
CITY:ORANGESTATE: CAZIP CODE:
92865
CAPACITY: 20TOTAL ENROLLED CHILDREN: 20CENSUS: 10DATE:
09/20/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:00 AM
MET WITH:Director AHN, SUNG JATIME VISIT/
INSPECTION COMPLETED:
05:00 PM
NARRATIVE
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On 9/20/2024, Licensing Program Analysts (LPA), Valdez Santana and Jung, conducted an onsite inspection for the purpose of an Annual Inspection. Upon arrival at 9:00AM, LPAs were led on a tour by Director Ahn, Sung Ja. The overall census observed was three (3) staff, one (1) adult, nine (9) infant children, and one (1) preschool child. Staff 2 (S2) had their preschool child in the infant classroom; see LIC 809D for deficiency cite. LPAs observed director take preschool child out of infant class and take them to the preschool. Facility hours are 6:30AM – 6:00PM, Monday through Friday.

The Facility Personnel Report Summary reviewed 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. Director was reminded that all adults 18 and over, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a Child Care Center. A civil penalty of $100.00 minimum/day for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.

During the inspection, items which could pose a danger to children (detergents, cleaning compounds, and medications) were observed to be accessible to children; see LIC 809D for deficiency cited. Poisons/Hazardous Items are not kept on the premises. Food is prepared on site; breakfast, lunch, and snacks are provided. Parents provided their own purees for infants. Food prep areas were clean and sanitary. LPAs observed expired children’s milk being stored in the kitchen fridge; see LIC 809D for deficiency cited. Menus were posted where they could be reviewed by authorized representatives. Bottles, dishes, and food containers brought by the infants’ authorized representatives were labeled with the infants’ names. Floors, children’s equipment, and furniture were clean, observed to be in good repair, and free of sharp edges. All storage containers for solid waste, including moveable bins, had tight fitting covers that were kept on and in good repair. There was drinking water available, both indoors and outdoors, to children by refillable bottles labeled with the children’s names.
(Go to Page 2)
SUPERVISORS NAME: Martha Malane
LICENSING EVALUATOR NAME: Soo Jin Jung
LICENSING EVALUATOR SIGNATURE: DATE: 09/20/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/20/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 17
Document Has Been Signed on 09/24/2024 11:03 AM - It Cannot Be Edited


Created By: Soo Jin Jung On 09/20/2024 at 02:50 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

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

FACILITY NAME: SMILES MONTESSORI CHILDCARE
FACILITY NUMBER: 304371465

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/20/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type A
Section Cited
CCR
101430(a)(3)(A)
Infant Care Activities
(A) Staff shall place infants up to 12-months of age on their backs for sleeping.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation and interview, the licensee did not comply with the section cited above in that, Staff 3 placed one sleeping infant on their stomach, which poses an immediate health, safety or personal rights risk to persons in care. Staff 3 stated they were trained to place infants on their tummies for nap time to prevent spitting up.
POC Due Date: 09/27/2024
Plan of Correction
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Director stated they will train staff to place sleeping infants on their backs. Director stated they will submit in writing the topic of training with staff signature and date to LPA by due date.
Type A
Section Cited
CCR
101216.1(c)(1)
Teacher Qualifications and Duties
(c) To be a fully qualified teacher, a teacher shall have one of the following: (1) Twelve postsecondary semester or equivalent quarter units in early childhood education or child development completed, with passing grades, at an accredited or approved college or university; and at least six months of work experience in a licensed child care center or comparable group child care program.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on record review, the licensee did not comply with the section cited above in that, 3 out 3 staff did not have 12 ECE units, which poses an immediate health, safety or personal rights risk to persons in care.
POC Due Date: 09/27/2024
Plan of Correction
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Director stated they will submit proof of one of the following for plan of correction: infant course enrollment for staff 1, replace infant staff with those who have required units, or disenroll infants to meet ratio.
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:Martha Malane
LICENSING EVALUATOR NAME:Soo Jin Jung
LICENSING EVALUATOR SIGNATURE:
DATE: 09/20/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/20/2024


LIC809 (FAS) - (06/04)
Page: 2 of 17
Document Has Been Signed on 09/24/2024 11:03 AM - It Cannot Be Edited


Created By: Soo Jin Jung On 09/20/2024 at 02:50 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

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

FACILITY NAME: SMILES MONTESSORI CHILDCARE
FACILITY NUMBER: 304371465

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/20/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
101439(d)(2)
Infant Care Center Fixtures, Furniture, Equipment and Supplies
(d) Swings, playpens and all such equipment and furniture shall be assembled or installed according to the manufacturer's instructions, and shall be maintained in good repair and safe condition. (2) A baby walker shall not be allowed on the premises of a child care center in accordance with Health and Safety Code Section 1596.846.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, the licensee did not comply with the section cited above in that, LPAs observed 1 baby walker in the infant play yard, which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 09/20/2024
Plan of Correction
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Director threw out baby walker during LPAs visit.
Type B
Section Cited
CCR
101226(d)
Health-Related Services
(d) The licensee shall maintain the following first-aid supplies in a location accessible to staff but inaccessible to children:

