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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198020471
Report Date: 04/03/2024
Date Signed: 04/03/2024 11:42:13 AM

Document Has Been Signed on 04/03/2024 11:42 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
L.A. DAY CARE-EAST, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME:ACACIA MONTESSORI SCHOOL COVINA INC.FACILITY NUMBER:
198020471
ADMINISTRATOR:
ADMINISTRATOR/
DIRECTOR:		MILDRED BAUTISTAFACILITY TYPE:
850
ADDRESS:450 W ROWLAND STTELEPHONE:
(626) 966-9356
CITY:COVINASTATE: CAZIP CODE:
91723
CAPACITY: 60TOTAL ENROLLED CHILDREN: 48CENSUS: 21DATE:
04/03/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
TIME VISIT/
INSPECTION BEGAN:
08:20 AM
MET WITH:Director Mildred Bautista TIME COMPLETED:
TIME VISIT/
INSPECTION COMPLETED:
12:00 PM
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On 04/03/24 licensing Program Analyst (LPA) Mary Silva conducted an unannounced random annual inspection. Upon arrival at approximately 8:20am, LPA met with Director Mildred Bautista. LPA was led on a tour of the facility. This is a preschool program which consists of four classrooms, one of which is not currently occupied. Per licensee, there are currently 48 children enrolled in the program. Hours of operation for this facility are Monday-Friday from 6:30am-6:30pm.

Licensing staff observed all required forms/publications to be posted by the front entrance. 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. Facility offers breakfast, lunch and two snacks. Lunch is prepared by an outside vendor.

PHYSICAL PLANT: All areas were identified on the Facility Sketch were inspected. The following classrooms were inspected: Room #1 Dragonflies: 9 children and 4 staff, Room #2 Busy Bees: 8 children and 3 staff, Room #3 Butterflies: 4 children and 3 staff, Room #4 Ladybugs was found to be unoccupied. Staff names were recorded. Teacher-child ratios were observed to be in accordance with Title 22 regulations. The Licensee is within the conditions, limitations, and capacity specified on the license. All children were observed to be under visual supervision of a teacher during tour.

LPA observed the napping equipment (mats/cots) and bedding were inspected for good condition, appropriate storage, and cleanliness. The facility washes the sheets and blankets weekly. Storage for children's belongings were inspected. All toilets and washing facilities are in safe and sanitary operating conditions.

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SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Mary Silva
LICENSING EVALUATOR SIGNATURE: DATE: 04/03/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/03/2024
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
L.A. DAY CARE-EAST, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: ACACIA MONTESSORI SCHOOL COVINA INC.
FACILITY NUMBER: 198020471
VISIT DATE: 04/03/2024
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First Aid supplies are available and complete. Drinking water was readily available indoors. Children have individual sports bottle with their name. Facility provides water from vendor Sparkletts via water dispenser.

At this time, the office is used as an isolation area, there is a cot available for an ill child to rest and the staff restroom will be used if needed.

Licensing staff observed disinfectants, cleaning solutions, medication and other items that are dangerous to children, were inaccessible to children. Classroom 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.

Licensing staff observed the valve on the required 2A 10BC fire extinguisher indicates fully charged and was serviced on 03/06/2024, as indicated on service tag. Per State Fire Marshall standards, fire extinguishers shall be serviced annually. Facility has a functioning carbon monoxide and smoke detector that meets statutory requirements. Director states there are no weapons, firearms, or bodies of water on the premises.

OUTDOORS: At 9:05am, licensing staff 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 adequate shade in the play yard. There is an outside play space that has two play areas, one has a swing set, climbing structure and sandbox for children in care. The other outside play space was observed for younger children it is adjacent to the first play area. Drinking water is readily available outdoors. Children have individual sports bottle with their name.

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. ____________________________________Page 2________________________________

SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Mary Silva
LICENSING EVALUATOR SIGNATURE:

DATE: 04/03/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/03/2024
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
L.A. DAY CARE-EAST, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: ACACIA MONTESSORI SCHOOL COVINA INC.
FACILITY NUMBER: 198020471
VISIT DATE: 04/03/2024
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Disaster drills have been conducted at least every six months. There is at least one person trained in CPR and Pediatric First Aid present during this inspection. Licensing staff also reviewed staff records. The review of Staff records was documented on the LIC 859. Staff present had proof of the AB 1207 Mandated Reporter Training certificate on file. Staff present had proof against TB, measles, pertussis, and influenza. Children’s Records were reviewed for completeness; Inspection of required forms was made and documented on the LIC 857.

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 are available at: https://www.ada.gov/resources/child-care-centers/.
Assembly Bill (AB) 2370, Chapter 676, Statutes of 2018, requires all licensed Child Care Centers (CCCs) constructed before January 1, 2010, to test their water (used for drinking and food preparation) for lead contamination before January 1, 2023, and then every 5-years after the date of the first test. For childcare center licenses issued after July 1, 2022, the licensee shall test their water for lead within 180 days of licensure pursuant to Written Directives section 101700 (PIN 21-21.1-CCP). Facility tested water outlets for lead contamination in January 2023.

Director Mildred Bautista was reminded that all adults 18 and over, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, 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 for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.

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SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Mary Silva
LICENSING EVALUATOR SIGNATURE:

DATE: 04/03/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/03/2024
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
L.A. DAY CARE-EAST, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: ACACIA MONTESSORI SCHOOL COVINA INC.
FACILITY NUMBER: 198020471
VISIT DATE: 04/03/2024
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To improve the quality and value of the new inspection process, a survey may be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or CARE tools, please send inquiries to inspectionprocess@dss.ca.govFor additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/inspection-process.

Director Mildred Bautista was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain childcare by connecting them to childcare providers and Resource and Referral Agencies (R&Rs) throughout California.



At this time, the licensee is in compliance with California Title 22 Regulations. Therefore, there are no citations being issued today.

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.



Exit interview was conducted with Director Mildred Bautista, report and appeal rights were given.

_____________________________________Page 4_________________________________

SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Mary Silva
LICENSING EVALUATOR SIGNATURE:

DATE: 04/03/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/03/2024
LIC809 (FAS) - (06/04)
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