304371564-7-18-2022-06-CC-KDEI-CG4RXH-20220707132446

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 304371564
Report Date: 07/07/2022
Date Signed: 07/18/2022 02:38:59 PM

Document Has Been Signed on 07/18/2022 02:38 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, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME:	MONTESSORI WAY LEARNING CENTER,INC.		FACILITY NUMBER:	304371564
ADMINISTRATOR:	MEDAGANGODA, SHAMALEE		FACILITY TYPE:	850
ADDRESS:	2401 IRVINE AVENUE		TELEPHONE:	(714) 318-2174
CITY:	NEWPORT BEACH	STATE: CA	ZIP CODE:	92660
CAPACITY: 42	TOTAL ENROLLED CHILDREN: 42	CENSUS: 0	DATE:	07/07/2022
TYPE OF VISIT:	Prelicensing	ANNOUNCED	TIME BEGAN:	10:05 AM
MET WITH:	Administrator Ms. Medagangoda, Shamalee		TIME COMPLETED:	01:40 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	Licensing Program Analyst (LPA) Ms. Ketki Desai conducted an announced on site pre-licensing inspection at the childcare center. It is a New center. LPA met with the Owner/ Applicant Ms. Medagangoda, Shamalee who gave a tour of the Child Care Center on the premises of Harbor Christian Church. Three rooms and outdoor play yard is designated to the Child Care Center. The applicant has requested to provide care and supervision for 42 Pre-school age children 2 to 6 years of age, Monday through Friday 7:00 AM. to 6.00 PM. in the assigned three classrooms. (Room # 1, 2 and 3). Facility offers Full day session: ( 9.00 am to 3.00 PM) Half day session : 9 am to 12.00 Noon) extended Day care program (Morning: 7.00 am to 9.00 ) Afternoon extended care from ( 3.00 PM to 6.00 PM). LPA observed staff following CDC and Dept of Public Health Guidelines. Due to COVID Pandemic parents shall be encouraged to follow the CDC and COVID requirements. A review of the Facility Personnel Report Summary on this date indicates that all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions. The facility is on the premises of The Harbor Christian Church in a separate building across facility, with parking area for parents. Manual sign in table has been set up at the entrance of the facility, where parents shall sign in and the children shall enter through the designated classroom door. Upon arrival each child has an health evaluation along with hand washing before they participate in the activities. Isolation area is the Director’s office, located in-between the two classrooms and the sick child shall use the restroom located in teacher's lobby area inside the Church building and there is an additional mat with linens for the sick child in the Director's office. (1)

SUPERVISORS NAME: Thuy Ho
LICENSING EVALUATOR NAME: Ketki Desai
LICENSING EVALUATOR SIGNATURE:	DATE: 07/07/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/07/2022

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, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME: MONTESSORI WAY LEARNING CENTER,INC.	FACILITY NUMBER: 304371564
	VISIT DATE: 07/07/2022

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LPA discussed the posting requirements including, but limited to, the following:
· Facility License in public area (101160)
· Emergency Disaster Plan (LIC 610)
· Earthquake Preparedness Check List (LIC 9148)
· Parents’ Rights Poster (PUB 393)
· Personal Rights (LIC 613A)
· Menus / Activity Schedule
· Notice of Site Visit (LIC 9213) and Type A deficiencies / Plan of Corrections of Type A deficiencies
· Granted Waivers (available for review)
· Child Car Seat Law (PUB 269) & · COVID Posters.

The following were inspected in the indoor activity space:
· Classroom are adequately equipped with age and size appropriate furniture and equipment
· Drinking water is available inside through personalized water bottles and water pitchers in each preschool rooms.
· Sign in/Sign out procedure was reviewed and meets regulation requirements (Manual sign in and out)
· Facility has built in smoke detector, carbon monoxide detector, additional carbon monoxide detectors are also installed in each rooms with fire extinguishers mounted in each classrooms that meet statutory requirements.
· Cubbies available for storage of individual child’s personal belongings and/or bedding
· Napping equipment: Mats are used and are stored in the teacher's closet, napping linens and blankets are provided by the parents, facility also has additional linens if needed.
· Facility provides AM/PM snacks, lunch is brought from home. This containers are labelled and stored in the individual cubbies.
Rooms are well lighted with proper ventilation
Each room has age appropriate activity items and space to move around.
Room # 3 is the designated activity room where small group of children shall engage in an activity with the qualified teacher.
Each room has a wall mounted open faced heater, which has been disconnected from the main power and Applicant has placed a safe barrier in front covering the heater. (2)

SUPERVISORS NAME: Thuy Ho
LICENSING EVALUATOR NAME: Ketki Desai
LICENSING EVALUATOR SIGNATURE:	DATE: 07/07/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/07/2022

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, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME: MONTESSORI WAY LEARNING CENTER,INC.	FACILITY NUMBER: 304371564
	VISIT DATE: 07/07/2022

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LPA measured the three assigned Preschool rooms

Indoor activity space : 1476'53 divided by 35 = 42'19 (42 children)
Facility has sufficient indoor activity space to accommodate the requested capacity of 42 children.

