434415069-7-12-2023-52-CC-MESA-CTNQN5-20230712121833

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 434415069
Report Date: 07/12/2023
Date Signed: 07/12/2023 12:18:42 PM

Document Has Been Signed on 07/12/2023 12:18 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, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612

FACILITY NAME:	CALAVERAS MONTESSORI SCHOOL		FACILITY NUMBER:	434415069
ADMINISTRATOR:	AMANDA WAGNER		FACILITY TYPE:	830
ADDRESS:	1331 E. CALAVERAS BOULEVARD		TELEPHONE:	(408) 945-1331
CITY:	MILPITAS	STATE: CA	ZIP CODE:	95035
CAPACITY: 12	TOTAL ENROLLED CHILDREN: 12	CENSUS: 10	DATE:	07/12/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	09:30 AM
MET WITH:	Melissa Wyant and Amanda Wagner		TIME COMPLETED:	12:30 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	On Wednesday, July 12, 2023 at 9:30 am, Licensing Program Analyst (LPA) Manel Estoesta conducted an unannounced Required 1 Year Inspection. LPA met with Center Director Amanda Wagner and Program Director Melissa Wyant. Present on this visit were 3 staff and 10 infant children. Facility operates from Monday to Friday 7am to 6pm. LPA toured the facility to conduct a Health and Safety Inspection with the Directors. The Infant Program is operating in the Nido Room. LPA observed the required posted materials including two active waivers (shared bathroom with preschool program with license #434415070 and electronic sign in/out). The child care center is clean, safe and sanitary. Facility bathrooms are clean, sanitary and operable. There is a separate staff bathroom not utilized by the children which also an Isolation Bathroom for a Sick Child. Bed boxes previously reviewed and approved by the department are used instead of cribs. Mats are used for older children. LPA observed bottles, dishes, and containers of food brought by the infant’s authorized representative are labeled with the infant’s name and the current date. The infant changing tables are placed within arm’s reach of a sink while in use. Outdoor activity space is fenced and play equipment were maintained in a safe condition and free of hazards. The areas around or under play structures are cushioned with poured rubber foam. LPA observed solid waste containers with tight-fitting lids in each room and in the playground. Program Director stated that facility does not possess nor store any weapons on the premise LPA observed 10 infants with 3 attending staff (teacher and aide). The teacher/child ratio was in compliance during today's visit. Director understands the conditions, limitations, and capacity. Director understands that infants shall always be visually supervised and never left unattended.

SUPERVISORS NAME: Jason Jang
LICENSING EVALUATOR NAME: Manel Estoesta
LICENSING EVALUATOR SIGNATURE:	DATE: 07/12/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/12/2023

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, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612

FACILITY NAME: CALAVERAS MONTESSORI SCHOOL	FACILITY NUMBER: 434415069
	VISIT DATE: 07/12/2023

NARRATIVE

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Facility files were reviewed. The facility is using an online software application "1Core" for the sign in and out procedures and "Compass" for facility's operation such as family engagement and communication. LPA reviewed Disaster Drills, and Fire and Earthquake Drills are conducted monthly. LPA obtained copies of the Facility's updated Personnel Report, Child Care Facility Roster and a copy of the sign in for the day.

Staff files were reviewed, which included records of Criminal Record and Child Abuse Index Clearance, Health Screening Report with TB Clearance, records of immunization, Mandated Reporter Training and passing teacher units. There was at least one person with documented training on preventive health practices, including current certification in Pediatric CPR and First Aid present at the facility.

LPA reviewed children files. LPA observed the medical assessment and the Information and Emergency Information form (LIC 700) in the children files. Each child’s file contains a Needs and Services Plan (Infant Feeding and Toilet Training), LIC 9227 individual feeding plan. LPA reviewed Sleep Logs with the Program Director.

LPA discussed the safe sleep regulations with Directors 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 licensee [facility representative] 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) 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

See 809 C.

SUPERVISORS NAME: Jason Jang
LICENSING EVALUATOR NAME: Manel Estoesta
LICENSING EVALUATOR SIGNATURE:	DATE: 07/12/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/12/2023

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, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612

FACILITY NAME: CALAVERAS MONTESSORI SCHOOL	FACILITY NUMBER: 434415069
	VISIT DATE: 07/12/2023

NARRATIVE

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Continuation.

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/inspection-process.

Directors were reminded that all adults 18 and over, 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.

In the areas that were evaluated, no deficiencies were observed at the time of the visit.

A notice of site visit was given and must remain posted for 30 days.

Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

Exit interview conducted and report was reviewed with the Program Director Melissa Wyant and Child Care Center Director Amanda Wagner.

SUPERVISORS NAME: Jason Jang
LICENSING EVALUATOR NAME: Manel Estoesta
LICENSING EVALUATOR SIGNATURE:	DATE: 07/12/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/12/2023

LIC809 (FAS) - (06/04)

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