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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197494645
Report Date: 04/05/2023
Date Signed: 04/05/2023 02:26:46 PM

Document Has Been Signed on 04/05/2023 02:26 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
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME:WOODLAKE MONTESSORI PRESCHOOLFACILITY NUMBER:
197494645
ADMINISTRATOR:HORDAGODA, NOESHFACILITY TYPE:
850
ADDRESS:23363 BURBANK BLVDTELEPHONE:
(323) 767-4517
CITY:WOODLAND HILLSSTATE: CAZIP CODE:
91367
CAPACITY: 57TOTAL ENROLLED CHILDREN: 57CENSUS: 32DATE:
04/05/2023
TYPE OF VISIT:Case Management - Annual ContinuationUNANNOUNCEDTIME BEGAN:
09:31 AM
MET WITH:Director/Owner Noesh HordagodaTIME COMPLETED:
02:30 PM
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On 4/5/2023 at 9:00 AM, Maria Rendon and Antonio Almanza, Licensing Program Analysts (LPAs), conducted an unannounced Annual Required Visit. LPAs met with Noesh Hordagoda, Director and explained the purpose of the visit. Director guided LPAs on a tour of the facility. Days and hours of operation are Monday through Friday from 7:00 AM to 6:00 PM. LPA verified facility phone number is 818-835-9595. During today’s visit there are 5 adults providing care to 32 preschool children.

The facility is located on the same premises as Woodland Hills Church of Christ. The facility has a circular driveway that goes around the premises and there is no gates at the entrance or exit of the driveway. The facility has classroom 1, classroom 2, two children’s bathrooms within classroom 2, and office. Staff bathrooms are located in the church building on the North West side of the playground.



There is no swimming pool or other bodies of water on the premises. There are no firearms or ammunition allowed or stored on the premises. Disinfectants, cleaning solutions, medication and other hazardous items are made inaccessible.

Furniture and equipment are in good condition, free of sharp, loose or pointed parts. Playground equipment is in safe condition, free of sharp, loose or pointed parts. All toilets and handwashing facilities are in safe and sanitary operating condition. Floors in the facility are clean and safe.

The surface of the outdoor activity space is maintained in a safe condition and is free of hazards. The outdoor playground has an area with concrete and an area with artificial turf. There is a large tree that provides shade. There is a block and wrought iron fence around the playground.

The Director is reporting that the kitchen is not used for food preparation. Parents provide food and snacks. Solid waste storage containers have tight-fitting covers and are in good repair.

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SUPERVISORS NAME: Betty Bell
LICENSING EVALUATOR NAME: Antonio Almanza
LICENSING EVALUATOR SIGNATURE: DATE: 04/05/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/05/2023
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
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: WOODLAKE MONTESSORI PRESCHOOL
FACILITY NUMBER: 197494645
VISIT DATE: 04/05/2023
NARRATIVE
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Drinking water is available both indoors and outdoors. The facility is free of flies, insects and rodents. Facility has functioning smoke detectors and carbon monoxide detectors in each classroom that meet statutory requirements. LPAs observed fire extinguishers in each classroom that were serviced on 08/22/22.

Director was advised that prior to working or volunteering in a licensed child care facility, all individuals subject to a criminal record review have received a criminal record clearance or exemption. No individuals excluded by the Department are allowed to be present.

Capacity and limitations as specified on the license are being maintained. At least one person trained in CPR and Pediatric First Aid is present when children are at the facility or at offsite activities. The name of the child care center director or fully-qualified teacher(s) designated to act in the director’s absence has been reported to the Department.

Director was advised that all children are under supervision, including visual supervision, of a teacher at all times. Facility shall maintain a ratio of one teacher supervising no more than 12 children in care. LPAs reviewed a sample of children’s files and observed files were complete with contact information for authorized representative and or relatives or others who can assume responsibility for the child. LPAs reviewed a sample of staff files and observed files were complete with documentation of meeting qualification requirements, immunization records for influenza, pertussis and measles and current documentation of completed mandated reporter training. Menus are posted at least one week in advance where an authorized representative can view them.

Incidental Medical Services (IMS) are not currently being provided. Licensee is aware that an IMS plan is required to be submitted to the licensing office if they provide any of these services. Information regarding Americans with Disability Act (ADA) can be obtained by contacting US Department of Justice toll free ADA Information line at (800) 514-0301(voice), (800) 514-0383 (TDD) and website link https://www.ada.gov/childqanda.htm

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 [email protected]. 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

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SUPERVISORS NAME: Betty Bell
LICENSING EVALUATOR NAME: Antonio Almanza
LICENSING EVALUATOR SIGNATURE:

DATE: 04/05/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/05/2023
LIC809 (FAS) - (06/04)
Page: 2 of 3
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: WOODLAKE MONTESSORI PRESCHOOL
FACILITY NUMBER: 197494645
VISIT DATE: 04/05/2023
NARRATIVE
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Director was reminded that all adults 18 and over, 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.

During today’s visit the facility is in substantial compliance, no deficiencies are cited.

A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with the Director Noesh Hordagoda.

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SUPERVISORS NAME: Betty Bell
LICENSING EVALUATOR NAME: Antonio Almanza
LICENSING EVALUATOR SIGNATURE:

DATE: 04/05/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/05/2023
LIC809 (FAS) - (06/04)
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