153808746-5-9-2023-12-CC-EROZ-CRNMPU-20230509094743

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 153808746
Report Date: 05/08/2023
Date Signed: 05/09/2023 09:47:51 AM

Document Has Been Signed on 05/09/2023 09:47 AM - 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, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME:	BALAS MONTESSORI		FACILITY NUMBER:	153808746
ADMINISTRATOR:	BALAS, SHANNON M.		FACILITY TYPE:	850
ADDRESS:	555 S. CHINA LAKE BLVD. #100		TELEPHONE:	(760) 375-8261
CITY:	RIDGECREST	STATE: CA	ZIP CODE:	93555
CAPACITY: 75	TOTAL ENROLLED CHILDREN: 75	CENSUS: 65	DATE:	05/08/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	11:26 AM
MET WITH:	Shannon Balas		TIME COMPLETED:	03:17 PM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	On 05/08/23 at 11:26 a.m. Licensing Program Analysts (LPA) Esequiel Rodriguez conducted an unannounced Annual Required inspection at the Balas Montessori Development Center to assess the Center's operation of their Program and current physical plant status. Also, to evaluate the Center's continuing ability to meet compliance with California Code of Regulations (CCR) Title 22, Health and Safety requirements, and other applicable State and Licensing Statutory requirements. The LPA met with the Facility Director, Shannon Balas and stated the purpose for the inspection. The LPA was provided with copy of the Child Care Center children rosters for each classroom (LIC 9040), Personnel Report (LIC 500). The Center maintains on file a current Designation of Facility Responsibility (LIC 308) However, it is not updated with current site supervisor (updated during inspection), Sign in and Sign Out Rosters and Parent Handbook. The required Plan of Operation was not located. At 10:15 a.m. LPA Rodriguez along with the Center's Director conducted a walk trough of the entire Center. The Center's Plan of Operation in accordance with Title 22, Section 101173 was discussed. The facility license is posted on a prominent place of the Center. During the walk through/inspection of the Facility the LPA discussed observations of Title 22 requirements. The Center is clean, safe, sanitary and well maintain. All utilities are operational and in good order. First aid kits are available and complete (inaccessible to children.) The fire extinguishers, smoke alarms and carbon monoxide monitors are in compliance and fully operational. The Center conducts and records emergency disaster drills. The parents board was reviewed and has all the required items posted in an area accessible to parents. The following items are posted: PUB 393, Notification of Parent’s Rights Poster; PUB 269, Child Passenger Restraint System poster; LIC 610, Emergency Disaster Plan, LIC 9148, Earthquake Preparedness form; LIC 613A, Personal Rights. The Parents Handbook is available.

SUPERVISORS NAME: Scott Herring
LICENSING EVALUATOR NAME: Esequiel Rodriguez
LICENSING EVALUATOR SIGNATURE:	DATE: 05/08/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/08/2023

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, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME: BALAS MONTESSORI	FACILITY NUMBER: 153808746
	VISIT DATE: 05/08/2023

NARRATIVE

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Disinfectants, cleaning solutions, poisons and other items that are dangerous to children are inaccessible to children. Furniture and equipment were inspected for age appropriate and observed to be in good repair and defects free. Sign in/out rosters, telephone service, heating, lighting and ventilation were evaluated and no defects were noted. There are clean safe and sanitary individual space/cubbies with children's names. The facility utilizes a designated isolated area to isolate ill children. The toys and material use for instructions meet regulatory requirements. The trash cans contain tight lids. All toilets, hand washing, and bathing facilities shall be in safe and sanitary operating condition..

The outdoor play areas were noted free of hazards. Playground items are properly secure and free of loose or sharp objects. Equipment was inspected for safety, cushioning material, good repair and age appropriateness. Climbing structures are age appropriate, play equipment is properly securely and anchored with adequate resilient. There is cushioning material underneath and around the inside and outside play areas. On the outside play area, there is an adequate water fountain, and shaded area for rest. The playground is well fenced all around, and no bodies of water observed.

LPA observed staff providing care and supervision children. At no time the LPA observed no child being unsupervised. The LPA conducted a review of several Staff records. The review included, but was not limited to the following: Criminal record statements (LIC 508) Record of submission of Child Abuse Index Checks. Staff qualification. Reference letters and verifying work experience on file. Health clearances, including TB clearances. Pediatric CPR/first aid cards for designated staff. 15 hours of health & safety training for designated Staff. Notice of Employee Rights receipts (LIC 9052). Statement Acknowledging Requirement to Report Suspected Child Abuse. (LIC 9108) and Mandated Reporter Training certificate. Copy of driver’s license. Personnel Record (LIC 501) or application/resume with required information.

A review of staff records on today's date indicates that the Center staff, and other individuals listed on the LIC 500, Personnel Report and other personnel working at the Facility have received Criminal Record, FBI, DOJ and Child Abuse Central Index Check clearances or exemptions. Several staff files were reviewed.

SUPERVISORS NAME: Scott Herring
LICENSING EVALUATOR NAME: Esequiel Rodriguez
LICENSING EVALUATOR SIGNATURE:	DATE: 05/08/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/08/2023

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, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME: BALAS MONTESSORI	FACILITY NUMBER: 153808746
	VISIT DATE: 05/08/2023

NARRATIVE

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Also, a review of several Children records was conducted. The review included, but was not limited to the following: Admission agreements. Needs and Services Plans for infants,. Immunization Records (“blue cards; PM 286) for non-school-age children. Authorizations for dispensing medications signed by parents. Identification and Emergency Information forms (LIC 700) Child’s Pre-admission Health History- Parents’ Report forms (LIC 702) Child’s Pre-admission Health Evaluations- Physician’s Report forms (LIC 701)
Documentation required for health-related services (e.g., blood-glucose monitoring, nebulizer care LIC 9166, gastrostomy-tube care LIC 701A and LIC 701B) Consent for Emergency Medical Treatment forms (LIC 627) 6]

Unusual Incident/Injury or Death Reports (LIC 624) Parents’ Rights (LIC 995) receipts, signed and dated.
Personal Rights receipts (LIC 613), signed and dated.

At the time of the inspection, the LPA observed appropriate Staffing Ratio and Capacity: Staffing ratios per number of children in care was in compliance. LPA observed the children in care being properly care and no signs of abuse or neglect was noted. LPA observed the children in care being treated with dignity and respect.

There is no food service provided at the Center, but if the parents bring food for their children the food containers are properly labeled and maintained in a clean and sanitary place and/or refrigerated until is time for consumption.

During today's inspection the LPA observed no deficiencies that may hinder the health and safety of the children in care; therefore, no deficiencies were cited. Overall, the Center is in compliance with Title 22 regulations.

The LPA went over this report and an exit Interview was conducted and a copy of this Report, Children's Record Review form, LIC 857, Review of Staff Records form, LIC 859, Notice of Site Visit, LIC 9213 were provided to Center's Director, Shannon Balas.

SUPERVISORS NAME: Scott Herring
LICENSING EVALUATOR NAME: Esequiel Rodriguez
LICENSING EVALUATOR SIGNATURE:	DATE: 05/08/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/08/2023

LIC809 (FAS) - (06/04)

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