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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 304371580
Report Date: 01/17/2024
Date Signed: 01/17/2024 02:53:34 PM

Document Has Been Signed on 01/17/2024 02:53 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:NOBIS MONTESSORIFACILITY NUMBER:
304371580
ADMINISTRATOR:FOSTER, SUSANFACILITY TYPE:
830
ADDRESS:264 NORTH MAIN STREETTELEPHONE:
(714) 997-8333
CITY:ORANGESTATE: CAZIP CODE:
92868
CAPACITY: 16TOTAL ENROLLED CHILDREN: 16CENSUS: 8DATE:
01/17/2024
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
08:15 AM
MET WITH:Susan Foster, Director/ ApplicantTIME COMPLETED:
11:00 AM
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Licensing Program Analyst (LPA) P Rivas conducted an unannounced case management visit for the purpose of increasing the capacity from capacity of 16 infants to 24 infants. LPA was assisted by Director/Applicant Susan Foster

The facility has requested to provide care and supervision to 24 infants ages 6 weeks to 18 months old in Rooms #5 and # 6, Monday to Friday from 7:00 am to 6:00 pm. Children are dropped off, signed in and out manually inside the classroom . The facility has met all the posting requirements .

The facility is currently licensed for 16 infants in room 6. LPA observed four staff and 8 infants in care. The facility representative, Susan Foster was reminded that all adults 18 and over responsible for administration or direct supervision of staff, persons who provides care and supervision to children, and staff who have contact with children, 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. LPA was provided copy of f/p clearance for staff #1 which showed that s/he was associated)OCA) to facility# 30437580 (missing #1) and 304371548.

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.

There is an elementary school on the premises (classroom #4) under the Department of Education and facility has provided the Private School Affidavit. There is a separate playground and bathrooms. The "girls" restroom next to room #5 is designated as the bathroom for the elementary school children.
SUPERVISORS NAME: Monica Cuddy
LICENSING EVALUATOR NAME: Pat Rivas
LICENSING EVALUATOR SIGNATURE: DATE: 01/17/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/17/2024
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 3
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: NOBIS MONTESSORI
FACILITY NUMBER: 304371580
VISIT DATE: 01/17/2024
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The facility has designated the Boys bathroom which is directly next to room #6 that contained 2 sinks and 4 toilet for infant use. The facility is also designating the 1/2 bathroom inside the House/Office for infant use. There is one toilet and one sink in the half bathroom.
Total sinks; 5 sinks and 5 toilets viewed.
Classroom #6 was previously measured on
The indoor activity space measurement for the current requested capacity is as follows:
Indoor activity space Room # 6 based on measurement on 12/28/2022 is : 589 square feet divided by 35 = 16.82 ( 17 infants , which included the deduction of the napping area which was 279 square feet).

Room #5- Room was empty and did not have equipment and supplies, room measurement will be redone when fully equipped.


Total sinks: 5
Total Toilets:5

Outdoor activity space based on measurement dated 12/28/22 is: 980 square feet plus 378 square feet measured on 07/13/23 . The total measurement for the outside activity space which was based on prior visits is; 1358 square feet. (divide by 75 =18.11 (18 ) children which insufficient for the requested capacity.

Based on today's visit the following is needed prior to licensure;
1. Measurement of room #5 that includes the furniture, fixtures equipment and supplies.
2 Waiver request for outside activity space
3. Fire clearance
4. Final review by management.
SUPERVISORS NAME: Monica Cuddy
LICENSING EVALUATOR NAME: Pat Rivas
LICENSING EVALUATOR SIGNATURE:

DATE: 01/17/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/17/2024
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: NOBIS MONTESSORI
FACILITY NUMBER: 304371580
VISIT DATE: 01/17/2024
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The facility is equipped with carbon monoxide detector.
Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other important information communication platforms. To receive important licensed related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-care-licensing/subscribe and select the Child Care option to receive email communication.”
There is a diaper changing table in Room # 6 that has 4 raised sides at least 3 inches. The diaper changing table is located within the arm's reach of a sink. The director and staff were reminded of safe sleep regulations and logging every 15 minutes check on infants and toddlers under 24 months old. The logs for every 15 minutes checking on sleeping infants were reviewed
LPA discussed the Safe sleep practice with director, Susan Foster .

NIH: https://safetosleep.nichd.nih.gov/safesleepbasics/environment/room/text_alternative
Safe to Sleep Campaign: https://safetosleep.nichd.nih.gov/materials
· 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.
A notice of site visit was given to Ms. Foster and must remain posted on, or immediately adjacent to, the interior side of the main door for 30 days.
Exit interview was conducted and report was reviewed with the licensee/ Applicant, Ms. Foster . Appeal rights were discussed.
SUPERVISORS NAME: Monica Cuddy
LICENSING EVALUATOR NAME: Pat Rivas
LICENSING EVALUATOR SIGNATURE:

DATE: 01/17/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/17/2024
LIC809 (FAS) - (06/04)
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