010213903-8-23-2023-52-CC-JJAN-CUYUPR-20230823154559

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 010213903
Report Date: 08/23/2023
Date Signed: 08/23/2023 03:46:18 PM

Document Has Been Signed on 08/23/2023 03:46 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
OAKLAND SOUTH EAST, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612

FACILITY NAME:	MONTESSORI SCHOOL AT WASHINGTON AVENUE		FACILITY NUMBER:	010213903
ADMINISTRATOR:	YOUSSEF, MARIAN		FACILITY TYPE:	850
ADDRESS:	14795 WASHINGTON AVENUE		TELEPHONE:	(510) 357-8432
CITY:	SAN LEANDRO	STATE: CA	ZIP CODE:	94578
CAPACITY: 111	TOTAL ENROLLED CHILDREN: 66	CENSUS: 58	DATE:	08/23/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	10:00 AM
MET WITH:	Marian Youssef		TIME COMPLETED:	03:55 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	On 08/23/2023 at approximately 10:00AM, Licensing Program Analysts (LPAs) Jaleesa Jackson and Manel Estoesta met with Director Marian Youssef for an unannounced annual required inspection for Montessori School at Washington Avenue. Present for the inspection were the Director and 8 staff who are all fingerprint cleared. The total children enrolled are 66 and the census is 58 children. At the time of inspection the Child Care Center is within ratio. The program for the preschool children is Monday through Friday from 7:00am to 6:00pm. The Child Care Center was toured to conduct a Health and Safety Inspection. The parents scan an QR code to sign the children in and out using an website called Curacubby. There are four (4) classrooms that are all in use during todays visit. There are shelves and coat racks for the children to store their belongings. The classrooms all have chairs and tables equipped for children to use. The learning materials are organized. The toys are kept in safety bins and cabinets for easy access for the children. The napping equipment is stored in cubbies with a labeled name and number chart. All hazardous materials and toxins are kept out of reach from children and are not accessible. There are five (5) fully charged 2A10BC fire extinguishers. There are working smoke detectors, carbon monoxide detectors and fully stocked first aid kits. The isolation area is in the staff meeting room. The school provides AM and PM snacks. Water is available to refill the children’s bottle as needed. LPAs observed a snack menu that is posted in the front near check in. The children bring their own lunch and water bottles labeled with their names on them. Continued on 809-C

SUPERVISORS NAME: Jason Jang
LICENSING EVALUATOR NAME: Jaleesa Jackson
LICENSING EVALUATOR SIGNATURE:	DATE: 08/23/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/23/2023

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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Document Has Been Signed on 08/23/2023 03:46 PM - It Cannot Be Edited

Created By: Jaleesa Jackson On 08/23/2023 at 01:04 PM

Link to Parent Document Below:

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612

FACILITY NAME: MONTESSORI SCHOOL AT WASHINGTON AVENUE	FACILITY NUMBER: 010213903
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 08/23/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

HSC

1597.16(a)(1)

Lead Testing

(1) A licensed child day care center, as defined in Section 1596.76, that is located in a building that was constructed before January 1, 2010, shall have its drinking water tested for lead contamination levels on or after January 1, 2020, but no later than January 1, 2023, and every five years after the date of the initial test. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on record review, the licensee did not comply with the section cited above which posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 08/23/2023
	Plan of Correction
1 2 3 4	Deficiency cleared lead inspection completed 01/21/2023

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

SUPERVISOR'S NAME:

Jason Jang

LICENSING EVALUATOR NAME:

Jaleesa Jackson

LICENSING EVALUATOR SIGNATURE:

DATE: 08/23/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/23/2023

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
OAKLAND SOUTH EAST, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612

FACILITY NAME: MONTESSORI SCHOOL AT WASHINGTON AVENUE	FACILITY NUMBER: 010213903
	VISIT DATE: 08/23/2023

NARRATIVE

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LPAs observed the outdoor play area which consist of a play structure with a slide. The play yard has tan bark all around to absorb falls. There are multiple trees around the yard to provide shade. The outdoor play area is also fenced all around with secured gates. There are no bodies of water on the premises. There are no firearms on premises.

LPAs reviewed eight (8) children’s files and nine (9) staff files during the inspection. LPAs review an updated staff and child roster. A copy was obtained from Director. The staff interview was completed with Director Marian Youssef. The Director and staff have completed the Health and Safety training and CPR/First Aid is current. The Director has conducted and documented the fire and disaster drills. The last drill was conducted 07/18/2023.

To improve the quality and value of the new inspection process, a survey may 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 CARE tools, please send email inquiries 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/inspection-process.

Director was reminded that all adults 18 and over, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, 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 for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.

Assembly Bill (AB) 2370, Chapter 676, Statutes of 2018, requires all licensed Child Care Centers (CCCs) constructed before January 1, 2010, to test their water (used for drinking and food preparation) for lead contamination before January 1, 2023, and then every 5-years after the date of the first test.

For child care center licenses issued after July 1, 2022, the licensee shall test their water for lead within 180 days of licensure pursuant to Written Directives section 101700 (PIN 21-21.1- CCP).

Continued on 809-C

SUPERVISORS NAME: Jason Jang
LICENSING EVALUATOR NAME: Jaleesa Jackson
LICENSING EVALUATOR SIGNATURE:	DATE: 08/23/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/23/2023

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
OAKLAND SOUTH EAST, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612

FACILITY NAME: MONTESSORI SCHOOL AT WASHINGTON AVENUE	FACILITY NUMBER: 010213903
	VISIT DATE: 08/23/2023

NARRATIVE

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LPA verified that the lead testing was completed in accordance to the Written Directives outlined in PIN 21-21.1-CCP.

CCC DID NOT COMPLETE TESTING PRIOR TO THEIR DEADLINE

LPA referred director to the Department website for lead: Lead Toxicity Prevention and Water Testing Information.

LPA reviewed storage of “medication and equipment/supplies, and reviewed children’s, personnel, and administrative records.

For IMS information see PIN 22-02-CCP. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice) or (800) 514-0383 (TTY) and link to publication. Commonly Asked Questions about Child Care Centers and the ADA are available at: https://www.ada.gov/resources/child-care- centers/.

Director was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with Director Marian Youssef.

SUPERVISORS NAME: Jason Jang
LICENSING EVALUATOR NAME: Jaleesa Jackson
LICENSING EVALUATOR SIGNATURE:	DATE: 08/23/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/23/2023

LIC809 (FAS) - (06/04)

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