Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197417032
Report Date: 05/05/2017
Date Signed 05/09/2017 01:07:35 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 6167 BRISTOL PARKWAY #400
CULVER CITY, CA 90230
FACILITY NAME:MONTESSORI OF CHATSWORTHFACILITY NUMBER:
197417032
ADMINISTRATOR:ERBE, ANNAFACILITY TYPE:
830
ADDRESS:10616 ANDORA AVENUETELEPHONE:
(818) 709-2980
CITY:CHATSWORTHSTATE: CAZIP CODE:
91311
CAPACITY:16CENSUS: 12DATE:
05/05/2017
TYPE OF VISIT:Required - 3 YearUNANNOUNCEDTIME BEGAN:
02:09 PM
MET WITH:Katherine NathanTIME COMPLETED:
03:45 PM
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Licensing Program Analysts (LPAs), Margarit Sislyan met with the facility Katherine Nathan (Assistant Director) and conducted a Random visit.

Upon arrival, LPA observed 12 infants 4 teachers.
All rooms are clean and safe. Telephone service was verified. Heating, lighting, and ventilation are adequate. Drinking water is available.
LPA observed:
Furniture & Equipment age appropriate and in good repair
No Baby walkers on premises
High chairs or feeding tables have broad-based legs. Plastic seats in good repair
Sanitary solution out of infant reach.
Changing tables have at least 1 inch thick padding covered with washable vinyl or plastic. Sides raised a minimum of 3 inches. Changing table within arm’s length of sink when in use.
Toys were safe, with no sharp ages, splinters or points, nor made of small parts that can be pulled off and swallowed.
Cribs or other appropriate napping equip available for each crib age infant
Placement of cribs, cots or mats allows for entry/exit from the napping space
Play area was observed to be free of debris. Play area was inspected for hazards and inaccessibility to bodies of water.
Children are inspected for illnesses as they are picked up from their class. Most ill children are sent home prior to the end of the school day. A review of medication policy indicated that prescription over the counter medication is administered and only with parent's written permission. The designated person administers the medication and documents the dosage, date and time onto a log. Medication is properly labeled and stored in its original container. There is a separate area for isolation and care of ill children in the office. There is a mat and blanket available for each ill child.
SUPERVISOR'S NAME: Sharon GreeneTELEPHONE: (310) 337-4313
LICENSING EVALUATOR NAME: Margarit SislyanTELEPHONE: (310) 337-4346
LICENSING EVALUATOR SIGNATURE:

DATE: 05/05/2017
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/05/2017
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, 6167 BRISTOL PARKWAY #400
CULVER CITY, CA 90230
FACILITY NAME: MONTESSORI OF CHATSWORTH
FACILITY NUMBER: 197417032
VISIT DATE: 05/05/2017
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Play area was observed to be free of debris. Play area was inspected for hazards. There are no bodies of water.
The food is provided by parents, it is properly labeled and stored in a separate baskets.
Teacher child ratios were observed. Care and supervision was evaluated to determine if the basic needs of children are met and appropriate. Sign in and out sheets were reviewed. The parent board was reviewed and has all of the required forms posted.
Children's records were reviewed and observed to be complete.

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 Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226.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

LPA informed the director forms and a copy of Title 22 Regulations may be obtained at the department's website www.ccld.ca.gov
No deficiencies cited according to Title 22 Regulation
A copy of this report must be available to the public, at the facility site for 3 years.
An exit interview was conducted.
SUPERVISOR'S NAME: Sharon GreeneTELEPHONE: (310) 337-4313
LICENSING EVALUATOR NAME: Margarit SislyanTELEPHONE: (310) 337-4346
LICENSING EVALUATOR SIGNATURE:

DATE: 05/05/2017
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/05/2017
LIC809 (FAS) - (06/04)
Page: 2 of 2