304371150-10-31-2024-06-CC-NKTN-DAKNR4-20241031104055

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 304371150
Report Date: 10/31/2024
Date Signed: 10/31/2024 10:41:11 AM

Document Has Been Signed on 10/31/2024 10:41 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
ORANGE COUNTY CC RO, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME:	INT'L CHRISTIAN MONTESSORI ACADEMY OF COSTA MESA		FACILITY NUMBER:	304371150
ADMINISTRATOR/ DIRECTOR:	MARIA TEEL		FACILITY TYPE:	830
ADDRESS:	2950 MCCLINTOCK WAY		TELEPHONE:	(714) 966-0303
CITY:	COSTA MESA	STATE: CA	ZIP CODE:	92626
CAPACITY: 22	TOTAL ENROLLED CHILDREN: 22	CENSUS: 10	DATE:	10/31/2024
TYPE OF VISIT:	Case Management - Legal/Non-compliance	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	09:45 AM
MET WITH:	Maria Teel, Director		TIME VISIT/ INSPECTION COMPLETED:	10:45 AM

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	Licensing Program Analyst (LPA) Tran conducted an unannounced Case Management - Legal/Non-Compliance for the purpose of ensuring the facility is in compliance with California Title 22 Regulations, Health and Safety Codes and Stipulation and Waiver, and Order # 6622306102-B dated 04/10/2024. At 8:30am, LPA Tran met with Director Maria Teel. LPA Tran informed the Director purpose of the visit. LPA Tran and the facility representative toured the facility inside and outside, and the floor and yard plan (LIC 999) were verified. Census was taken in individual classrooms. The overall census observed was 6 infants and 4 staff members in the Infant room and 4 toddlers and 2 staff members in the Toddler room. During the inspection, it was determined the facility is operating within its licensed capacity and within compliance of staff to child ratios. Facility hours are 7a.m.- 6p.m., Monday through Friday. A review of the Facility Personnel Report Summary on this date 07/25/2024 indicates all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions. Director was reminded that all adults 18 and over, including employees and volunteers, 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 up to $500.00 maximum per day/per person will be assessed if this regulation is violated. During the inspection of the indoor activity space, items which could pose a danger to children (detergents, cleaning compounds, and medications) were observed to be stored out of the reach of children. Poisons/Hazardous Items are not kept on the premises. Food is prepared on site; snacks are provided as needed. Bottles and food containers brought from home are properly labeled with name and date and other refrigerated items. Trash receptacles containing solid waste have tight fitting lids. Food prep areas were clean and sanitary. Food is properly stored. Menus are posted where they can be reviewed by parents. Floors, equipment, and furniture were clean and observed to be in good repair and free of sharp edges. (Continue next page)

SUPERVISORS NAME: Martha Malane
LICENSING EVALUATOR NAME: Nguyen K Tran
LICENSING EVALUATOR SIGNATURE:	DATE: 10/31/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/31/2024

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
ORANGE COUNTY CC RO, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME: INT'L CHRISTIAN MONTESSORI ACADEMY OF COSTA MESA	FACILITY NUMBER: 304371150
	VISIT DATE: 10/31/2024

NARRATIVE

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(Page 2 of Report)

There is drinking water available to children indoors by Arrowhead water container and disposable cups. The children's bathrooms are clean and sanitary. Changing table has raised sides at least three inches high and is within an arm’s reach of a hand washing sink. Toys observed to be clean age appropriate. Children nap on cots and cribs, bedding is stored individually and is changed daily. Sleep logs are documented on Brightwheel app and kept in the napping area. The facility has conducted an emergency drill within the past six months and keeps documentation of drills. The facility has a at least one working smoke detector, one working carbon monoxide detector and at least one functioning fire extinguisher. Facility meets all posting requirements.

The outdoor activity space was inspected for compliance. Required shade, drinking water and fencing were inspected. The playground is enclosed by a fence at least four feet in height and is in good repair. The surface of the outdoor activity space is maintained and free of hazards. The cushioning material around outdoor play equipment and other similar equipment appeared to be enough to absorbs falls. Drinking water in the outdoor activity space is provided by Arrowhead water container and disposable cups. The outdoor equipment and toys are in good repair and free of sharp edges. There are no bodies of water present at the facility. The inspected outdoor facility grounds are safe, sanitary and in good repair.

According to Stipulation and Waiver, and Order # 6622306102-B dated 04/10/2024, Section E. Egress Devices: Within thirty (30) days of the effective date of this Stipulation, Respondents shall install devices on each door that allows for ingress or egress to the facilities and shall maintain them in good working order. The devices shall emit a noise sufficient to alert respondents of staff when a door to the outside of the facilities is being opened. The devices must remain on during facilities business hours. During today's inspection, LPA observed 3 ingress/egress devices, one was installed on the front door of the facility, one was installed on the hallway door of the facility and one was installed on the playground gate of the facility. When tested, all 3 alarms were functioning appropriately and emitted noise sufficient to alert respondents of staff when a door to the outside of the facilities is being opened.

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SUPERVISORS NAME: Martha Malane
LICENSING EVALUATOR NAME: Nguyen K Tran
LICENSING EVALUATOR SIGNATURE:	DATE: 10/31/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/31/2024

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
ORANGE COUNTY CC RO, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME: INT'L CHRISTIAN MONTESSORI ACADEMY OF COSTA MESA	FACILITY NUMBER: 304371150
	VISIT DATE: 10/31/2024

NARRATIVE

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(Page 3 of the Report)

Staff files were reviewed for staff present during the facility inspection on this date. Proof of immunization against pertussis, measles for staff members were reviewed and within compliance. Beginning March 31, 2018, H&S Code 1596.8662 requires all directors and employees to complete mandated reporting training, and to renew the training every two years. All reviewed staff files has current Mandated Reporter training certificate. At least one staff member present possesses current EMSA approved Pediatric CPR/First Aid certifications, which expires 04/2025.

Children's records were reviewed, and there was a separate, complete and current record for each child. LPA observed and reviewed LIC 9227 Individual Infant Sleeping Plan in children’s files. Care and supervision was evaluated to determine if the basic needs of infants are met and appropriate. Infant Needs and Assessments are done quarterly or updated as needed. In the areas reviewed the children’s files were found to be in full compliance. Sign in/out procedure was reviewed for compliance. The person who signs the child in and out uses their unique log in via Brightwheel application and records the time of the day.

In the areas that were evaluated, no deficiencies were observed of the California Code of Regulations, Title 22, Health and Safety Codes and Stipulation and Waiver, and Order # 6622306102-B at the time of the visit.

Appeal Rights were discussed. The facility representative was provided a copy of their appeal rights (LIC 9058) and their signature on this form acknowledges receipt of these rights. All appeals must be in writing and received by the Regional Office within 15 business days. A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with the Director Maria Teel.

(End of Report)

SUPERVISORS NAME: Martha Malane
LICENSING EVALUATOR NAME: Nguyen K Tran
LICENSING EVALUATOR SIGNATURE:	DATE: 10/31/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/31/2024

LIC809 (FAS) - (06/04)

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