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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 304371582
Report Date: 09/14/2022
Date Signed: 09/14/2022 04:22:19 PM

Document Has Been Signed on 09/14/2022 04:22 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:VILLAGE MONTESSORI CENTERFACILITY NUMBER:
304371582
ADMINISTRATOR:PATEL, NAYNAFACILITY TYPE:
850
ADDRESS:22900 LOS ALISOS BLVD.TELEPHONE:
(949) 837-8518
CITY:MISSION VIEJOSTATE: CAZIP CODE:
92691
CAPACITY: 76TOTAL ENROLLED CHILDREN: 62CENSUS: 47DATE:
09/14/2022
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
01:05 PM
MET WITH:Licensee/DirectorTIME COMPLETED:
05:00 PM
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Licensing Program Analyst (LPA) Mahnaz (Nancy) Malek conducted an announced on site pre-licensing inspection at this childcare center for the purpose of changing ownership from license # 304370688. LPA met with the Licensee/Director, Nayna Patel and administrator/partner, and Samir Patel who gave a tour of the preschool rooms. 3 rooms (Orange, Blue and Green Rooms), and outdoor area have been designated for preschool children. LPA observed 47 children with 6 staff in the preschool program.

The applicant has requested to provide care and supervision for 76 pre-school children ages 2 to 6 years old, Monday through Friday from 7:15 am to 5:45 pm.

LPA observed staff following CDC and Dept of Public Health Guidelines. Due to COVID Pandemic parents shall be encouraged to follow the CDC and COVID requirements.

A review of the Facility Personnel Report Summary on this date indicates that all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions.

Parents sign in and out electronically at the entrance of the building by Bright Wheel App. Parents drop off from the side gate of the building. Upon arrival each child has an health evaluation along with hand washing before they participate in the activities.
Isolation area is in the corner of the office which has equipped with a mat and beddings are available for the sick child. The staff bathroom which is close to the office is designated for sick children if need to.
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SUPERVISORS NAME: Rina Lopez
LICENSING EVALUATOR NAME: Mahnaz Malek
LICENSING EVALUATOR SIGNATURE: DATE: 09/14/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/14/2022
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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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: VILLAGE MONTESSORI CENTER
FACILITY NUMBER: 304371582
VISIT DATE: 09/14/2022
NARRATIVE
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LPA discussed the posting requirements including, but not limited to the following:
· Facility License in public area (101160)
· Emergency Disaster Plan (LIC 610)
· Earthquake Preparedness Check List (LIC 9148)
· Parents’ Rights Poster (PUB 393)
· Personal Rights (LIC 613A)
· Menus / Activity Schedule
· Notice of Site Visit (LIC 9213) and Type A deficiencies / Plan of Corrections of Type A deficiencies
· Granted Waivers (available for review)
· Child Car Seat Law (PUB 269) & · COVID Posters.
Posters are posted at the entrance, in front of the office.

The following were inspected in the indoor activity space (Total of 3 classrooms)
· Classrooms are adequately equipped with age and size appropriate furniture and equipment
· Drinking water is available inside through personalized water bottles and drinking fountain in each classroom.
· Sign in/Sign out procedure was reviewed.
· Facility has in-built smoke detectors & carbon monoxide detectors on the ceiling. There is one fire extinguisher mounted that meets statutory requirements.
· Cubbies available for storage of individual child’s personal belongings
· Napping equipment: Children in this program will nap on mats. Beddings and blankets will be provided by the parents and washed weekly. Additional sheets are available if needed.
· Facility has a full day and part day program and parents provide AM/PM snacks and lunch to children.
Rooms are well lighted with proper ventilation
There is one sink and drinking fountain in each classroom. There are restrooms to share between the classrooms.
Medications are stored in the locked box . First Aid kit and Emergency kit is present and inspected.

Continued on page 3
SUPERVISORS NAME: Rina Lopez
LICENSING EVALUATOR NAME: Mahnaz Malek
LICENSING EVALUATOR SIGNATURE:

DATE: 09/14/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/14/2022
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: VILLAGE MONTESSORI CENTER
FACILITY NUMBER: 304371582
VISIT DATE: 09/14/2022
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LPA measured the Preschool classrooms. Orange Room, Blue Room, and Green Room.