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, the licensee did not comply with the section cited above in that, the facility did not have a complete first aid kit available, which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 09/27/2024
Plan of Correction
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Director stated they will purchase a complete first aid kit and submit photo proof to LPA by due date.
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:Martha Malane
LICENSING EVALUATOR NAME:Soo Jin Jung
LICENSING EVALUATOR SIGNATURE:
DATE: 09/20/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/20/2024


LIC809 (FAS) - (06/04)
Page: 3 of 17
Document Has Been Signed on 09/24/2024 11:03 AM - It Cannot Be Edited


Created By: Soo Jin Jung On 09/20/2024 at 02:50 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

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

FACILITY NAME: SMILES MONTESSORI CHILDCARE
FACILITY NUMBER: 304371465

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/20/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
101238(g)
Buildings and Grounds
(g) Disinfectants, cleaning solutions, poisons and other items that could pose a danger if readily available to children shall be stored where inaccessible to children.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, the licensee did not comply with the section cited above in that, cleaning solutions were not made inaccessible to children in care, which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 09/27/2024
Plan of Correction
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Director stated they will move the the cleaning solutions to a locked area inaccessible to children in care.
Type B
Section Cited
CCR
101238.2(d)(1)
Outdoor Activity Space
(d) The surface of the outdoor activity space shall be maintained: (1) In a safe condition for the activities planned.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, the licensee did not comply with the section cited above in that, infant play yard surface and play equipment were not clean and sanitary, which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 09/27/2024
Plan of Correction
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Director stated they will clean the outdoor activity space and maintain cleanliness at all times. Director stated they will send LPA picture proof of clean space by due date.
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:Martha Malane
LICENSING EVALUATOR NAME:Soo Jin Jung
LICENSING EVALUATOR SIGNATURE:
DATE: 09/20/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/20/2024


LIC809 (FAS) - (06/04)
Page: 4 of 17
Document Has Been Signed on 09/24/2024 11:03 AM - It Cannot Be Edited


Created By: Soo Jin Jung On 09/20/2024 at 02:50 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

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

FACILITY NAME: SMILES MONTESSORI CHILDCARE
FACILITY NUMBER: 304371465

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/20/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
101430(a)(3)(E)
Infant Care Activities
(E) If an infant falls asleep before being placed in a crib, staff shall move the infant to a crib as soon as possible.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation and interview, the licensee did not comply with the section cited above in that, one infant was observed sleeping in an infant swing, which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 09/27/2024
Plan of Correction
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Director stated they will review safe sleep procedures with staff to ensure that infants who fall asleep be moved to a crib as soon as possible. Director stated they will submit signed training session to LPA by due date.
Type B
Section Cited
HSC
1596.7995(a)(1)
General Provisions and Definitions
(1) Commencing September 1, 2016, a person shall not be employed or volunteer at a day care center if he or she has not been immunized against influenza, pertussis, and measles. Each employee and volunteer shall receive an influenza vaccination between August 1 and December 1 of each year.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on record review, the licensee did not comply with the section cited above in that, 3 out of 3 staff did not have complete immunization records on file, which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 10/18/2024
Plan of Correction
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Director stated they will submit proof of complete immunization records for all three staff to LPA by due date.
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:Martha Malane
LICENSING EVALUATOR NAME:Soo Jin Jung
LICENSING EVALUATOR SIGNATURE:
DATE: 09/20/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/20/2024


LIC809 (FAS) - (06/04)
Page: 5 of 17
Document Has Been Signed on 09/24/2024 11:03 AM - It Cannot Be Edited


Created By: Soo Jin Jung On 09/20/2024 at 02:50 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

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

FACILITY NAME: SMILES MONTESSORI CHILDCARE
FACILITY NUMBER: 304371465

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/20/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
101216(g)(1)
Personnel Requirements
(1) Except as specified in (3) below, good physical health shall be verified by a health screening, including a test for tuberculosis, performed by or under the supervision of a physician not more than one year prior to or seven days after employment or licensure.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on record review, the licensee did not comply with the section cited above in that, 3 out of 3 staff did not complete their health screening, which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 10/18/2024
Plan of Correction
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Director stated they will submit current health screening for all three staff to LPA by due date.
Type B
Section Cited
CCR
101217(a)(7)
Personnel Records
(a) The licensee shall ensure that personnel records are maintained on the licensee, administrator and each employee. Each personnel record shall contain the following information: (7) Past experience, including types of employment and former employers.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on record review, the licensee did not comply with the section cited above in that, 3 out of 3 staff did not have proof of past experience, which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 09/27/2024
Plan of Correction
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Director stated they will provide proof of past experience for all three staff to LPA by due date.
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:Martha Malane
LICENSING EVALUATOR NAME:Soo Jin Jung
LICENSING EVALUATOR SIGNATURE:
DATE: 09/20/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/20/2024


