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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 304371634
Report Date: 07/17/2023
Date Signed: 07/17/2023 03:39:08 PM

Document Has Been Signed on 07/17/2023 03:39 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:ROBIN HOOD MONTESSORI SCHOOLFACILITY NUMBER:
304371634
ADMINISTRATOR:PATEL, LITAFACILITY TYPE:
830
ADDRESS:27500 MARGUERITE PARKWAY # 6TELEPHONE:
(949) 364-6342
CITY:MISSION VIEJOSTATE: CAZIP CODE:
92692
CAPACITY: 12TOTAL ENROLLED CHILDREN: 12CENSUS: 8DATE:
07/17/2023
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Applicant and directorTIME COMPLETED:
01:30 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 changing ownership from facility # 304370625 to operate an infant program at this site. LPA met with the applicant, Lita Patel, director Ramoa Klymko. LPA also met with applicant's spouse, Patel and director's spouse, Fridehlm Klymko who gave a tour of the entire facility to LPA. There is one classroom which has been designated for infants and toddlers ages 3 months to 24 months old. Today LPA observed there were 8 children in the infant room with 3 staff.

The applicant has requested to provide care and supervision for 12 infants and toddlers ages 3 to 24 months old in one room, Monday through Friday from 7:00 am to 6:00 pm.

Parents sign in and out electronically at the entrance of the building in the lobby are. 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 corner of the entrance of the building. There is additional playpen with beddings available for the sick child in the Director's office until the parents pick up the sick child/ren. There is staff bathroom close to the director's office to be used for sick child/ren temporarily.

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)

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SUPERVISORS NAME: Thuy Ho
LICENSING EVALUATOR NAME: Mahnaz Malek
LICENSING EVALUATOR SIGNATURE: DATE: 07/17/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/17/2023
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: ROBIN HOOD MONTESSORI SCHOOL
FACILITY NUMBER: 304371634
VISIT DATE: 07/17/2023
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· 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.
Age appropriate furniture and equipment’s
Toys, tactile equipment's
Room is well lighted with ventilation.
Infant room has napping area with cribs separated by a half wall from the activity area but it is not completely closed. A gate is required to close the infant crib area from the activity area.
There is sufficient open area for the child to move.
Changing table is placed inside the room facility wall equipped with a sink attached to the changing diaper table. LPA discussed the positioning of the changing table for visual observation of children while using it. The diaper changing table has padded surface no less than one inch tick with washable vinyl. It has raised sides on four sides at least 3 inches high. The director stated there are always two staff in the infant room for ratio of 1:4 so there is no problem one staff changes diaper facility wall. The other staff in the room supervise the rest of the children while the other staff is changing diapers.
Storage cubbies are arranged to store personal belongings
There are 5 cribs in the napping area with mattress and tight fitting sheets in infant room, and there are mats available for older children to nap on the floor on the other side of the room. 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. Formula for infants and lunch for older infants are provided by parents. Facility provides morning and afternoon snacks.
There are two refrigerator available in infant room to store the milk and other items.
LPA reminded the director that all the food shall be labeled with the child's name and date.
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SUPERVISORS NAME: Thuy Ho
LICENSING EVALUATOR NAME: Mahnaz Malek
LICENSING EVALUATOR SIGNATURE:

DATE: 07/17/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/17/2023
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: ROBIN HOOD MONTESSORI SCHOOL
FACILITY NUMBER: 304371634
VISIT DATE: 07/17/2023
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LPA measured the assigned room for infants and toddlers.
Infant Room measurement is: 410.48 square feet divided by 35 square feet is: 11.73 (12 children).
Infant Room is equipped with a crib area for napping measured 91.56 square feet which is not calculated in the activity are. There is one diaper changing table in this room that are built in with a sink.
LPA discussed the diaper changing procedure with director and reminded the staff never leave any child unattended on the diaper changing when changing diaper.
There is one sink and one toilet adjacent to the infant room.

Total sinks: 2 X 15= 30 children
Total toilet: 1 X 15 = 15 children

Outdoor activity space: 930.93 square feet divided by 75 = 12.41 (12 children) .
Outdoor space for infant's use is the side yard which 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 concreted. The director stated they would cover the flooring with soft materials and will send pictures to LPA. There is no high play structure on the outdoor activity space for the infants. There is a stroller for 6 infants stationed outdoor to have the infants in it when outdoor.

LPA discussed the Safe sleep practice with the director, Ramona Klymko.

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

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

DATE: 07/17/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/17/2023
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: ROBIN HOOD MONTESSORI SCHOOL
FACILITY NUMBER: 304371634
VISIT DATE: 07/17/2023
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· 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.

Fire clearance received from Orange County Fire Authority approving the requested capacity of 12 infants in one room. .
The director, Ramona Klymko 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.
The facility representative, Ramona Klymko 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, 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.

LPA discussed the safe sleep regulations with director, Ramona Klymko 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, Ramona Klymko 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.

For IMS information, see PIN 22-02-CCP. A Plan of Operation that includes IMS must be submitted to the Department. The following information regarding ADA was provided: US Department of Justice (USDOJ)
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SUPERVISORS NAME: Thuy Ho
LICENSING EVALUATOR NAME: Mahnaz Malek
LICENSING EVALUATOR SIGNATURE:

DATE: 07/17/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/17/2023
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: ROBIN HOOD MONTESSORI SCHOOL
FACILITY NUMBER: 304371634
VISIT DATE: 07/17/2023
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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, available at: http://www.ada.gov/childqanda.htm.
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. LPA discussed the checking on infants every 15 minutes during nap time and provided a sample of every 15 minutes check log. LPA also provided the LIC 9227 the infant sleeping plan form to the center representatives.
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 platforms.

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. The facility representative was informed of the MyChildCarePlan.org site, a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

Based on today’s indoor and outdoor measurements, the sinks and toilets availability, the request of the facility for 12 infants ages 3 to 24 months old in one room will be final reviewed and discussed with management in the Regional Office and after receiving the following corrections. The facility will be notified if any additional information is required. Exit interview conducted and report was reviewed with the director, Ramona Klymko.

1- The crib area in the infant room shall be enclosed completely to separate the crib area from the activity area. The director stated they would install the gate to close off this area and will send a final picture of this area to LPA.

2- Final photo of the infant side yard to show the flooring with cushioning.

End of report
SUPERVISORS NAME: Thuy Ho
LICENSING EVALUATOR NAME: Mahnaz Malek
LICENSING EVALUATOR SIGNATURE:

DATE: 07/17/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/17/2023
LIC809 (FAS) - (06/04)
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