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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 073405026
Report Date: 11/08/2022
Date Signed: 11/08/2022 03:36:48 PM


Document Has Been Signed on 11/08/2022 03:36 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, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612



FACILITY NAME:SPRINGFIELD MONTESSORI SCHOOLFACILITY NUMBER:
073405026
ADMINISTRATOR:SHASHI LALFACILITY TYPE:
850
ADDRESS:2780 MITCHELL DRIVETELEPHONE:
(925) 944-0626
CITY:WALNUT CREEKSTATE: CAZIP CODE:
94598
CAPACITY:226CENSUS: 120DATE:
11/08/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
01:15 PM
MET WITH:Tammie MeyerTIME COMPLETED:
04:00 PM
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On 11/8/22 at 1:15 pm Licensing Program Analyst (LPA) Monica Mathur conducted an unannounced Annual Inspection at Springfield Montessori School. LPA met with Office staff Rosanne Esplanada, and Site Supervisor, Tammie Meyer (designated person). Licensee/Director, Shashi Lal was not in the premises today. Facility's operating days and hours are Monday to Friday from 7am-6pm in 9 Rooms.

The physical plant was inspected. LPA toured the premises with Rosanne Esplanda.
Indoor space: Classrooms, restrooms were inspected. Facility was in compliance with teacher child ratios during inspection. Some rooms were napping, other rooms were engaged in various activities under the visual supervision of the teachers. Disinfectants, cleaning solutions, and other items dangerous to the health and safety of children were stored in places inaccessible to them. Cabinets, drawers, and rooms used for storage were inaccessible. 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. Trash cans for solid waste had tight-fitting covers on and were in good repair. LPA observed a working Fire extinguisher, Smoke and Carbon Monoxide Detectors. Log shows that the last Fire Drill was conducted in last 6 months. Facility does not provide transportation for children, but Director understands that children cannot be left alone, unattended in parked vehicles. Required postings were observed to be posted.
Outdoor space was inspected and observed to be fenced and safe. The play equipment was maintained in good condition and free of hazards. Areas around and under high climbing equipment and slides were cushioned with material that absorbs falls. Shade is provided and there were no bodies of water observed. Drinking water is readily available to children during indoor and outdoor activities.
File Review: Children sign in and out procedures and logs were reviewed. A sample of children and staff files was taken for review. All files contained required documents. There was at least one teacher with current certification in Pediatric CPR/First Aid present at the facility during inspection. Children's Roster was reviewed.
SUPERVISOR'S NAME: Sherelle JohnsonTELEPHONE: (510) 622-2592
LICENSING EVALUATOR NAME: Monica MathurTELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:
DATE: 11/08/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/08/2022
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: SPRINGFIELD MONTESSORI SCHOOL
FACILITY NUMBER: 073405026
VISIT DATE: 11/08/2022
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This facility provides Incidental Medical Services – IMS. LPA reviewed storage of medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226.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

Site Supervisor was reminded that all adults 18 and over, including employees and volunteers, 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 up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

Reminded Lead Testing needs to be completed and submitted before January 1, 2023.

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.

In the areas that were evaluated, no regulatory violations were observed.
Exit interview conducted and report was reviewed with Site Supervisor, Tammie Meyer. A NOTICE OF SITE VISIT was given and must remain posted for 30 days.
SUPERVISOR'S NAME: Sherelle JohnsonTELEPHONE: (510) 622-2592
LICENSING EVALUATOR NAME: Monica MathurTELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:

DATE: 11/08/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/08/2022
LIC809 (FAS) - (06/04)
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