Indoor activity space : 2714 square feet divided by 35= 77.54 which accommodates 78 children.
The facility has requested 76 preschool children.

Total sinks : 11 X 15= 165 children
Total Toilets: 8 X 15= 120 children

Facility has age appropriate sinks and toilets inside the classrooms to meet the needs of the children.

Preschool outdoor play yard:


Outdoor measurements: 8148 divided by 75= 108.64 which accommodates 109 children.

Facility has designated Preschool yard outside preschool rooms and following were observed:
· Playground is fully enclosed by an appropriate fencing
· Drinking water is available outdoors by personal water bottles and a water fountain
· Outdoor activity space is supplied with age and size appropriate equipment, including climbing play structures and outdoor activity toys,
· An adequate amount of cushioning material in under and around the play structure.
· Adequate shade is provided by shaded building.

The play structure is safe for the age group to be served (2-6 years old)
Based on the indoor /outdoor measurements, sink and toilet availability, facility has sufficient space to accommodate 76 preschool children in three classrooms.

Fire clearance received from OC Fire Authority approving the capacity of 76 children for preschool.
The document for Director, Nayna Patel is current on the required Immunization/ Mandated Reporter Training, Pediatric CPR/ First training. Certificate for the Preventive Health training (Nutrition and Lead component) will be provided to LPA.
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SUPERVISORS NAME: Rina Lopez
LICENSING EVALUATOR NAME: Mahnaz Malek
LICENSING EVALUATOR SIGNATURE:

DATE: 09/14/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/14/2022
LIC809 (FAS) - (06/04)
Page: 3 of 5
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: VILLAGE MONTESSORI CENTER
FACILITY NUMBER: 304371582
VISIT DATE: 09/14/2022
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Following items were discussed at the time of Exit interview.
Criminal Record Statement : Applicant/Director, Nayna Patel 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, 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 up to $500.00 maximum per day/per person will be assessed if this regulation is violated.
Safe Sleep : LPA discussed the safe sleep regulations with Nayna Patel 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 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.

Incidental Medical Services (IMS) This facility plans to provide Incidental Medical Services – IMS. For IMS information, see PIN 22-02-CCP. A Plan of Operation that includes IMS must be submitted to the Department. 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 facility will send the written plan.

Review of records to be maintained

Child Care Centers :LPA reviewed with Nayna Patel the LIC 311A, Records to Be Maintained at the Facility, for child’s records, personnel records, administrative records, and documents to be posted.

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SUPERVISORS NAME: Rina Lopez
LICENSING EVALUATOR NAME: Mahnaz Malek
LICENSING EVALUATOR SIGNATURE:

DATE: 09/14/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/14/2022
LIC809 (FAS) - (06/04)
Page: 4 of 5
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: VILLAGE MONTESSORI CENTER
FACILITY NUMBER: 304371582
VISIT DATE: 09/14/2022
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Subscribe to CCLD important information

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 platform.

To receive important license 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.

To improve the quality and value of the new inspection process, a survey will 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 tools, please send them by email 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/process.

A license for 76 Preschool age children (2 to 6 years) in Orange Room, Blue Room, and Green Room, Monday to Friday from 7:15 am to 5:45 pm will be issued after completing the following items and final review at our office:

Facility needs to complete the following items before a license is issued

(1) Securing 3 tall cabinets in the Orange Room, Bead chain shelf and Metal inset shelf in Blue Room, and Metal inset shelf in Green Room.


(2) Certificate of Health and Safety Training including lead poisoning and nutrition for the applicant.
(3) Correction of association to the new facility number of the Administrator.
(4) Written permission for the designated location of emergency disaster location.
(5) Written Plan for Incidental Medical Services (IMS).
(6) Sand boxes shall be free of foreign objects and shall have a cover, (There are a total of 2 sand boxes outdoor).
Applicant shall submit the proof of correction within 30 days to LPA.
Report read and appeal rights presented to Applicant/Director, Nayna Patel.
End of the reports
SUPERVISORS NAME: Rina Lopez
LICENSING EVALUATOR NAME: Mahnaz Malek
LICENSING EVALUATOR SIGNATURE:

DATE: 09/14/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/14/2022
LIC809 (FAS) - (06/04)
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