Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 013420949
Report Date: 08/12/2021
Date Signed: 08/12/2021 03:04:30 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, SUITE 1102
OAKLAND, CA 94612
FACILITY NAME:RISING STAR MONTESSORI SCHOOLFACILITY NUMBER:
013420949
ADMINISTRATOR:GAVEY, ANN ROSEFACILITY TYPE:
850
ADDRESS:1421 HIGH STREETTELEPHONE:
(510) 865-4536
CITY:ALAMEDASTATE: CAZIP CODE:
94501
CAPACITY:122CENSUS: 0DATE:
08/12/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
01:30 PM
MET WITH:Sharon DjafaripourTIME COMPLETED:
03:15 PM
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On 08/12/2021 at 01:30 PM Licensing Program Analyst (LPA) Arminder Singh conducted an unannounced Annual/Random inspection at Rising Star Montessori School. LPA met with Licensing Liaison, Sharon Djafaripour and explained the purpose of today's inspection. Facility’s License, Emergency Disaster Plan, Parents’ Rights Poster PUB393, Personal Rights. Licensing Liaison states children bring their own lunch from home and snacks are provided at facility. Facility's operating days and hours are Monday to Friday 8:30 AM to 5:00 PM.

At 01:45 PM the physical plant was inspected. LPA toured the premises with Licensing Liaison.

Indoor space: During today's inspection there were no children present at the facility. The facility is currently closed for "set up week". Disinfectants, cleaning solutions, and other items that are dangerous to the health and safety of children were stored in places inaccessible to them. Cabinets, drawers, and rooms used for storage were locked. Furniture and equipment were age appropriate and in good condition, free of sharp, loose, or pointed parts. Restrooms for children were observed to be in safe, sanitary, and functioning condition. Floors were clean and free from tripping hazard. Foods and beverages were stored safely. Food storage area were clean, free of litter, rubbish, and rodents/vermin. Trash cans for solid waste had tight-fitting covers on and were in good repair. Licensing Liaison stated that facility does not possess nor store any weapons on the premises. LPA observed a 3A40BC Fire extinguisher, Smoke and Carbon Monoxide Detectors, and fire pull stations. Log shows that the last Fire Drill was completed on July 16, 2021. Facility does not provide transportation for children, but Licensing Liaison understands that children cannot be left alone, unattended in parked vehicles.

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SUPERVISOR'S NAME: Loretta DysonTELEPHONE: (510) 695-0243
LICENSING EVALUATOR NAME: Arminder SinghTELEPHONE: (510) 725-2063
LICENSING EVALUATOR SIGNATURE:

DATE: 08/12/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/12/2021
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, SUITE 1102
OAKLAND, CA 94612
FACILITY NAME: RISING STAR MONTESSORI SCHOOL
FACILITY NUMBER: 013420949
VISIT DATE: 08/12/2021
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Outdoor Space: Outdoor playground was inspected and observed to be fenced and safe . The play equipment was maintained in good condition and free of hazards. The play equipment does have a wood chip surface. Shade is provided by way of large awnings/canopies/overhang. There were no bodies of water observed. Drinking water is arranged to be readily available to children during indoor and outdoor activities.

File Review: LPA reviewed files from the previous term. Two (2) Staff files (s1-s2) were taken for review and were complete. Five (5) children files (c1-c5) were taken for review and were complete.

Licensing Liaison acknowledges that if any children who are enrolled that require Incidental Medical Services the facility should submit IMS Plan with Oakland Regional Office. Isolation of sick child was discussed, and Licensing Liaison explained that a sick child is brought to the front lobby area to be isolated from other children. Child is always under visual supervision while being cared for.

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.

Beginning January 1, 2019 AB 2370 requires licensed homes and centers to share information on the risks and effects of lead exposure with enrolling and re-enrolling families.

"Mandated Reporter" training for CA Child Care Providers that all staff are required to complete as of January 1, 2018. [Starting May 2019, both General Training followed by Child Care Providers Training is required to be taken]. The website for the online training is: http://www.mandatedreporterca.com/training/childcare.htm.

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SUPERVISOR'S NAME: Loretta DysonTELEPHONE: (510) 695-0243
LICENSING EVALUATOR NAME: Arminder SinghTELEPHONE: (510) 725-2063
LICENSING EVALUATOR SIGNATURE:

DATE: 08/12/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/12/2021
LIC809 (FAS) - (06/04)
Page: 2 of 3
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, SUITE 1102
OAKLAND, CA 94612
FACILITY NAME: RISING STAR MONTESSORI SCHOOL
FACILITY NUMBER: 013420949
VISIT DATE: 08/12/2021
NARRATIVE
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LPA reminded Licensing Liaison of the applicable civil penalties for those adults who have not received fingerprint clearances, are not associated to the license, and who come in contact with or provide care and supervision to the children. For an initial violation, civil penalty amounts to $100.00 per person per day with a maximum of $500.00 per person. For a subsequent violation within a 12-month period, civil penalty amounts to $100.00 per person per day with a maximum of $3000.00 per person.

Licensing Liaison is encouraged to visit the Department’s website at www.cdss.ca.gov to access resources for Providers, Title 22 Regulations, Online option to pay Annual License fee, Adoption of new Laws, etc.

Website for provider resources:
http://www.cdss.ca.gov/inforesources/Community-Care/Self-Assessment-Guides-and-Key-Indicator-Tools/Quarterly-Updates

childcareadvocatesprogram@dss.ca.gov


In the areas that were evaluated, no regulatory violations were observed.

At 03:00 PM Exit Interview was conducted, where this report was reviewed and discussed with Licensing Liaison. Report was signed by the Administrator confirming receipt of documents.



A NOTICE OF SITE VISIT WAS ISSUED, AND MUST BE POSTED ON OR ADJACENT TO THE INTERIOR SIDE OF THE MAIN DOOR INTO THE FACILITY FOR 30 CONSECUTIVE DAYS.

END OF REPORT
SUPERVISOR'S NAME: Loretta DysonTELEPHONE: (510) 695-0243
LICENSING EVALUATOR NAME: Arminder SinghTELEPHONE: (510) 725-2063
LICENSING EVALUATOR SIGNATURE:

DATE: 08/12/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/12/2021
LIC809 (FAS) - (06/04)
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