LIC809 (FAS) - (06/04)
Page: 6 of 17
Document Has Been Signed on 09/24/2024 11:03 AM - It Cannot Be Edited


Created By: Soo Jin Jung On 09/20/2024 at 02:50 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

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

FACILITY NAME: SMILES MONTESSORI CHILDCARE
FACILITY NUMBER: 304371465

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/20/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
101415(c)
Infant Care Center Director Qualifications and Duties
(c) At least three of the semester or equivalent quarter units required in Sections 101215.1(h)(1)(B), (h)(2) and (h)(3) shall be related to the care of infants.

This requirement is not met as evidenced by:
Deficient Practice Statement
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2
3
4
Based on record review, the licensee did not comply with the section cited above in that, 3 out of 3 infant staff did not have the required infant units, which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 09/27/2024
Plan of Correction
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Director stated they will provide proof of infant units for all three staff to LPA by due date.
Type B
Section Cited
CCR
101419.2(a)
Infant Needs and Services Plan
(a) Prior to the infant's first day at the center, the infant care center director or assistant director shall complete a needs and services plan for the infant.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on record review, the licensee did not comply with the section cited above in that all infant enrolled did not have a needs and services plan on file, which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 09/27/2024
Plan of Correction
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Director stated they will submit a needs and services plan for each infant under 12 months of age to LPA by due date.
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:Martha Malane
LICENSING EVALUATOR NAME:Soo Jin Jung
LICENSING EVALUATOR SIGNATURE:
DATE: 09/20/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/20/2024


LIC809 (FAS) - (06/04)
Page: 7 of 17
Document Has Been Signed on 09/24/2024 11:03 AM - It Cannot Be Edited


Created By: Soo Jin Jung On 09/20/2024 at 02:50 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

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

FACILITY NAME: SMILES MONTESSORI CHILDCARE
FACILITY NUMBER: 304371465

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/20/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
101220.1(g)
Immunizations
(g) The licensee shall document each child's immunizations and shall maintain such documentation in the center for as long as the child is enrolled.

This requirement is not met as evidenced by:
Deficient Practice Statement
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2
3
4
Based on record review, the licensee did not comply with the section cited above in that, facility did not document current immunization record for 6 out of 6 infants, which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 10/18/2024
Plan of Correction
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Director stated they will submit current immunziation record for all 6 infants to LPA by due date.
Type B
Section Cited
CCR
101227(a)(19)
Food Services
(19) All food shall be protected against contamination. Contaminated food shall be discarded immediately.

This requirement is not met as evidenced by:
Deficient Practice Statement
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3
4
Based on observation, the licensee did not comply with the section cited above in that, there were four expired gallons of children's milk being store in the kitchen, which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 09/20/2024
Plan of Correction
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Director threw out all expired milk during LPAs visit. Director stated they will promptly throw out all expired milk going foward.
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:Martha Malane
LICENSING EVALUATOR NAME:Soo Jin Jung
LICENSING EVALUATOR SIGNATURE:
DATE: 09/20/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/20/2024


LIC809 (FAS) - (06/04)
Page: 8 of 17
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: SMILES MONTESSORI CHILDCARE
FACILITY NUMBER: 304371465
VISIT DATE: 09/20/2024
NARRATIVE
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(Page 2)
The children's restrooms were clean and sanitary. Older infants nap on cots, bedding was stored individually. The facility had sufficient infant napping equipment. The facility had indoor activity space for infants that was physically separate from space used by preschool children. The facility conducted an earthquake emergency drill on 09/10/2024. The facility had a working carbon monoxide detector. Facility met all posting requirements.

Three (3) staff’s files were reviewed. Three out of three staff files were incomplete; see LIC 809D for deficiency cited.

Six (6) children’s files were reviewed. Six out of six children’s files were incomplete; see LIC 809D for deficiency cited. LPAs observed five (5) infants from 0-12 months. LPA reviewed LIC 9227 Individual Infant Sleeping Plan and Sleep Log for infants from 0-24 months in children’s files. All five infants under 12 months did not have a complete LIC 9227. All 12 enrolled infants under 24 months of age did not have a infant needs and services plan; see LIC 809D for deficiency cited. Sign in/out procedure was reviewed for compliance. Based on LPAs’ file review, three infants were not signed in; LIC 809D for deficiency cited.

