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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 013417509
Report Date: 06/25/2025
Date Signed: 06/25/2025 03:09:40 PM

Document Has Been Signed on 06/25/2025 03:09 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:LITTLE ELEPHANT MONTESSORIFACILITY NUMBER:
013417509
ADMINISTRATOR/
DIRECTOR:		NATANYA MOOREFACILITY TYPE:
850
ADDRESS:5782 MILES AVENUETELEPHONE:
(510) 597-1963
CITY:OAKLANDSTATE: CAZIP CODE:
94618
CAPACITY: 33TOTAL ENROLLED CHILDREN: 24CENSUS: 22DATE:
06/25/2025
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:45 AM
MET WITH:Jennifer Kottage Luend TIME VISIT/
INSPECTION COMPLETED:
03:15 PM
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On 6/25/2025 at 9:45am, Licensing Program Analyst (LPA) Catherine Fernandes arrived unannounced on a Random Annual Inspection and met with Assistant Director Jennifer Kottage Luend. The center was toured for a health and safety inspection. The facility operates from Monday through Friday from 8:00am–6:00pm. Present in care were 22 preschool age children with an additional three fingerprinted cleared staff members. The teacher- child ratio is within compliance according to regulations. The center operates out of a converted two story house and consists of two main classrooms and enclosed outdoor play area. The entrance to the childcare center the is the front door or the gate on the left side of the property.

Postings: LPA observed the license, the Parent's rights poster and the child passenger restraints form posted at both of the entrances of the center. LPA reminded the center that when any wavier is given it must be posted with the license.

Classrooms: There are two main classrooms within the center, the room towards the front of the building is the butterfly classroom and the room towards the back is the caterpillar classroom. LPA observed room floors and surfaces to be clean and safe, the furniture and equipment were maintained in good condition, free of sharp, loose or pointed parts. The heating, lighting and ventilation is adequate. The activities and toys appear to be age appropriate for the children in care. The children have their own hooks to store personal belongings. During today's inspection, LPA did not observe cleaning supplies, medication or toxic items accessible to children. There are pets in the classroom, two turtles, two snakes, one lizard and a fish tank.

Bathrooms: There is a total of three toilets and three sinks available for the children which are sanitary and in operational conditions. LPA observed supplies for the children to wash and dry their hands. There is a separate staff bathroom located on the lower floor.


Report continues on 809C
NAME OF LICENSING PROGRAM MANAGER: Mayla Mendoza
NAME OF LICENSING PROGRAM ANALYST: Catherine Fernandes
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 06/25/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/25/2025
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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California Health & Human Services Agency
California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:
  • Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.
  • Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)
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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: LITTLE ELEPHANT MONTESSORI
FACILITY NUMBER: 013417509
VISIT DATE: 06/25/2025
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Food Service: The kitchen area was maintained in a clean manner. Lunches and snack are brought from home. THe center does have snacks if needed. All the children have personal water bottles and access to clean drinking water while indoors and outdoors. The center has conducted their lead testing will submit a copy to CCL. Cleaning supplies were stored in separate areas from the food supplies. There are tight fitting lids on the trash cans that contained food.
Outdoor yard: The play area is fully fenced with shaded areas for the children. The activity space is maintained, and free of hazards. There is a sandbox in the play area, LPA reminded the center to cover the sandbox when center is closed. There is a play structure that is bolted to the ground and secured. There is a climbing structure that is cushioned to absorb a fall. LPA did not observed any pools, fishponds, fixed in place wading pools or similar bodies of water on the property. There is a plastic water container, LPA reminded the center that after each use the container needs to be emptied out. There is a chicken coop which at the moment does not contain chickens.

Safety: The center has maintained their fire clearance which has been approved by the Oakland Fire department. The center has a working smoke/carbon monoxide detector in the first classroom, there are fully charged fire extinguishers in each of the classrooms and pull down fire alarm at the front and back door of the center. The center has a first aid kit in the kitchen and conducts and documents their disaster drills every six months with the last one completed on 6/12/25.

Records: A physical census of the children was taken and cross referenced with the electronic sign-in and out log, all children were accounted for and properly signed in. A random sampling of five children's files were reviewed and complete. LPA reviewed all present staff files (4) and observed current immunization records, health screenings, teacher qualifications and mandated reporter certificates. The center has provided proof of at least one staff member with a current CPR certificate. There is a working telephone number for the center. While at the center LPA reviewed the children's rosters, LPA reminded the center that all areas of the roster must be filled out. LPA has requested an updated Personnel report, a schedule for the children and the lead testing report.

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NAME OF LICENSING PROGRAM MANAGER: Mayla Mendoza
NAME OF LICENSING PROGRAM ANALYST: Catherine Fernandes
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 06/25/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/25/2025
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: LITTLE ELEPHANT MONTESSORI
FACILITY NUMBER: 013417509
VISIT DATE: 06/25/2025
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Medications (IMS): LPA reviewed one child's file that requires medication, LPA observed the containers had unaltered labels and the medication was centrally stored in a locked box, in the kitchen. All medication is safe and inaccessible to children. LPA reminded the center the importance of getting written approval from the child's authorized representative.
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/.

Asst. 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 21-21.1CCP). LPA verified that the lead testing was completed in accordance to the Written Directives outlined in PIN 21-21.1-CCP. PIN 22-05-CCP Page Four: Center will provide updated lead testing report.

Asst. 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.

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.

Report continues on 809C

NAME OF LICENSING PROGRAM MANAGER: Mayla Mendoza
NAME OF LICENSING PROGRAM ANALYST: Catherine Fernandes
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 06/25/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/25/2025
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: LITTLE ELEPHANT MONTESSORI
FACILITY NUMBER: 013417509
VISIT DATE: 06/25/2025
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No deficiencies were cited during today's inspection.


The following is needed for the facility file:
LIC500 Personnel report
LIC308 Designation of Facility Responsible
LIC610 Disaster Plan (updated)
updated Admission Agreement and parent handbook (if any changes have been made)
Daily Schedule for the children
Copy of a complete roster

A notice of site visit was given and must remain posted for 30 days
Exit interview conducted and report was reviewed with the Asst. Director
Report and Notice of site visit provided.
NAME OF LICENSING PROGRAM MANAGER: Mayla Mendoza
NAME OF LICENSING PROGRAM ANALYST: Catherine Fernandes
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 06/25/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/25/2025
LIC809 (FAS) - (06/04)
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