<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376700282
Report Date: 08/27/2021
Date Signed: 08/27/2021 01:36:18 PM

Document Has Been Signed on 08/27/2021 01:36 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, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108
FACILITY NAME:MONTESSORI SCHOOL OF KEARNY MESAFACILITY NUMBER:
376700282
ADMINISTRATOR:AMITHA PERUSINGHEFACILITY TYPE:
850
ADDRESS:3411 SANDROCK ROADTELEPHONE:
(858) 505-0332
CITY:SAN DIEGOSTATE: CAZIP CODE:
92123
CAPACITY: 57TOTAL ENROLLED CHILDREN: 0CENSUS: 52DATE:
08/27/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
10:10 AM
MET WITH:Amitha PerusingheTIME COMPLETED:
11:40 AM
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
On 8/27/21 @ 10:10AM, LPA Nancy Diaz conducted an unannounced inspection. LPA met with Amitha Perusinghe, site director. A tour of the classrooms were conducted with staff Teresa Sotelo. Observed present today were 52 preschool children in the following rooms:
Room #2 with 6 children and staff Shantal Sanchez
Room #3 with 26 children and staff Maria Morales & Kelly Barcellos
Room #4 with 20 children and staff Veranja Vandabona; Teresa Sotelo; Estephanie Garnica and Amitha Perusinghe.

A review of staff records on this date indicates that all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse clearances or exemptions. The licensee has not exceeded the conditions, limitations and capacity specified on the license. At least one person is trained in CPR and Pediatric First aid was present today (Shantal Sanchez).
Mrs. Perusinghe stated that everyone including herself has recently renewed their CPR/First Aid certificates, however they were unable to print everyone's certificate.

Facility do not maintain any bodies of water or weapons within the premises. Disinfectants, cleaning solutions, poisons and other items that are dangerous to children are inaccessible. Facility is currently not maintaining medications. Furniture and equipment are in good condition, free of sharp, loose or pointed parts. All toilets, handwashing facilities are in safe and sanitary operating condition. All floors are clean and safe. The child care center was observed to be clean, safe, sanitary and in good repair to ensure the safety and well-being of children, employees and visitors. Facility maintains a carbon monoxide detector that meet the standards established in Chapter 8 of Part 2 of Division 12.
CONTINUED
SUPERVISORS NAME: Tashima Daniel
LICENSING EVALUATOR NAME: Nancy Diaz
LICENSING EVALUATOR SIGNATURE: DATE: 08/27/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/27/2021
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 6
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108
FACILITY NAME: MONTESSORI SCHOOL OF KEARNY MESA
FACILITY NUMBER: 376700282
VISIT DATE: 08/27/2021
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
26
27
28
29
30
31
32
The kitchen, food-preparation and storage areas are kept clean, free of litter. Food are protected against contamination. All storage containers for solid waste have a tight-fitting covers that are kept on and in good repair.

Playground equipment was observed to be in safe condition, free of sharp, loose or pointed parts. The surface of the outdoor activity space are maintained in safe condition and free of hazards. The areas around or under high climbing equipment, swings, slides, and similar equipment was cushioned with material that absorbs a fall.

An isolation area has been designated for children who becomes ill during the day.

Children’s records were reviewed today. All required forms were on file. Menus are posted in a place visible by the child’s authorized representative. All children are signed in/out by a representative who uses a full legal signature and has recorded the time of day. Child’s record also contain a medical assessment.

Staff records reviewed today contain a health screening as required by the regulation.
All staff have immunization record indicating that they have been immunized against influenza, pertussis and measles.

Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. When any IMS is provided, an updated 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
SUPERVISORS NAME: Tashima Daniel
LICENSING EVALUATOR NAME: Nancy Diaz
LICENSING EVALUATOR SIGNATURE:

DATE: 08/27/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/27/2021
LIC809 (FAS) - (06/04)
Page: 2 of 6
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108
FACILITY NAME: MONTESSORI SCHOOL OF KEARNY MESA
FACILITY NUMBER: 376700282
VISIT DATE: 08/27/2021
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
26
27
28
29
30
31
32
Type A deficiency was cited today. Type A deficiency if not corrected poses an immediate risk to the health, safety or personal rights of children in care.

Type B deficiencies were cited today. Type B deficiency if not corrected poses a potential risk to the health, safety or personal rights of children in care.

Upon receipt, licensee shall post and provide copies of this licensing report to parents/guardians of children in care at the facility and to parents/guardians of children newly enrolled at the facility during the next 12 months.

