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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 304371605
Report Date: 01/27/2023
Date Signed: 01/27/2023 03:44:54 PM

Document Has Been Signed on 01/27/2023 03:44 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
ORANGE CO CHILD CARE, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
FACILITY NAME:CHILDREN'S MONTESSORI CENTER OF YORBA LINDAFACILITY NUMBER:
304371605
ADMINISTRATOR:KEMPS, DISHNIFACILITY TYPE:
830
ADDRESS:17550 YORBA LINDA BLVD.TELEPHONE:
(714) 528-0831
CITY:YORBA LINDASTATE: CAZIP CODE:
92886
CAPACITY: 12TOTAL ENROLLED CHILDREN: 12CENSUS: 2DATE:
01/27/2023
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Applicant and directorTIME COMPLETED:
12:30 PM
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Licensing Program Analyst (LPA) Mahnaz (Nancy) Malek conducted an announced on site pre-licensing inspection at this childcare center for the purpose of change of ownership from license # 304370354 to operate an infant center. LPA met with the Applicant, Ge Huijun and director, Dishni Kemps. LPA was given a tour with director of the Infant classroom on this combination center. One Infant room (Room # $) has been designated for Infant care ages birth to 24 months old.

The applicant has requested to provide care and supervision for 12 infants (birth to 24 months old) Monday through Friday 6:30 AM. 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. One staff and 2 children were observed.

Parents sign in and out manually at the entrance of the building. The entrance is from the rear site of the building entering the playground by opening a gate digitally. There are two locks and a barrier fence at this entrance for dropping off and picking up children. 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 at the entrance of the facility and there is an additional cot with bedding for the sick child in the Director's office. The bathroom for sick children is the staff bathroom.
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SUPERVISORS NAME: Thuy Ho
LICENSING EVALUATOR NAME: Mahnaz Malek
LICENSING EVALUATOR SIGNATURE: DATE: 01/27/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/27/2023
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 CO CHILD CARE, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
FACILITY NAME: CHILDREN'S MONTESSORI CENTER OF YORBA LINDA
FACILITY NUMBER: 304371605
VISIT DATE: 01/27/2023
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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.
Safe sleep posters / SIDS

The following was observed in the Infant room (Room # 4)
· Age appropriate furniture and equipment’s
· Toys, tactile equipment's
· Room is well lighted with ventilation.
· Infant room has a napping area with cribs for that is separated by Plexiglass from activity area.
There is sufficient open area for the child to move
Changing table is placed in the corner of the room at a arm's length of the sink, there are two sinks in the infant room
Storage cubbies are arranged to store personal belongings
There are 5 cribs in the napping area with mattress with tight fitting sheets.
One crib shall be used by one infant at a time only.
Flooring is wood and carpeting.
All Infant items will be provided by the parents : Diapers/ Wipes/ Lotions / formula and Mother's milk
There is a Refrigerator in the classroom to store the milk and other items.
LPA observed all the food borough from home were labeled with the child's name and dated in the refrigerator.
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SUPERVISORS NAME: Thuy Ho
LICENSING EVALUATOR NAME: Mahnaz Malek
LICENSING EVALUATOR SIGNATURE:

DATE: 01/27/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/27/2023
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 CO CHILD CARE, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
FACILITY NAME: CHILDREN'S MONTESSORI CENTER OF YORBA LINDA
FACILITY NUMBER: 304371605
VISIT DATE: 01/27/2023
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LPA discussed the Safe sleep practice with the director, Dishni Kemps.

NIH: https://safetosleep.nichd.nih.gov/safesleepbasics/environment/room/text_alternative
Safe to Sleep Campaign: https://safetosleep.nichd.nih.gov/materials
· Always place infants on their backs for sleeping
· Use only a tight-fitting sheet on the crib or play yard mattress
· Do not hang any items from the crib or above the crib
· Keep all items, including blankets, out of the crib or play yard
· Pacifiers may be used as long as they do not have items attached to them
· Infants should not be swaddled or have any items covering them while sleeping
· The temperature of the room should be comfortable enough for an adult to wear a T-shirt and not be too hot or too cold.
LPA measured the assigned Room (Infant Room # 4)
Indoor activity space : 534 square feet divided by 35 = 15.26 (15 children).
The facility has enough indoor space to meet the requested capacity for indoor space for 12 infants in infant Room. The napping area which was not included in the activity area is 147 square feet.
Total sinks: 2 X 15= 30 children and 1 X 15 toilets= 15 children
Infant outdoor play yard : Facility has designated Infant yard, all fenced inside the preschool yard. The following was observed:
· Playground is fully enclosed by an appropriate fencing, Outdoor activity space is supplied with age and size appropriate equipment, outdoor activity toys, the area is covered with grass. There are 2 low high plastic slides on the grass. The director was reminded to cover the falling zone with rubber mats for additional caution. There are 3 gates on the playground. Gate # 1 is for dropping off and picking up children. This gate has two locks on it. Parents enter digitally. There is a 2nd fencing in front of this gate for 2nd barrier.
Gate # 2 is always locked with chain and pad lock. Gate # 3 is for entering and exiting staff only. This gate has a latch on the top. An alarm device will be installed on this gate.
All these gates lead to the parking lot of the shopping center.

Outdoor activity space: 936 square feet divided by 75 = 12.48 (12 children)
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SUPERVISORS NAME: Thuy Ho
LICENSING EVALUATOR NAME: Mahnaz Malek
LICENSING EVALUATOR SIGNATURE:

DATE: 01/27/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/27/2023
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 CO CHILD CARE, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
FACILITY NAME: CHILDREN'S MONTESSORI CENTER OF YORBA LINDA
FACILITY NUMBER: 304371605
VISIT DATE: 01/27/2023
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Facility has sufficient space to accommodate 12 Infants and toddlers in the designated Infant yard.

Fire clearance received from Orange County Fire Authority approving the requested capacity of 12 infants and toddlers in room # 4.

The director, Dishni Kemp is current on the required Immunization/ Pediatric CPR/ First training and has 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 : The Director, Dishni Kemps 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 director, Dishni Kemps and 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 the director, Dishni Kemp 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 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.

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SUPERVISORS NAME: Thuy Ho
LICENSING EVALUATOR NAME: Mahnaz Malek
LICENSING EVALUATOR SIGNATURE:

DATE: 01/27/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/27/2023
LIC809 (FAS) - (06/04)
Page: 4 of 5
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE CO CHILD CARE, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
FACILITY NAME: CHILDREN'S MONTESSORI CENTER OF YORBA LINDA
FACILITY NUMBER: 304371605
VISIT DATE: 01/27/2023
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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

Child Care Centers : LPA reviewed 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.

Facility needs to complete the following items before a final license can be issued:


(1) Providing shade for the infant/toddler playground.
(2) Installing alarm device on the exit door leading to parking lot in the infant room # 4.
(3) Installing alarm device on the exit door # 3 on the playground leading to parking lot.

A license for a total of 12 infants and toddlers, ages birth to 24 months old in Room # 4, Monday to Friday 6.30 am to 6:00 PM, will be issued upon receiving the above corrections and Management approval.

Exit interview conducted and report was reviewed with the director, Dishni Kemps.
End of reports
SUPERVISORS NAME: Thuy Ho
LICENSING EVALUATOR NAME: Mahnaz Malek
LICENSING EVALUATOR SIGNATURE:

DATE: 01/27/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/27/2023
LIC809 (FAS) - (06/04)
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