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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 015700622
Report Date: 10/11/2023
Date Signed: 10/11/2023 04:38:17 PM

Document Has Been Signed on 10/11/2023 04:38 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:MONTESSORI SCHOOL OF SAN LEANDROFACILITY NUMBER:
015700622
ADMINISTRATOR:MORENO, TERESAFACILITY TYPE:
850
ADDRESS:16492 FOOTHILL BOULEVARDTELEPHONE:
(510) 278-0288
CITY:SAN LEANDROSTATE: CAZIP CODE:
94578
CAPACITY: 131TOTAL ENROLLED CHILDREN: 131CENSUS: 59DATE:
10/11/2023
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME BEGAN:
02:40 PM
MET WITH:Teresa MorenoTIME COMPLETED:
05:00 PM
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A Prelicensing inspection was conducted today 10/11/2023 at 2:40PM by Licensing Program Analyst (LPA) Melanie Otsuji. LPA met with Applicant, Teresa Moreno. The applicant has submitted a CHANGE IN OWNERSHIP application for a PRESCHOOL license for 131 preschoolers. The program will operate from 7AM - 6PM, Monday through Friday, in 4 classrooms. A health and safety inspection was conducted inside and outside and the facility was previously measured and measurements are as follows:

INDOORS: 4593.15 square feet = 131 children
OUTDOORS: 13157.94 square feet = 175 children

The center has obtained an approved fire inspection clearance from the Alameda County Fire Department on 10/9/2023.

The preschool rooms are equipped with varied age appropriate materials and equipment. There are a total of 11 toilets and 11 sinks available for children use. Staff have access to three adult bathrooms. Facility will provide AM/PM snacks with children bringing lunch from home. Menu will be posted at least one week in advance in a place visible for the authorized representative to see. Facility has three playgrounds with age appropriate materials and shade for children. Facility will utilize Director's office and staff bathroom as necessary for an ill child. Mats were observed today. Sarah Nasr is a fully qualified director and a complete director packet has been submitted. Facility will utilize an electronic sign in/out database and each authorized representative has a unique identifier. Paper sign in/out will be utilized as needed.
SUPERVISORS NAME: Wynn Norona
LICENSING EVALUATOR NAME: Melanie Otsuji
LICENSING EVALUATOR SIGNATURE: DATE: 10/11/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/11/2023
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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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: MONTESSORI SCHOOL OF SAN LEANDRO
FACILITY NUMBER: 015700622
VISIT DATE: 10/11/2023
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Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02- CCP. 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) or (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
LPA reviewed with Applicant the LIC 311A, Records to Be Maintained At The Facility, for child’s records, personnel records, administrative records, and documents to be posted.
LPA discussed the safe sleep regulations with applicant 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 the Applicant of the importance of checking for 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.

Applicant was informed of the MyChildCarePlan.org site, 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.

Exit interview conducted and report was reviewed with the applicant, Teresa Moreno.

A license for 131 preschool children, will be issued effective today 10/11/2023.

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 platforms.
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.
SUPERVISORS NAME: Wynn Norona
LICENSING EVALUATOR NAME: Melanie Otsuji
LICENSING EVALUATOR SIGNATURE:

DATE: 10/11/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/11/2023
LIC809 (FAS) - (06/04)
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