An exit interview was conducted with Mrs. Amitha. LPA provided a copy of this report and appeal rights. Notice of site visit was provided today. This notice was observed posted by Mrs. Amitha and shall remain posted for 30 days.
SUPERVISORS NAME: Tashima Daniel
LICENSING EVALUATOR NAME: Nancy Diaz
LICENSING EVALUATOR SIGNATURE:

DATE: 08/27/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/27/2021
LIC809 (FAS) - (06/04)
Page: 3 of 6
Document Has Been Signed on 08/27/2021 01:36 PM - It Cannot Be Edited


Created By: Nancy Diaz On 08/27/2021 at 12:10 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
, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108

FACILITY NAME: MONTESSORI SCHOOL OF KEARNY MESA
FACILITY NUMBER: 376700282

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/27/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
08/30/2021
Section Cited
CCR
101229(a)(1)

1
2
3
4
5
6
7
RESPONSIBILITY FOR PROVIDING CARE AND SUPERVISION. (a) The licensee shall provide care and supervision as necessary to meet the children's needs.
(1) No child(ren) shall be left without the supervision of a teacher at any time, except as specified in Sections 101216.2(e)(1) and 101230(c)(1). Supervision shall include visual observation.
1
2
3
4
5
6
7
Mrs. Perusinghe shall submit a written plan of correction to the department no later than 8/30/2021.
8
9
10
11
12
13
14
This regulation requirement was not met as evidenced by: Based on LPA's observation. A 10-year old child was observed in the bathroom without supervision. The same child was allowed to walk from the bathroom and to the second floor (residential apartment) to get a bottle of water without staff visual supervision. Child was unaccounted for about 6-10 minutes.
8
9
10
11
12
13
14

1
2
3
4
5
6
7
1
2
3
4
5
6
7

1
2
3
4
5
6
7
1
2
3
4
5
6
7
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:Tashima Daniel
LICENSING EVALUATOR NAME:Nancy Diaz
LICENSING EVALUATOR SIGNATURE:
DATE: 08/27/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/27/2021


LIC809 (FAS) - (06/04)
Page: 4 of 6
Document Has Been Signed on 08/27/2021 01:36 PM - It Cannot Be Edited


Created By: Nancy Diaz On 08/27/2021 at 12:17 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
, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108

FACILITY NAME: MONTESSORI SCHOOL OF KEARNY MESA
FACILITY NUMBER: 376700282

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/27/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
08/27/2021
Section Cited
CCR
101216.3

1
2
3
4
5
6
7
TEACHER-CHILD RATIO.
(a) There shall be a ratio of one teacher visually observing and supervising no more than 12 children in attendance...
This regulation requirement was not met as evidenced by:
1
2
3
4
5
6
7
This was corrected during the inspection when 2 children were pulled from Room #3 and was transferred to Room #4. Mrs. Amitha shall submit a plan of action to the department no later than 8/30/21.
8
9
10
11
12
13
14
Based on LPA's observation, there were 26 preschool and schoo-age children in Room #3 with staff Maria Morales & Kelly Barcellos
8
9
10
11
12
13
14
Type B
09/10/2021
Section Cited
HSC1596.8662(4)(b)(1)

1
2
3
4
5
6
7
MANDATED REPORTER TRNG. ...employee of a licensed child day care facility shall complete the mandated reporter trng...and shall complete renewal mandated reporter trng. every two years...
This requirement was not met as evidenced by:
1
2
3
4
5
6
7
Ms. Amitha shall ensure that staff renew their Mandated Reporter Training course no later than 9/10/21. Ms. Amitha shall submit copies of completed Manadated Reporter Training certificates no later than 9/10/21.
8
9
10
11
12
13
14
Based on LPA's review of staff records, the following staff's Mandated Reporter Training certificates have expired:
Amitha Perusinghe; Veranja Vandabona and Kelly Barcellos.
8
9
10
11
12
13
14
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:Tashima Daniel
LICENSING EVALUATOR NAME:Nancy Diaz
LICENSING EVALUATOR SIGNATURE:
DATE: 08/27/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/27/2021


LIC809 (FAS) - (06/04)
Page: 5 of 6
Document Has Been Signed on 08/27/2021 01:36 PM - It Cannot Be Edited


Created By: Nancy Diaz On 08/27/2021 at 12:28 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
, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108

FACILITY NAME: MONTESSORI SCHOOL OF KEARNY MESA
FACILITY NUMBER: 376700282

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/27/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
09/10/2021
Section Cited
CCR
101216.1(c)(1)

1
2
3
4
5
6
7
(c) To be a fully qualified teacher, a teacher shall have one of the following:
(1) Twelve post-secondary semester or equivalent quarter units in early childhood education or child development completed, with passing grades, ... and at least six months of work experience in a licensed child care center or comparable group child care program.
1
2
3
4
5
6
7
Ms. Amitha shall obtain Maria Morales' transcript and submit to the department no later than 9/10/21.
8
9
10
11
12
13
14
This requirement was not met as evidenced by: Based on LPA's review of staff records, Maria Morales' transcript was not available for review.
8
9
10
11
12
13
14

1
2
3
4
5
6
7
1
2
3
4
5
6
7

1
2
3
4
5
6
7
1
2
3
4
5
6
7
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:Tashima Daniel
LICENSING EVALUATOR NAME:Nancy Diaz
LICENSING EVALUATOR SIGNATURE:
DATE: 08/27/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/27/2021


LIC809 (FAS) - (06/04)
Page: 6 of 6