434415070-7-12-2023-52-CC-MESA-CTNQQ7-20230712122153

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 434415070
Report Date: 07/12/2023
Date Signed: 07/12/2023 12:21:58 PM

Document Has Been Signed on 07/12/2023 12:21 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:	434415070
ADMINISTRATOR:	AMANDA WAGNER		FACILITY TYPE:	850
ADDRESS:	1331 E. CALAVERAS BOULEVARD		TELEPHONE:	(408) 945-1331
CITY:	MILPITAS	STATE: CA	ZIP CODE:	95035
CAPACITY: 36	TOTAL ENROLLED CHILDREN: 36	CENSUS: 30	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:	01:00 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 visit. LPA met with the Center Director Amanda Wagner and the Program Director Melissan Wyant. Present on this visit were 6 staff and 30 preschool 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 Preschool Program is operating in the Primary and Pre-Primary Room. LPA observed the required posted materials including two active waivers posted (shared bathroom with the infant program with license #434415069 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. Cleaning supplies, poisons, and other dangerous items are stored and are inaccessible to the children. Outdoor activity space is fenced and play equipment were maintained in a safe condition and free of hazards. Drinking water is readily available for the children in each room and in the outdoor playground area. LPA observed solid waste containers with tight-fitting lids in each room and in the playground areas. 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. The facility does not possess nor store any weapons on the premises. Facility files were reviewed. The facility is using an online software application "1Core" for the sign in and out procedures and "compass" facility's operation such as family engagement and communication etc. 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.

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)

Page: 1 of 2

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: 434415070
	VISIT DATE: 07/12/2023

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

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 which included records of receipt for Parents' Rights Notice, Identification and Emergency Information, Consent for Emergency Medical Treatment form, and Immunization.

This facility provides Incidental Medical Services – IMS. LPA reviewed storage of medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226.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

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)

Page: 2 of 2