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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 015700555
Report Date: 01/31/2022
Date Signed: 01/31/2022 01:33:38 PM

Document Has Been Signed on 01/31/2022 01:33 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:LEVEL UP MONTESSORI - HAYWARDFACILITY NUMBER:
015700555
ADMINISTRATOR:AGARWAL, SANDHYAFACILITY TYPE:
850
ADDRESS:31145 MISSION BOULEVARDTELEPHONE:
(408) 431-7003
CITY:HAYWARDSTATE: CAZIP CODE:
94544
CAPACITY: 92TOTAL ENROLLED CHILDREN: 92CENSUS: 20DATE:
01/31/2022
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
11:39 AM
MET WITH:Sundari GanesanTIME COMPLETED:
01:52 PM
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A PRE-LICENSING VISIT was conducted on this date 1/31/2022 by Licensing Program Analyst (LPA), Melanie Otsuji. LPA met with Center Director, Sundari Ganesan. The Applicant has submitted an application for a CHANGE IN OWNERSHIP for a PRESCHOOL with TODDLER OPTION license. The Green Room will be a toddler-option room, while Purple, Orange and Blue rooms will be for preschool children. Hours of operation are from 7:30am-6:00pm, Monday through Friday. Also present during today's visit were 3 additional staff members and 20 preschoolers. A health and safety inspection was conducted inside and outside. The following are the measurements:

INDOORS: 3302.255 square feet = 94 children
OUTDOORS: 3372.24 square feet = 45 children

Openers and closers have current CPR/FA. Playground equipment is in good condition. Drinking water is available inside and outside. A yard waiver is being requested to allow no more than 45 children at a time on the play yard. All toilets and hand washing facilities are in safe and sanitary operating conditions. Children bring AM/PM snacks and lunch from home. Facility has back up snacks should a child forget theirs at home. The storage of napping equipment was observed. The sign in and out logs were reviewed. Facility has a functioning carbon monoxide detector which is hard wired into the fire alarm system.

This facility plans to provide Incidental Medical Services – IMS. For IMS information, see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. A 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.
SUPERVISORS NAME: Wynn Norona
LICENSING EVALUATOR NAME: Melanie Otsuji
LICENSING EVALUATOR SIGNATURE: DATE: 01/31/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/31/2022
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 STE 1102
OAKLAND, CA 94612
FACILITY NAME: LEVEL UP MONTESSORI - HAYWARD
FACILITY NUMBER: 015700555
VISIT DATE: 01/31/2022
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Sundari Ganesan is a fully qualified Director and a complete Director's packet was submitted to the Department.

Director was reminded that all adults 18 and over responsible for administration or direct supervision of staff, persons who provides care and supervision to children, and staff who have contact with children, 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.


LPA discussed the safe sleep regulations with Director and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed 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. Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other important information communication platform.

To receive important licensed-related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-care-licensing/subscribe and select the Child Care option to receive email communication.


A license for 90 preschool children operating in 4 classrooms (Purple, Orange, Blue), which includes up to 12 toddlers in the toddler-option program (Green), will be issued effective today, 1/31/2022.


An exit interview was conducted.
SUPERVISORS NAME: Wynn Norona
LICENSING EVALUATOR NAME: Melanie Otsuji
LICENSING EVALUATOR SIGNATURE:

DATE: 01/31/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/31/2022
LIC809 (FAS) - (06/04)
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