434416975-4-29-2024-07-CC-MMOO-D4T38S-20240429180203

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 434416975
Report Date: 04/29/2024
Date Signed: 04/29/2024 06:02:10 PM

Document Has Been Signed on 04/29/2024 06:02 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, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME:	ORION MONTESSORI SCHOOL		FACILITY NUMBER:	434416975
ADMINISTRATOR/ DIRECTOR:	SORAYA RAFAT		FACILITY TYPE:	840
ADDRESS:	1055 SOUTH MONROE STREET		TELEPHONE:	(408) 881-4853
CITY:	SAN JOSE	STATE: CA	ZIP CODE:	95128
CAPACITY: 30	TOTAL ENROLLED CHILDREN: 26	CENSUS: 21	DATE:	04/29/2024
TYPE OF VISIT:	Required - 3 Year	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	02:35 PM
MET WITH:	Soraya Rafat		TIME VISIT/ INSPECTION COMPLETED:	06:20 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	Licensing Program Analyst (LPA) Marilou Monico met with Site Director, Soraya Rafat, for an unannounced Required - 3 Year inspection. The purpose of today's inspection was explained with Soraya. Facility's License, Notification of Parents’ Right Poster, Child Car Seat Law, Personal Rights (LIC 613A), Emergency Disaster Plan, Menus, Activity Schedule, and Earthquake Preparedness Checklist were observed to be posted. The facility has an active waiver to share the playground with the preschool children at different times. The center's operating hours are Monday through Friday from 07:30 AM to 5:30 PM. The facility is licensed to serve children ages 5 years to 12 years old in Rooms 46 and 54. LPA toured the indoor and outdoor areas. At 2:59 PM, LPA observed that S2 was alone in Room 46 supervising 21 children. S2 stated that S3 left the classroom to go to the bathroom. Fire drill was conducted on March 19, 2024. The facility has current children's roster and a copy was provided to LPA during the inspection. Cleaning products, disinfectants, sharp objects were stored inaccessible to children. Furniture and equipment were observed to be age appropriate and in good condition. The facility is clean. The bathrooms for children and staff are clean, sanitary, and operable. Site Director stated that the center has a third party cleaning service that comes and clean the facility after daycare hours. The center provides afternoon snacks to the children. There is a food preparation in Room 46. The food preparation area is equipped with refrigerator, microwave, storage space for food, and a sink with hot and cold running water. Drinking water is available for the children indoor via individual water bottles. LPA observed trash cans with tight fitting covers for the disposable of solid wastes. The facility has fire extinguishers and working smoke and carbon monoxide detectors. The school is using Playground 3 for outdoor space. Shade is provided by canopies and trees. Drinking water is readily available for the children outdoor via individual water bottles. No bodies of water were observed. Site Director stated that there are no we weapons or firearms on the premises. *Continuation on next pages:*

SUPERVISORS NAME: Joel Segura
LICENSING EVALUATOR NAME: Marilou Monico
LICENSING EVALUATOR SIGNATURE:	DATE: 04/29/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/29/2024

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, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME: ORION MONTESSORI SCHOOL	FACILITY NUMBER: 434416975
	VISIT DATE: 04/29/2024

NARRATIVE

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LPA reviewed six (6) random children's files. Children records reviewed include Admission Agreement, Identification and Emergency Information, Consent for Emergency Medical Treatment, Parent Right's Receipt, Personal Rights, and Health History.

LPA reviewed two (2) staff files. Staff records reviewed include Employee Rights, Statement Acknowledging Requirement to Report Child Abuse, Health Screening Report with TB Clearance, Immunizations (Measles, Pertussis, and Influenza) and required training. LPA reminded Site Director that the Mandated Reporter Training shall be renewed by all staff every two years. At least one staff member present during the inspection has current Pediatric CPR/First Aid certifications.

Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02-CCP. 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 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/resources/child-care-centers/.

Site Director, Soraya Rafat was reminded that all adults 18 and over, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, 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 for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.

Assembly Bill (AB) 2370, Chapter 676, Statutes of 2018, requires all licensed Child Care Centers (CCCs) constructed before January 1, 2010, to test their water (used for drinking and food preparation) for lead contamination before January 1, 2023, and then every 5-years after the date of the first test.

For child care center licenses issued after July 1, 2022, the licensee shall test their water for
lead within 180 days of licensure pursuant to Written Directives section 101700 (PIN 21-21.1-
CCP).

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SUPERVISORS NAME: Joel Segura
LICENSING EVALUATOR NAME: Marilou Monico
LICENSING EVALUATOR SIGNATURE:	DATE: 04/29/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/29/2024

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, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME: ORION MONTESSORI SCHOOL	FACILITY NUMBER: 434416975
	VISIT DATE: 04/29/2024

NARRATIVE

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LPA verified that the lead testing was completed in accordance to the Written Directives
outlined in PIN 21-21.1-CCP.

Site Director, Soraya Rafat, was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&R's) throughout California.

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.

As a result of this inspection, Type A deficiency was issued. Exit interview conducted and report was reviewed with Site Director, Soraya Rafat. A Notice of Site Visit has been issued and must remain posted for 30 days.

LPA informed Site Director that this report dated 04/29/24 documents one Type A citation which shall be posted for 30 consecutive days as there is an immediate risk to the health, safety, or personal rights of children in care.

Assembly Bill 633 was provided and discussed with Site Director. LPA informed the Site Director to provide a copy of this licensing report dated 04/29/2024 that documents any Type A citation to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled children for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC9224) must be placed in the child's file for verification.

A NOTICE OF SITE VISIT WAS GIVEN AND MUST REMAIN POSTED FOR 30 DAYS.

SUPERVISORS NAME: Joel Segura
LICENSING EVALUATOR NAME: Marilou Monico
LICENSING EVALUATOR SIGNATURE:	DATE: 04/29/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/29/2024

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 04/29/2024 06:02 PM - It Cannot Be Edited

Created By: Marilou Monico On 04/29/2024 at 05:14 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
, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME: ORION MONTESSORI SCHOOL	FACILITY NUMBER: 434416975
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 04/29/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type A

Section Cited

CCR

101516.5(b)(1)

Teacher-Child Ratio

(b) There shall be a staffing ratio of one teacher and one aide present to every 28 children in attendance. (1) A teacher shall supervise no more than 14 children or with an aide a maximum of 28 children. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on LPA's observation, the licensee did not comply with the section cited above. S2 was alone in the classroom supervising 21 children when S3 left to go to the bathroom. This poses an immediate health, safety or personal rights risk to persons 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.
	POC Due Date: 04/30/2024
	Plan of Correction
1 2 3 4	Site Director stated that a written plan to maintain the required ratio at all times to be sent to Licensing by 04/30/24.

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

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:

Joel Segura

LICENSING EVALUATOR NAME:

Marilou Monico

LICENSING EVALUATOR SIGNATURE:

DATE: 04/29/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/29/2024

LIC809 (FAS) - (06/04)

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