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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 013416513
Report Date: 10/13/2023
Date Signed: 10/13/2023 03:30:27 PM

Document Has Been Signed on 10/13/2023 03:30 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:VALLEY MONTESSORI SCHOOLFACILITY NUMBER:
013416513
ADMINISTRATOR:SUAN, ANAFACILITY TYPE:
830
ADDRESS:1273 NORTH LIVERMORE AVETELEPHONE:
(925) 455-8021
CITY:LIVERMORESTATE: CAZIP CODE:
94551
CAPACITY: 52TOTAL ENROLLED CHILDREN: 52CENSUS: 40DATE:
10/13/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
07:45 AM
MET WITH:Ana SuanTIME COMPLETED:
03:40 PM
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On October 13, 2023, Licensing Program Analyst (LPA) Simerjit Kaur arrived at the facility unannounced for an UNANNOUNCED ANNUAL RANDOM INSPECTION for Infant component with toddler option. LPA met with director Ana Suan. Present during the inspection were 40 children and 14 staff members. This center also includes an elementary school and middle school. There is a private non-profit school on site and the Director is aware children in care may not commingle at any time. The facility was toured by LPA and Director Ana Suan to conduct a Health and Safety Inspection. The center operates Monday - Friday from 7:30 A.M. - 6:00 P.M.

This facility utilizes of 5 classrooms (Eucalyptus, Cypress, Maple, Oak, and Poplar). The floors were free of tripping hazards. Furniture and napping equipment were age appropriate and in good condition. Disinfectants, cleaning solutions, poisons and other items that are dangerous to children were inaccessible during the inspection. The toilets and sinks were clean and in operable condition. The indoor and outdoor activity space for the toddler program is physically separate from the preschool component. Outdoor activity space and playground equipment were observed to be safe, free of hazards and had appropriate cushioning material to absorb falls. There is a shaded area provided for the children. The bedding sheets washed weekly by center. Kitchen/food preparation and storage areas were observed to be clean, and free of evidence of rodents. Drinking water is available both indoors and outdoors. Meals are provided by parents and AM/PM snacks provided by center. There is a menu posted in the kitchen. The center also offers meals through Choice Lunch.

There are no pools or similar bodies of water at this facility. Required licensing documents were posted. Fire extinguishers, carbon monoxide and smoke detectors meet State Fire Marshall standards. Disaster Drill is conducted at least every six months and the last drill was conducted on 9/20/23. LPA verified both opening and closing staff have current CPR/First aid training. The center is in compliance with the sign in and out procedure. LPA reviewed children and staff files. Teachers present today meet the qualification requirements. A copy of children’s roster was obtained.
Continued on LIC 809C...
SUPERVISORS NAME: Jason Jang
LICENSING EVALUATOR NAME: Simerjit Kaur
LICENSING EVALUATOR SIGNATURE: DATE: 10/13/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/13/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.

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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: VALLEY MONTESSORI SCHOOL
FACILITY NUMBER: 013416513
VISIT DATE: 10/13/2023
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Facility 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.

LPA referred facility representative to the Department website for lead: Lead Toxicity Prevention and Water Testing information.
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). LPA verified that the lead testing was completed in accordance to the Written Directives outlined in PIN 21-21.1-CCP.
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 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-carecenters/.
LPA discussed the safe sleep regulations with and discussed the Child Care facility representative Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-andresources/safe-sleep as an additional resource.
LPA also informed licensee facility director of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.
LPA also encouraged facility director to frequently visit our website at www.ccld.ca.gov for licensing regulations and updates, as well as all forms can be downloaded. For licensing updates and Quarterly Child Care Distribution email, email childcareadvocatesprogram@dss.ca.gov and ask to be added to the email list.

See 809D for deficiencies cited. A notice of site visit was given and must remain posted for 30 days. Exit interview conducted with Director Ana Suan.

SUPERVISORS NAME: Jason Jang
LICENSING EVALUATOR NAME: Simerjit Kaur
LICENSING EVALUATOR SIGNATURE:

DATE: 10/13/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/13/2023
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Document Has Been Signed on 10/13/2023 03:30 PM - It Cannot Be Edited


Created By: Simerjit Kaur On 10/13/2023 at 02:37 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: VALLEY MONTESSORI SCHOOL
FACILITY NUMBER: 013416513

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/13/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
101170(e)
Criminal Record Clearance
(e) All individuals subject to a criminal record review pursuant to Health and Safety Code Section 1596.871 shall prior to working, residing or volunteering in a licensed facility:

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on record review, the licensee did not comply with the section cited above in 4 staff members are fingerprint clear but not associated to facility, which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 10/16/2023
Plan of Correction
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Facility director shall ensure and verify staff is associatet the facility by 10/16/2023.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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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:Simerjit Kaur
LICENSING EVALUATOR SIGNATURE:
DATE: 10/13/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/13/2023


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