010213903-8-16-2021-52-CC-JWIN-C5XVZH-20210816165246

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 010213903
Report Date: 08/16/2021
Date Signed: 08/16/2021 04:53:49 PM

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:	MONTESSORI SCHOOL AT WASHINGTON AVENUE		FACILITY NUMBER:	010213903
ADMINISTRATOR:	YOUSSEF, MIRIAN		FACILITY TYPE:	850
ADDRESS:	14795 WASHINGTON AVENUE		TELEPHONE:	(510) 357-8432
CITY:	SAN LEANDRO	STATE: CA	ZIP CODE:	94578
CAPACITY:	111	CENSUS: 36	DATE:	08/16/2021
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	02:30 PM
MET WITH:	Marian Youssef		TIME COMPLETED:	04:30 PM

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On 08/16/2021 Licensing Program Analyst (LPA) Jabari Wilson conducted a 1 year required UNANNOUNCED ANNUAL INSPECTION. LPA met with Director Marian Youssef and the facility was toured to conduct a Health and Safety Inspection. Also present at the time of this inspection were 6 staff members and 33 children in care. The facility is within ratio and capacity compliance today. This program operates out of 4 classrooms. All classrooms were inspected for age appropriate furnishings, equipment, and adequate storage for children’s belongings. LPA observed the cleanliness of floors and surfaces, the presence of working dual carbon monoxide/smoke detectors, fire alarms, and multiple fully charged 2A10BC fire extinguishers that are accessible. The bathrooms have age appropriate faucets and toilets in working condition. The outdoor play area is large and fully fenced. There is tanbark under/around the climbing equipment. The play structures appear to be fully intact with no visual defects or concerns. There are no pools, hot tubs or other accessible bodies of water. Cleaning supplies/toxins are stored inaccessible to children in care. All required postings are present. Parents provide children with their own food; in the event a child has no food or is still hungry, the facility will serve snacks. LPA reviewed storage of food, medication and medical equipment/supplies and is inaccessible to the children. Per Director, there are no firearms present on the premises.

A copy of the facility personnel roster and children’s roster was obtained. LPA reviewed the file of 6 children enrolled in the program and 7 staff members files, who are fingerprint cleared, completion of Mandated Reporter training (some outdated) as well as proof of immunizations. Each child's file reviewed is complete and contains a medical assessment. The opener Marian Youssef, and closer Rosa Zamora, have current CPR/First Aid certificates that expire 08/12/2023 and 08/15/2023 respectfully, and proof of education and/or experience was also present. The center also conducts and documents fire and earthquake drills every month and the log shows that the last drill was conducted on 07/21/2021.

SEE LIC809 C FOR CONTINUANCE

SUPERVISOR'S NAME: Jason Jang	TELEPHONE: (510) 725-7009
LICENSING EVALUATOR NAME: Jabari Wilson	TELEPHONE: 510-622-2602
LICENSING EVALUATOR SIGNATURE:	DATE: 08/16/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/16/2021

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: MONTESSORI SCHOOL AT WASHINGTON AVENUE	FACILITY NUMBER: 010213903
	VISIT DATE: 08/16/2021

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LPA also discussed with the Director that ALL assistants, volunteers, frequent visitors, over the age of 18, must be fingerprint cleared and associated prior to being in the presence of children in care. An immediate civil penalty will be assessed from $100 to $3000 per person, per incident.

Director was reminded of the responsibility as a mandated reporter and the trainings must be done once every two years. LPA also encouraged the Director to frequently visit our website at www.ccld.ca.gov for licensing regulations and updates, as well as all forms can be downloaded.

Individual Medical Services (IMS) policy was discussed. The Director is reminded that when any changes to the IMS plan is made, an updated Plan for Providing 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 website at: http://www.ada.gov/childqanda.htm.

For licensing updates, email childcareadvocatesprogram@dss.ca.gov and ask to be added to the email list.

Effective August 1, 2003 California Law requires Child Care licensees to report unusual incidents or injuries to children in care to child’s parents and to the Department of Social Services using the Unusual Incident/Injury form (LIC 624). Incidents must be reported within 24 hours by phone, fax, or electronic mail.

There are no deficiencies cited today, however technical assistance was provided (SEE LIC 9102). This report shall remain on file for 3 years. A notice of site visit was given and must remain posted for 30 days. Exit interview conducted with Director Marian Youssef.

SUPERVISOR'S NAME: Jason Jang	TELEPHONE: (510) 725-7009
LICENSING EVALUATOR NAME: Jabari Wilson	TELEPHONE: 510-622-2602
LICENSING EVALUATOR SIGNATURE:	DATE: 08/16/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/16/2021

LIC809 (FAS) - (06/04)

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