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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 013417785
Report Date: 08/12/2022
Date Signed: 08/12/2022 01:17:16 PM

Document Has Been Signed on 08/12/2022 01:17 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 STE 1102
OAKLAND, CA 94612
FACILITY NAME:FOUNTAINHEAD MONTESSORI SCHOOLFACILITY NUMBER:
013417785
ADMINISTRATOR:GOLDEN, JULIANNEFACILITY TYPE:
850
ADDRESS:949 CENTRAL AVETELEPHONE:
(925) 579-0110
CITY:LIVERMORESTATE: CAZIP CODE:
94550
CAPACITY: 60TOTAL ENROLLED CHILDREN: 60CENSUS: 37DATE:
08/12/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Julianne GoldenTIME COMPLETED:
01:25 PM
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On August 12, 2022 at approximately 10:00 A.M., Licensing Program Analyst (LPA) Simerjit Kaur conducted UNANNOUNCED ANNUAL RANDOM INSPECTION and met with center Director Julianne Golden. The center also is licensed for maximum of 12 toddler option program with preschool age children and the Director is aware children in care may not commingle. Present for this inspection was 9 staff members, 6 toddler age children and 37 preschool age children. LPA toured the facility to conduct a Health and Safety Inspection. The center operates Monday - Friday from 7:00 A.M. - 6:00 P.M.

There are 2 playgrounds designated for preschool age children and toddler age children. There are 2 rooms (Lassen, and Shasta) designated for preschool age children and 1 room (Whitney) for toddler age children. Classrooms have age appropriate furniture and equipment for the use of children in care. There is adequate heating and lighting in the facility. There is drinking water available indoors and outdoor. The Center is equipped with fully stocked first aid kits, fully charged fire extinguishers, carbon monoxide and fire alarms. The restrooms are located inside each classroom. There are adequate storage hooks for children's belongings. All toilets, hand washing and cleaning areas are in safe and sanitary operating condition during today's inspection. All storage containers for solid waste had a tight-fitting lids. Cots are available for use of children for naps. The bedding is sent home weekly to be washed by the child's family. Meals are provided by parents and AM/PM snacks provided by center. There is a menu posted inside Room Whitney. The staff restroom is located in Room Shasta.
The outside play structures have adequate and appropriate cushioning material to absorb falls. It was observed that there are no toxins or hazardous items accessible to children in care during today's inspection. The facility appears to be safe, and sanitary. The center is in compliance with the sign in and out procedure. The center has conducted and documented a fire/disaster drill on 8/10/22.

See 809-C for continuance
SUPERVISORS NAME: Jason Jang
LICENSING EVALUATOR NAME: Simerjit Kaur
LICENSING EVALUATOR SIGNATURE: DATE: 08/12/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/12/2022
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 2
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 STE 1102
OAKLAND, CA 94612
FACILITY NAME: FOUNTAINHEAD MONTESSORI SCHOOL
FACILITY NUMBER: 013417785
VISIT DATE: 08/12/2022
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The facility has current children's roster and personnel report and a copy was obtained. LPA reviewed children's files and staff files. The staff have current CPR/First Aid, Mandated Reporter Training and immunization. Activity schedules and required Community Care Licensing forms are posted and visible for review. LPA reviewed prescription medication and required forms. LPA qualified teachers.

Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. When any IMS is provided, an updated Plan of Operation that includes IMS must be submitted to the Department. 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.

For licensing updates email childcareadvocatesprogram@dss.ca.gov and ask to be added to the email list and visit www.ccld.ca.gov.

California Law requires Child Care Center personnel staff to Report Unusual Incidents or injuries to children in care to the child's parents and to the Department of Social Services using the Unusual Incident/Injury form (LIC 624). Do not leave an Unusual Incident Report on the Licensing Program Analyst voice mail.

No deficiencies cited today.
Notice of site visit form should be posted and must remain posted for 30 days. Exit interview conducted.
SUPERVISORS NAME: Jason Jang
LICENSING EVALUATOR NAME: Simerjit Kaur
LICENSING EVALUATOR SIGNATURE:

DATE: 08/12/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/12/2022
LIC809 (FAS) - (06/04)
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