444417076-9-27-2023-07-CC-CNEN-CW3UYE-20230927155950

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 444417076
Report Date: 09/27/2023
Date Signed: 09/27/2023 03:59:54 PM

Document Has Been Signed on 09/27/2023 03:59 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 SCHOOL		FACILITY NUMBER:	444417076
ADMINISTRATOR:	MADELYNN VAN DEN HEUVEL		FACILITY TYPE:	850
ADDRESS:	123 SOUTH NAVARRA DRIVE		TELEPHONE:	(831) 439-9625
CITY:	SCOTTS VALLEY	STATE: CA	ZIP CODE:	95066
CAPACITY: 90	TOTAL ENROLLED CHILDREN: 67	CENSUS: 62	DATE:	09/27/2023
TYPE OF VISIT:	Case Management - Other	UNANNOUNCED	TIME BEGAN:	02:47 PM
MET WITH:	Aurora Tershy		TIME COMPLETED:	04:09 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), Cortney Nelson, met with Assistant Director, Aurora Tershy, and explained purpose of visit, to conduct case management visit to measure toddler yard and review conditions of pre-licensing inspection conducted 3/30/2023. LPA was notified by Aurora that Site Director, Madelynn Van Den Heuvel, will be out of town until October 2nd. LPA measured toddler yard and observed the following measurements: Toddler Playground: 42.000 x 29.833 = 1252.986 42.000 x 14.667 = 616.014 Total= 1869 square feet Encumbered Space: 3.167 x 3.250= 10.293 (water heater unit) 3.667 x 12.667= 46.449 (garden box) 3.667 x 12.667= 46.449 (garden box) Total= 103.193 1869-103.193= 1765.807/75 SQ feet= 23 toddlers Based on measurements conducted on 3/30/2023, the primary yard measures for 40 preschool-age children. LPA advised that a staggered schedule waiver request shall be submitted as the toddler and preschool yards do not measure for the requested capacity of 90 children. LPA additionally advised that per HSC 1596.995 the maximum group size shall not exceed 12 toddlers. Original application was requested 25 toddlers, however LPA advised that revised Application for a Child Care Center (LIC200A) shall be submitted for revision of 24 toddlers as there are two toddler classrooms that will be used.

SUPERVISORS NAME: Joel Segura
LICENSING EVALUATOR NAME: Cortney Nelson
LICENSING EVALUATOR SIGNATURE:	DATE: 09/27/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/27/2023

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

FACILITY NAME: MONTESSORI COMMUNITY SCHOOL	FACILITY NUMBER: 444417076
	VISIT DATE: 09/27/2023

NARRATIVE

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LPA advised that the following corrections are still needed:
-Bathroom partition walls added to the toddler rooms (Jellyfish/Puffins) to accord the children safe, healthful, and comfortable accommodations.
-Replaced furnace in the Otter classroom to ensure proper temperature (min. 68 to max. 85 degrees) for child care compliance.
-Submit outdoor waiver request for preschool/toddler staggered outdoor play schedule. Waiver to include Section 101238.2(a) Outdoor Activity Space requiring 75 square feet per child. Preschool yard measured for 40 children and Toddler yard measured for 23 children, requested capacity is for 24 toddlers and 75 preschool-age children. The waiver shall address how the facility will ensure that at maximum 40 preschool-age children and 23 toddlers are utilizing the outdoor space, such as a staggered schedule. LPA advised submitting staggered schedule to demonstrate when classrooms will use the outdoor areas.
-Updated Application for a Child Care Center (LIC200A) to reflect adjusted toddler capacity of 24 toddlers. Original wet signature required.

LPA additionally advised that the facility is currently operating with a provisional license that will expire 10/4/2023. All documents must be submitted to the Department and approved prior to the deadline or the application for a child care center will be denied, resulting in immediate termination of the provisional license and operation of the facility shall immediately cease.

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

Exit interview conducted and report was reviewed with Assistant Director/Facility Representative, Aurora Tershy.

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

SUPERVISORS NAME: Joel Segura
LICENSING EVALUATOR NAME: Cortney Nelson
LICENSING EVALUATOR SIGNATURE:	DATE: 09/27/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/27/2023

LIC809 (FAS) - (06/04)

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