376700790-9-17-2024-51-CC-PMAA-D97VG4-20240917162454

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 376700790
Report Date: 09/17/2024
Date Signed: 09/17/2024 04:25:06 PM

Document Has Been Signed on 09/17/2024 04:25 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, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108

FACILITY NAME:	LEGACY MONTESSORI SCHOOL		FACILITY NUMBER:	376700790
ADMINISTRATOR/ DIRECTOR:	KATIE TSENG		FACILITY TYPE:	850
ADDRESS:	12310 NINTH STREET		TELEPHONE:	(858) 679-9949
CITY:	POWAY	STATE: CA	ZIP CODE:	92064
CAPACITY: 108	TOTAL ENROLLED CHILDREN: 108	CENSUS: 72	DATE:	09/17/2024
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	12:00 PM
MET WITH:	Katie Tseng		TIME VISIT/ INSPECTION COMPLETED:	04:40 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	On 9/17/24 at 12:00PM, Licensing Program Analysts, Patrick Ma and Renita Rodriquez, met with Director Katie Tseng for the purpose of an unannounced annual inspection. There were 72 children present with 9 teachers in 4 rooms. Facility is within ratio and capacity. Program operates M – F from 8:15 – 5:45PM. LPA toured the facility. The rooms were clean, orderly and a comfortable temperature during this visit. Adequate ventilation and heating are available. The furniture, books, games and toys are safe, age-appropriate and in good repair. There is a variety of activities available throughout the day. All required forms were posted. Students bring their lunches and snacks. Food has been stored separately from any chemicals or cleaning products. Drinking water is readily available. Napping equipment is sufficient for each child, bedding is stored separately, and mats are disinfected after use. Facility has ensured that there is adequate space between mats for easy passage and that they are not blocking entrances or exits. Hand washing and toileting areas are in a safe, sanitary and operating condition. Medications are kept in the Director’s office, inaccessible to children. Poisons, disinfectants, cleaning solutions and other items that are dangerous to children have been made inaccessible. There is no evidence of rodent or insect activity. Outdoor play area is fully fenced with sufficient cushioning and adequate shade, separate from other programs. Age appropriate playground equipment and outdoor surfaces are in a safe condition. Portable water is used outdoors. There are no bodies of water, firearms or ammunition on the property. The carbon monoxide detector is operational. The facility has a written disaster plan in place that meets regulatory requirement and has been conducting and documenting evacuation drills every six months. The facility does not transport children. LPA reviewed sign in/out sheets, a sample of personnel records and a sample of children's records. There is at least one staff present with current CPR and First Aid certification. Children are evaluated upon entry and monitored throughout the day for signs of illness. The isolation area for ill children awaiting pick up is the Director’s office.

SUPERVISORS NAME: Renesha Askew
LICENSING EVALUATOR NAME: Patrick Ma
LICENSING EVALUATOR SIGNATURE:	DATE: 09/17/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/17/2024

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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Document Has Been Signed on 09/17/2024 04:25 PM - It Cannot Be Edited

Created By: Patrick Ma On 09/17/2024 at 03:57 PM

Link to Parent Document Below:

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108

FACILITY NAME: LEGACY MONTESSORI SCHOOL	FACILITY NUMBER: 376700790
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 09/17/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

101171(a)

Fire Clearance

(a) All child care centers shall secure and maintain a fire clearance approved by the city or county fire department, the district providing fire protection services, or the State Fire Marshal. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on observation Toddler component room was changed from room 5 to rooms 3 & 4 without fire inspection or Department inspection approval which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 09/18/2024
	Plan of Correction
1 2 3 4	Director apologized for changing rooms prior to submitting request and receiving approval from the Department. Director provided LIC 200A during visit for room change request. Department will submit fire inspection request from local fire department.

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

SUPERVISOR'S NAME:

Renesha Askew

LICENSING EVALUATOR NAME:

Patrick Ma

LICENSING EVALUATOR SIGNATURE:

DATE: 09/17/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/17/2024

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
CCLD Regional Office, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108

FACILITY NAME: LEGACY MONTESSORI SCHOOL	FACILITY NUMBER: 376700790
	VISIT DATE: 09/17/2024

NARRATIVE

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Facility is reminded the Mandated Reporter Training is to be retaken every two years and can be accessed at the following website: www.mandatedreporterca.com.

Facility representative 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.

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. Director stated California Rural Water Association came out on 4/19/23 to test their water for lead but informed her facility did not need to be tested due to water filter system installed in all classrooms. Classroom sinks are used only for hand washing and not for food preparation or drinking. Director provided LPA letter acknowledging they applied for and was approved for free lead testing from the California Rural Water Association and copies of email exchanges confirming appointment. Director provided attestation letter stating facility has filtered water in all the classrooms for drinking and food preparation (if necessary) and sinks are for handwashing only.

This facility provides Incidental Medical Services – IMS. LPA reviewed storage of “medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. For IMS information see PIN 22-02-CCP. 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-carecenters/.

Licensee is advised to sign up for Quarterly Updates and Provider Information Notices (PINs) for one or more programs on our website: www.ccld.ca.gov. Select “Child Care” then “Quick Links” and Quarterly Updates. Select “Receive Important Updates” then put the email address in and choose which program(s) you would like to subscribe to and select “subscribe.”

SUPERVISORS NAME: Renesha Askew
LICENSING EVALUATOR NAME: Patrick Ma
LICENSING EVALUATOR SIGNATURE:	DATE: 09/17/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/17/2024

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
CCLD Regional Office, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108

FACILITY NAME: LEGACY MONTESSORI SCHOOL	FACILITY NUMBER: 376700790
	VISIT DATE: 09/17/2024

NARRATIVE

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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 email inquiries 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/inspection-process.
See LIC 809D for deficiency.

Exit interview conducted and report was reviewed with the facility representative Debbie Fairbrace due to a previously scheduled appointment Director had scheduled. A notice of site visit was given to licensee and must remain posted on, or immediately adjacent to, the interior side of the main door for 30 days.

SUPERVISORS NAME: Renesha Askew
LICENSING EVALUATOR NAME: Patrick Ma
LICENSING EVALUATOR SIGNATURE:	DATE: 09/17/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/17/2024

LIC809 (FAS) - (06/04)

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