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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 444417076
Report Date: 08/31/2023
Date Signed: 08/31/2023 12:37:00 PM

Document Has Been Signed on 08/31/2023 12:37 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:MONTESSORI COMMUNITY SCHOOLFACILITY NUMBER:
444417076
ADMINISTRATOR:MADELYNN VAN DEN HEUVELFACILITY TYPE:
850
ADDRESS:123 SOUTH NAVARRA DRIVETELEPHONE:
(831) 439-9625
CITY:SCOTTS VALLEYSTATE: CAZIP CODE:
95066
CAPACITY: 90TOTAL ENROLLED CHILDREN: 44CENSUS: 30DATE:
08/31/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
09:01 AM
MET WITH:Madelynn Van Den HeuvelTIME COMPLETED:
12:46 PM
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Licensing Program Analyst (LPA), Cortney Nelson, met with Site Director, Madelynn Van Den Heuvel, and explained purpose of visit. LPA was admitted into the facility by the Site Director and conducted observations of the preschool classroom.

LPA observed that AM snack is left on the counter for children to take freely from throughout the morning. LPA observed perishable items (such as yogurt, cheese, and cream cheese) were left on the counter for at least one hour and forty minutes, as the items were already out on the counter upon arrival. Additionally, children are serving the foods to themselves, sometimes without staff assistance, and LPA observed children grabbing food items with their hands from the serving bowl.

During snack, children were served grapes that were not sliced, which poses a choking hazard to preschool-age children.

LPA advised that per USDA, perishable items left out for two hours must be discarded and those exposed to hot temperatures shall be disposed within one hour. LPA observed full container of cream cheese on the counter during snack which shall not be served again if left on counter for two hours. LPA advised that snack has a designated time for children and perishable items are not left out in the classroom unattended for extended periods of time.

As a result of todays inspection, no deficiencies were cited.

Exit interview conducted and report was reviewed with the Site Director, Madelynn Van Den Heuvel.

A NOTICE OF SITE VISIT HAS BEEN GIVEN AND MUST BE POSTED FOR 30 DAYS.
SUPERVISORS NAME: Joel Segura
LICENSING EVALUATOR NAME: Cortney Nelson
LICENSING EVALUATOR SIGNATURE: DATE: 08/31/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/31/2023
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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