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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197494645
Report Date: 03/23/2021
Date Signed: 03/29/2021 05:37:53 PM

Document Has Been Signed on 03/29/2021 05:37 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, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME:WOODLAKE MONTESSORI PRESCHOOLFACILITY NUMBER:
197494645
ADMINISTRATOR:HORDAGODA, NOESHFACILITY TYPE:
850
ADDRESS:23363 BURBANK BLVDTELEPHONE:
(323) 767-4517
CITY:WOODLAND HILLSSTATE: CAZIP CODE:
91367
CAPACITY: 60TOTAL ENROLLED CHILDREN: 0CENSUS: 0DATE:
03/23/2021
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Noesh Hordagoda/DirectorTIME COMPLETED:
12:00 PM
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Licensing Program Analyst (LPA) Silva Garibyan met with director to conduct a pre-licensing inspection. The applicants submitted application for 60 preschool age children ages 2 years to entry to first grade . Applicants provided a tour of the facility at 10:20 A.M.. The facility will operate a Preschool program in two rooms. The fire department has granted the fire clearance for the capacity of 60 children. Fire Clearance granted on 10/13/20 by Inspector Cindy Struck, LA City Fire Department. The preschool is located inside of Woodland Hills Church of Christ Church. Control of property was verified with a copy of the Commercial Lease Agreement.
LPA toured the facility inside and outside.
The following are the measurements:

Preschool Indoor:

Room 1: 14.9 x 33.9 = 505.11 sq. ft/35 = 14 children

Room 2: 27.6 x 54.5 = 1,504.2 sq. ft./35 = 43 children

Total indoor measurement for preschool : 2,009.31 sq ft. / 35 = 57 preschool children

Preschool outdoor measurement:
( 59 x 68) + ( 19 x 37)= 4,012 + 703 = 4,715 sq. ft.
Preschool outdoor: 4,715 sq. ft./75= 62 children

The outdoor space is completely fenced in and there are no bodies of water. There is a shaded area ( covered by a canopy) for the preschool children. Continued
SUPERVISORS NAME: Mary Ruiz
LICENSING EVALUATOR NAME: Silva Garibyan
LICENSING EVALUATOR SIGNATURE: DATE: 03/24/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/24/2021
This report must be available at Child Care and Group Home facilities for public review for 3 years.

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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, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: WOODLAKE MONTESSORI PRESCHOOL
FACILITY NUMBER: 197494645
VISIT DATE: 03/23/2021
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Under all climbing apparatus is grass. Drinking water will be provided by the teacher carrying out a designated basket in each classroom that has a 1-gallon water bottle with cups, and a first-aid kit.
Based on the total 6 toilets and 6 sinks available for children's use, in two bathrooms, the facility accommodates 90 children.
There is a separate staff bathroom which will also be used by sick children. The isolation area is in the director's office.
Age appropriate toys and equipment were observed in good repair. Central heating and cooling was provided throughout the facility. Adequate lighting was observed. The classroom was clean, in good repair. Adequate storage for children’s belongings were observed in the classroom. Trash cans used for solid waste were observed with tight fitting lids. Disinfectants and cleaning solution and other toxins or poisons were made inaccessible to children, placed in locked storage room.

Napping Equipment: Cots and mats are available for children in care. Cots and mats are equipped with sheets.



Staff/Children Files: LPA observed all CCLD forms (blank) in files. Staff files were observed with sections for personnel, qualifications and evaluations. Children files were observed with sections for admissions agreement, immunization, medication consent, and authorizations.

The facility will provide morning and afternoon snacks. Parents will be asked to provide lunch, however the facility will offer an optional hot healthy lunch program. Snack and lunch menus are posted. Applicant was advised that family style meals shall not be be served during the pandemic and children and staff shall practice social distancing when children are served meals. There is a kitchen on site ( adjacent to the toddler room). The kitchen is equipped with a refrigerator, freezer, sink and microwave oven. The kitchen has cold and hot running water. The kitchen will be off limits to children in care.

Postings: LPA observed bulletin board outside the director's office for parents. Bulletin board will contain school updates and required postings by licensing (Facility License, Emergency Disaster Plan, Parents Rights Poster, Personal Rights Form)

Medication: All medication will be located in the Director's office. Continued

SUPERVISORS NAME: Mary Ruiz
LICENSING EVALUATOR NAME: Silva Garibyan
LICENSING EVALUATOR SIGNATURE:

DATE: 03/29/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/29/2021
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, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: WOODLAKE MONTESSORI PRESCHOOL
FACILITY NUMBER: 197494645
VISIT DATE: 03/23/2021
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Parents and authorized adult will sign children in and out using their original signatures.

The following was discussed during this inspection:


  • Licensee/Applicant was made aware that state law prohibits baby walkers, bouncy seats, exersaucers and any other items that fall into that category.
  • Licensee/Applicant was advised that regulation prohibits the smoking of tobacco in a private residence licensed as a family childcare home during the hours of operation.
  • Licensee/Applicant was reminded that all infants must be placed on their backs when sleeping to prevent S.I.D.S. (Sudden Infant Death Syndrome), and to never shake a baby to prevent the Shaken Baby Syndrome.
  • Applicant was also reminded that only children eating may be in highchairs and that car seats are utilized only for transportation.
  • The "Notification of Parent's Rights" (PUB394) was discussed with the licensee and the licensee was advised that it must be posted in an area of the home accessible to parents.
  • Licensee/Applicant was made aware of The Child Care Advocate Program (CCAP) that is administered from within the Community Care Licensing Division. CCAP participates in many community activities and special projects to disseminate information on the State’s licensing role, provide information to the public and parents on childcare licensing, and provide many other helpful resources to the licensees and the public. CCAP’s direct contact information is as followed: Phone number: (916) 654-1541; Email Address: childcareadvocatesprogram@dss.ca.gov
  • Also, discussed was; Commencing September 1, 2016, SB 792, prohibits a person from being employed or volunteering at a child care facility or family day care if he or she has not been immunized against influenza, pertussis and measles. Exemption were also discussed
  • Beginning on January 1, 2018, AB 1207, requires all licensed providers, applicants, directors and employees to complete training as specified on their mandated reporter duties and to renew their training every two years. Volunteers are encouraged but not required to take the training. Website: www.mandatedreporterca.com

Continued
SUPERVISORS NAME: Mary Ruiz
LICENSING EVALUATOR NAME: Silva Garibyan
LICENSING EVALUATOR SIGNATURE:

DATE: 03/29/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/29/2021
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, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: WOODLAKE MONTESSORI PRESCHOOL
FACILITY NUMBER: 197494645
VISIT DATE: 03/23/2021
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  • Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. When any IMS is provided, a Plan for Providing 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


Based on todays observations the facility shall be recommended for licensure with a capacity of 57 determined by the facility's indoor activity space.

Applicant was informed that the following is pending licensure and needs to be corrected within 30 days from the date of this report


· Director's current CPR/First Aid Certificate

· Director's Lead Poisoning Certificate

A copy of this report will be electronically mailed to the applicant for review and signature

A read receipt shall confirm as receipt of the electronically delivered report.

Applicant shall print and sign the report and mail the report to the licensing office, with an original signature.

If there are any questions or concerns, please contact the department at (424) 301-3077

SUPERVISORS NAME: Mary Ruiz
LICENSING EVALUATOR NAME: Silva Garibyan
LICENSING EVALUATOR SIGNATURE:

DATE: 03/29/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/29/2021
LIC809 (FAS) - (06/04)
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