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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198020458
Report Date: 06/17/2021
Date Signed: 06/17/2021 10:29:45 AM

Document Has Been Signed on 06/17/2021 10:29 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, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME:FOOTHILL PROGRESSIVE MONTESSORI PRESCHOOLFACILITY NUMBER:
198020458
ADMINISTRATOR:LOURDES WAYFACILITY TYPE:
850
ADDRESS:4526 INDIANOLA WAYTELEPHONE:
(818) 952-0129
CITY:LA CANADASTATE: CAZIP CODE:
91011
CAPACITY: 20TOTAL ENROLLED CHILDREN: 0CENSUS: 8DATE:
06/17/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
08:30 AM
MET WITH:Shamalie Goonewardene - LicenseeTIME COMPLETED:
10:35 AM
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Licensing Program Analyst (LPA) Nolan Tcheng conducted an unannounced random inspection. Upon arrival at 8:30am, LPA met with Licensee Shamalie Goonewardene. At 8:55am, Licensee led LPA on a tour of the facility. This is a preschool program which consists of 1 classroom. Per licensee, there are currently 18 children enrolled in the program. Hours of operation for this facility are Monday-Friday 7am-6pm.

PHYSICAL PLANT:


At 9am, LPA entered and inspected the classroom where 8 children with 2 staff members were present. Licensing staff observed all required forms/publications to be posted in the entrance of the classroom. Snack menus were reviewed to ensure that they are being posted one week in advance where it is visible by the child's authorized representative. Menus for the past 30 days are available upon request. At 9:02am, LPA observed the storage of napping equipment. Napping equipment was observed to be cots. All toilets, hand washing, and bathing facilities are safe, sanitary and are operating properly. All kitchen areas/food preparation areas and food storage areas are kept clean and are free of litter, rubbish and rodents and/or any other vermin. At this time, due to COVID, families are providing their own child's meals and snacks. LPA observed a fire extinguisher fully charged and last serviced 01/03/2021. At 9:05am, LPA observed disinfectants, cleaning solutions, medication and other items that are dangerous to children, were inaccessible to children. Furniture and equipment are in good condition, free of sharp, loose, or pointed parts. All floors are clean and safe. All storage containers for solid waste, including moveable bins shall have tight-fitting covers that are kept on, and in good repair. Trash cans used to discard food have tight fitting lids. The facility was observed to be free of flies, other insects and rodents. Sufficient individual storage space for children was observed and each child has a cubby. Drinking water was readily available indoors. At this time, the office is used as an isolation area. A cot is available for an ill child to rest on. First Aid supplies are available and complete. Facility has a functioning carbon monoxide detector that meets statutory requirements. LPA tested carbon monoxide and smoke detector located in classroom and it was observed to be functioning properly. REPORT CONTINUES PAGE 1 of 3
SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Nolan Tcheng
LICENSING EVALUATOR SIGNATURE: DATE: 06/17/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/17/2021
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 3
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: FOOTHILL PROGRESSIVE MONTESSORI PRESCHOOL
FACILITY NUMBER: 198020458
VISIT DATE: 06/17/2021
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Licensee states there are no weapons, firearms, or bodies of water on the premises. At 9:08am, LPA reviewed the outdoor play area. Outdoor playground equipment is in safe condition, free of sharp, loose or pointed parts. The surface of the outdoor activity space is maintained in a safe condition and is free of hazards. All areas around or under high climbing equipment, swings, slides, and similar equipment are cushioned with material that absorbs a fall. There is one outside play space noted as a sandbox and a structure next to a set of swings. Drinking water is readily available outdoors.

FACILITY RECORDS: Sign in and out sheets were reviewed to ensure that the person who signs the child in and out uses their full legal signature and records the time of the day. Staff files were reviewed for a health screening report and immunizations that meet regulatory requirements. Criminal Record Clearance for adults and verification of CPR/First Aid and health preventative practices documentation was reviewed. The name of the child care center director or fully qualified teacher(s) designated to act in the director's absence is on file. Educational background, training, and/or experience for each staff present are on file and were reviewed. Proof of current Mandated Reporter Training was present in each staff file. A random sample of Children’s Records were reviewed to ensure that they are complete.



INCIDENTAL MEDICAL SERVICES:
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

COVID-19 Health and Safety protocols were observed at the facility. Temperature checks were conducted at door and postings were observed.

LPA advised the licensee how to access forms, regulations and quarterly updates on line at: www.ccld.ca.gov. AB1207 Mandated Child Abuse Reporting – Implementation was discussed with Licensee. Website provided: http://mandatedreporterca.com/



REPORT CONTINUES PAGE 2 of 3
SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Nolan Tcheng
LICENSING EVALUATOR SIGNATURE:

DATE: 06/17/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/17/2021
LIC809 (FAS) - (06/04)
Page: 2 of 3
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: FOOTHILL PROGRESSIVE MONTESSORI PRESCHOOL
FACILITY NUMBER: 198020458
VISIT DATE: 06/17/2021
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The Notice of Site Visit (LIC 9213) – must remain posted for 30 days during the hours of operation after each site visit by a licensing representative. Failure to maintain posting as required will result in a civil penalty of $100.00.

Exit interview was conducted with Shamalie Goonewardene, Licensee, at 10:15am including, but not limited to Provider Rights, Appeal Procedures and Agencies Consultative Role.
SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Nolan Tcheng
LICENSING EVALUATOR SIGNATURE:

DATE: 06/17/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/17/2021
LIC809 (FAS) - (06/04)
Page: 3 of 3