304371548-9-8-2022-06-CC-MMAK-CJ3TYS-20220908150910

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 304371548
Report Date: 09/08/2022
Date Signed: 09/08/2022 03:09:18 PM

Document Has Been Signed on 09/08/2022 03:09 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
CCLD Regional Office, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME:	NOBIS MONTESSORI		FACILITY NUMBER:	304371548
ADMINISTRATOR:	FOSTER, SUSAN		FACILITY TYPE:	850
ADDRESS:	264 NORTH MAIN STREET		TELEPHONE:	(714) 997-8333
CITY:	ORANGE	STATE: CA	ZIP CODE:	92868
CAPACITY: 52	TOTAL ENROLLED CHILDREN: 52	CENSUS: 18	DATE:	09/08/2022
TYPE OF VISIT:	Case Management - Licensee Initiated	ANNOUNCED	TIME BEGAN:	12:00 PM
MET WITH:	Director		TIME COMPLETED:	03:45 PM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	Page 1 of 3 Licensing Program Analyst (LPA) Mahnaz (Nancy) Malek conducted an announced Case Management at this facility for the purpose of decreasing the existing total capacity from 52 children to 48 children and include 24 toddlers ages 18 months to 36 months old from Toddler Option Program to the new capacity of 48 children. LPA met with director, Susan Foster and Regional Director, Ashley Neitzke. LPA was given a tour of the facility. There were 18 napping preschool children with one staff in Room # 2 and there were no children in Room # 1. Room # 1 is designated for toddlers from Toddler Option Program (18 to 36 months old). During the walk through LPA observed facility is following CDC and Dept of Public Health Guidelines. A review of staff records on this date indicated that all facility staff or other individuals who required caregiver background checks have received criminal record and child abuse index clearances or exemptions. Currently facility is licensed for 52 preschool children ages 2 to 5 years old in Room # 1 and Room # 2 Monday through Friday 7.00 am. to 6.00 PM. There is an elementary school on the premises under the Department of Education and facility has provided the Private School Affidavit. (classrooms # 3 and 4). Facility has requested to designate Room # 1 for Toddlers and Room # 2 for preschool children. Preschool Program has its own yard. The facility will share the preschool yard with toddlers from Toddler Option Program on a rotating schedule. (A waiver will be requested). The facility has a side metal door where children are brought in by the parents, leading to the classroom, this side door remains open till 8:30 am, and remains locked till the pick up time. Any late drop off or pick ups the parents have to access the Office door across the Elementary school play yard. Parents sign in manually in each classroom. Continued on page 2

SUPERVISORS NAME: Rina Lopez
LICENSING EVALUATOR NAME: Mahnaz Malek
LICENSING EVALUATOR SIGNATURE:	DATE: 09/08/2022

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/08/2022

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 3

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME: NOBIS MONTESSORI	FACILITY NUMBER: 304371548
	VISIT DATE: 09/08/2022

NARRATIVE

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The director was reminded that the maximum group of toddlers are 12 toddlers. They need to keep the toddlers in two separate group of 12 once the enrollment goes up for more toddlers.

The following were inspected in the indoor activity space of Room # 1 for toddlers:
· Room # 1 is adequately equipped with age and size appropriate furniture and equipment.
· Drinking water is available through water pitchers and personal water bottles, which are refilled as needed.
· Sign in/Sign out procedure was reviewed and meets regulation requirements (Manual sign in and out)
· There is a working smoke detector, carbon monoxide detector and fire extinguisher that meet statutory requirements.
· Cubbies available for storage of individual child’s personal belongings and/or bedding
· Napping equipment: Mats are used and are stored in the classroom in a portable cabinet.
· Facility will provide AM/PM snacks and lunch.
There is an additional sink in this classroom. The restroom with 3 toilets and 3 sinks in located in the classroom specifically for Toddler Option Program. This bathroom is a connected bathroom to Room # 2. Room # 2 has its own bathroom of 3 toilets and 3 sinks.

The following were inspected in the outdoor activity space;
· Playground is fully enclosed by an appropriate fencing
· Drinking water is available outdoors by water pitchers and personal water bottles
· Outdoor activity space is supplied with age and size appropriate equipment, including climbing play structures, with a surrounding bike trail.
Play structures are placed on sand as a cushioning material and they are age appropriate in safe condition for children. The yard will be shared with toddlers from Toddler Option Program. LPA advised the director to make sure age appropriate toys and equipment are used for this group of children.
Shade is provided by the surrounding huge trees and building structure.
Fire clearance has been granted by Orange County Fire Authority approving the total capacity of 48 children , 24 preschool age children and 24 toddlers ages 18 months to 36 months old.
Facility Administrator is current on the required Pediatric CPR/First Training: Valid up to May 1st 2023
Continued on page 3

SUPERVISORS NAME: Rina Lopez
LICENSING EVALUATOR NAME: Mahnaz Malek
LICENSING EVALUATOR SIGNATURE:	DATE: 09/08/2022

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/08/2022

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
CCLD Regional Office, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME: NOBIS MONTESSORI	FACILITY NUMBER: 304371548
	VISIT DATE: 09/08/2022

NARRATIVE

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Total of indoor measurement for Room # 1 and Room # 2 is:
Total indoor space: 1811.68 divided by 35 = 51.76 ( 52 children)
Room # 1 for toddlers: 905 square feet divided by 35 is 25.88 (enough for 24 children)
Room # 2 for toddlers: 905 square feet divided by 35 is 25.88 (enough for 24 children)

Total children's sinks and toilets:
Sinks : 8 x 15 = 125 (children) / Toilets: 6 x 15 = 90 (children)
Room # 1 for toddlers use their own restroom with 3 toilets and 3 sinks which is separated from preschool restrooms.

Outdoor measurements activity space:
5951. 39 divided by 75 = 79.35 (79) children
Based on the measurements of indoor and outdoor space with sinks and toilets: Facility has sufficient space to accommodate 24 Preschool age children in Room # 2 and 24 toddlers in Room # 1.

In the areas that were evaluated, no deficiency was observed of the California Code of Regulations, Title 22, Division 12 at the time of the visit. Appeal Rights were presented. 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 director 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.

A license will be issued for the capacity of 48 children age 2-6 years old including 24 toddlers ages 18 to 36 months old in Room # 1, and 24 preschool children in Room # 2. Monday through Friday from 7:00 am to 6:00 pm after waiver approval for sharing the playground on a rotating schedule and final review. The applicant will be notified if any additional information is required.

Exit interview conducted and report was reviewed with the Regional Director, Ashley Neitzke.

End of reports.

SUPERVISORS NAME: Rina Lopez
LICENSING EVALUATOR NAME: Mahnaz Malek
LICENSING EVALUATOR SIGNATURE:	DATE: 09/08/2022

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/08/2022

LIC809 (FAS) - (06/04)

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