Total sinks : 3 X 15= 45 children / Total Toilets: 4 X 15= 60 children

Facility has age appropriate sinks and toilets in the classrooms.

Preschool outdoor play yard : Facility has designated Preschool yard outside room # 1 and following was observed:

· Playground is fully enclosed by an appropriate fencing
· Drinking water is available outdoors by water pitchers and personal water bottles
· Outdoor activity space is supplied with age and size appropriate equipment, including climbing play structures and outdoor activity toys,
· An adequate amount of cushioning material: wooden chips surrounded by artificial turf
· Adequate shade is provided by shaded structure (Awing sail )and roof line shade.
· There is also a bike trail area and a cemented open area for children to play. Children shall access the play yard from side door in room # 1.
The play structure is safe for the age group to be served (2-6 years old) It has wooden chips serving as a cushion with artificial turf surrounding it.
There is additional activities including: Bike trail/ sandbox area / open space where additional structures are placed for younger children. Shaded lunch area has been set up for outdoor lunch activity.

Total outdoor activity space: 1848 divided by 75 = 24'64 (25 children).

Based on the indoor measurements, sink and toilet availability, facility has sufficient space to accommodate the requested capacity of 42 Preschool age children (2-6 years old) in the assigned three classrooms. Facility does not have sufficient outdoor space to accommodate the requested capacity and therefore shall request a Waiver for staggered schedule to be followed in between the three rooms.
(3)

SUPERVISORS NAME: Thuy Ho
LICENSING EVALUATOR NAME: Ketki Desai
LICENSING EVALUATOR SIGNATURE:	DATE: 07/07/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/07/2022

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, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME: MONTESSORI WAY LEARNING CENTER,INC.	FACILITY NUMBER: 304371564
	VISIT DATE: 07/07/2022

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Fire clearance received from Newport Beach Fire prevention Bureau approving the requested capacity of 42 children in the three rooms.

Applicant Ms. Medagangoda, Shamalee is current on the required Immunization/ Pediatric CPR/ First training valid through May11th 2024 and have provided the completion certificate for the Preventive Health training (Nutrition and Lead component and Mandated Child abuse reporting training.

Following items were discussed at the time of Exit interview.
Criminal Record Statement : Applicant, Medagangoda, Shamalee was reminded that all adults 18 and over responsible for administration or direct supervision of staff, persons who provides care and supervision to children, and staff who have contact with children, 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.

Safe Sleep : LPA discussed the safe sleep regulations with applicant Ms. Medadangoda, Shamalee discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed applicant, Ms. Medagangoda, Shamlee of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

Incidental Medical Services (IMS) APPLICANT WILL WAIT UNTIL FACILITY OPENS TO DETERMINE IMS NEEDS: 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)/ (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 (4)

SUPERVISORS NAME: Thuy Ho
LICENSING EVALUATOR NAME: Ketki Desai
LICENSING EVALUATOR SIGNATURE:	DATE: 07/07/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/07/2022

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, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME: MONTESSORI WAY LEARNING CENTER,INC.	FACILITY NUMBER: 304371564
	VISIT DATE: 07/07/2022

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Review of records to be maintained

Child Care Centers :LPA reviewed with applicant, the LIC 311A, Records To Be Maintained At The Facility, for child’s records, personnel records, administrative records, and documents to be posted.

Subscribe to CCLD important information

Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other important information communication platform.

To receive important license-related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-care-licensing/subscribe and select the Child Care option to receive email communication.

To improve the quality and value of the new inspection process, a survey will 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 tools, please send them by email to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/process.

A license for 42 Preschool age children (2-6 years) in three assigned classrooms # 1/ 2 and 3. Monday to Friday 7.00 am to 6.00 PM, shall be issued upon management approval.

Facility shall request a Waiver for a rotating schedule for outdoor activities.

Report read and appeal rights presented to the applicant Ms. Medagangoda, Shamalee.

SUPERVISORS NAME: Thuy Ho
LICENSING EVALUATOR NAME: Ketki Desai
LICENSING EVALUATOR SIGNATURE:	DATE: 07/07/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/07/2022

LIC809 (FAS) - (06/04)

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