The outdoor activity space was inspected for compliance and was enclosed by a fence. The surface of the outdoor activity space and play equipment were not maintained and kept clean; see LIC 809D for deficiency cited. The cushioning material made of commercially produced rubber around the climbing equipment, slides, and other similar equipment was sufficient to absorb falls. Director stated there are no bodies of water present at the facility.

LPA discussed the safe sleep regulations with director and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed director of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment. LPAs observed a baby walker in the infant play yard; see LIC 809D for deficiency cited.
(Go to Page 3)
SUPERVISORS NAME: Martha Malane
LICENSING EVALUATOR NAME: Soo Jin Jung
LICENSING EVALUATOR SIGNATURE:

DATE: 09/20/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/20/2024
LIC809 (FAS) - (06/04)
Page: 14 of 17
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: SMILES MONTESSORI CHILDCARE
FACILITY NUMBER: 304371465
VISIT DATE: 09/20/2024
NARRATIVE
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(Page 3)
Assembly Bill (AB) 2370, Chapter 676, Statutes of 2018, requires all licensed Child Care Centers (CCCs) constructed before January 1, 2010, to test their water (used for drinking and food preparation) for lead contamination before January 1, 2023, and then every 5-years after the date of the first test.

For child care center licenses issued after July 1, 2022, the licensee shall test their water for lead within 180 days of licensure pursuant to Written Directives section 101700 (PIN 21-21.1-CCP). LPA referred director to the Department website for lead: Lead Toxicity Prevention and Water Testing Information.

LPA 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. Facility did not have a complete first aid kit available at the facility; see LIC 809D for deficiency cited.

The director was informed that Licensing Quarterly Updates are available at www.ccld.ca.gov Director may request to be added to an email list to receive a Quarterly Update by contacting the Child Care Advocate at childcareadvocatesprogram@dss.ca.gov or at www.ccld.ca.gov
LPA provided Guardian Information and website info: https://www.cdss.ca.gov/inforesources/cdss-programs/community-care-licensing/caregiver-background-check/guardian

Based on LPAs observations, record reviews, and interviews, the following violations were observed and are being cited in accordance with California Health and Safety Code and California Code of Regulations, Title 22, Division 12, Chapter 1; see LIC 809D for violations cited: 3 Type A, 12 Type B, 3 TV, 2 TA.

LPAs Valdez Santana and Jung informed licensee Ahn, Sung Ja that this report dated 9/20/2024 documents 3 Type A citations. Type A citations which shall be posted for 30 consecutive days as there are immediate risks to the health, safety, or personal rights of children in care.
(Go to Page 4)
SUPERVISORS NAME: Martha Malane
LICENSING EVALUATOR NAME: Soo Jin Jung
LICENSING EVALUATOR SIGNATURE:

DATE: 09/20/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/20/2024
LIC809 (FAS) - (06/04)
Page: 15 of 17
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: SMILES MONTESSORI CHILDCARE
FACILITY NUMBER: 304371465
VISIT DATE: 09/20/2024
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(Page 4)
Also, LPAs Valdez Santana and Jung informed the licensee Ahn, Sung Ja to provide a copy of this licensing report dated 9/20/2024 that documents any Type A citations to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification.

To improve the quality and value of the new inspection process, a survey may be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or CARE tools, please send email inquiries to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/inspection-process.

A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with the Director, Ahn, Sung Ja.

Report was translated in Korean by LPA Jung.

End of Report.
SUPERVISORS NAME: Martha Malane
LICENSING EVALUATOR NAME: Soo Jin Jung
LICENSING EVALUATOR SIGNATURE:

DATE: 09/20/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/20/2024
LIC809 (FAS) - (06/04)
Page: 16 of 17
Document Has Been Signed on 09/24/2024 11:03 AM - It Cannot Be Edited


Created By: Soo Jin Jung On 09/20/2024 at 03:56 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

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

FACILITY NAME: SMILES MONTESSORI CHILDCARE
FACILITY NUMBER: 304371465

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/20/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type A
Section Cited
CCR
101161(a)
(a) A licensee shall not operate a child care center beyond the conditions and limitations specified on the license, including the capacity limitation.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation and interview, the licensee did not comply with the section cited above in that, 1 preschool child was comingling with infants in the infant classroom, which poses an immediate health, safety or personal rights risk to persons in care.
POC Due Date: 09/20/2024
Plan of Correction
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LPAs observed director move the preschool child out of the infant classroom and taking them to preschool.
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:Martha Malane
LICENSING EVALUATOR NAME:Soo Jin Jung
LICENSING EVALUATOR SIGNATURE:
DATE: 09/20/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/20/2024


LIC809 (FAS) - (06/04)
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