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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 304371583
Report Date: 09/14/2022
Date Signed: 09/14/2022 04:19:41 PM

Document Has Been Signed on 09/14/2022 04:19 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:
304371583
ADMINISTRATOR:PATEL, NAYNAFACILITY TYPE:
830
ADDRESS:22900 LOS ALISOS BLVD.TELEPHONE:
(949) 837-8518
CITY:MISSION VIEJOSTATE: CAZIP CODE:
92691
CAPACITY: 20TOTAL ENROLLED CHILDREN: 14CENSUS: 14DATE:
09/14/2022
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Licensee/DirectorTIME COMPLETED:
01:00 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 # 304370689. LPA met with the Licensee/Director, Nayna Patel and administrator/partner, and Samir Patel who gave a tour of the Infant room. One room (Pink Room) and outdoor area have been designated for Infant care. LPA observed 14 infants and toddlers with 3 staff in infant room.

The applicant has requested to provide care and supervision for 20 infants and toddlers ages 8 months to 24 months old, Monday through Friday from 7:15 am to 5:45 pm in the assigned one Infant room.

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.

The facility has electronic sign in/out by Bright Wheel application. Manual sign in table has been set up at the entrance as a back up plan. Parents sign in and enter the designated classroom door. Upon arrival each child has an health evaluation along with hand washing before they participate in the activities.

Isolation area is the Director’s office, located at the entrance of the facility equipped with a mat with linens 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: 304371583
VISIT DATE: 09/14/2022
NARRATIVE
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LPA discussed the posting requirements including 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.
Safe sleep posters / SIDS

The following was observed in the Infant room
· Age appropriate furniture and equipment’s
· Toys, tactile equipment's
· Room is well lighted with ventilation.
· Infant room has a napping area with cribs for younger infants and mats for older infants.

Changing table is equipped with a sink within arm reach. There are a total of 2 sinks in the room.
Storage cubbies are arranged to store personal belonging.
Napping area: Currently the napping area is fenced off with 3 cribs in the napping area.
Cribs: Have a mattress with tight fitting sheets.
One crib shall be used by one infant at a time only.
There is a Refrigerator in the classroom to store the milk and other items. The director was advised all the food brought from home shall be labeled with the child's name and date.

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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)
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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: 304371583
VISIT DATE: 09/14/2022
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LPA discussed the Safe sleep practice with the director, Nayna Patel.

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.

LPA measured the assigned room for infants (Pink Room):
Indoor activity space : 700.67 square feet divided by 35 = 20.2 which accommodates 20 infants and toddlers. (The napping area was not included in the activity area).
Outdoor activity space: 1516 divided by 75 = 20.22 which accommodates 20 infants and toddlers.

Total sinks : 4 X 15= 60 children :
Total toilets: 2 X 15 = 30 children
Infant room has 2 sinks inside the classroom which is included in the Total sinks.

Facility has designated Infant yard which is fenced off between the preschool yard.
· Playground is fully enclosed by an appropriate fencing and wall.
· Outdoor activity space is supplied with age and size appropriate equipment, outdoor activity toys,
· An adequate amount of cushioning material: soft padded carpets
· Adequate shade is provided by shaded canopy.

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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: 304371583
VISIT DATE: 09/14/2022
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Facility has sufficient space to accommodate 20 Infants and toddlers in the designated Infant yard.

Fire clearance received from Orange County Fire Authority approving the requested capacity of 20 infants and toddlers in one room (Pink Room).

Applicant, Nayna Patel is current on the required Immunization/child abuse reporting training.
Pediatric CPR/ First training and will provide the completion certificate for the Preventive Health training (Nutrition and Lead component)
Following items were discussed at the time of Exit interview.
Criminal Record Statement : Applicant, 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 applicant, 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 applicant, Nayna Patel 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
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
Continued on page 5
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: 304371583
VISIT DATE: 09/14/2022
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Review of records to be maintained
Child Care Centers :LPA reviewed with applicant, the LIC 311A, Records To Be Maintained At The Facility, for child’s records, personnel records, administrative records, and documents to be posted.

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.

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


(1) Tall cabinet in Infant/Toddler Room (Pink Room) shall be secured.
(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).
Applicant shall submit the proof of correction within 30 days to LPA.

A license for 20 infants and toddlers ages 8 to 24 months old in Pink Room, Monday to Friday from 7:15 am to 5:45 pm will be issued upon receiving the above corrections and Management approval.

Report read and appeal rights presented to the applicant Nayna Patel.
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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