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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 191604893
Report Date: 04/23/2025
Date Signed: 04/23/2025 04:30:44 PM

Document Has Been Signed on 04/23/2025 04:30 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 RO, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME:PACIFICA MONTESSORI INC.FACILITY NUMBER:
191604893
ADMINISTRATOR/
DIRECTOR:		STEPHEN CALLFACILITY TYPE:
850
ADDRESS:6585 GREEN VALLEY CIRCLETELEPHONE:
(310) 417-3087
CITY:CULVER CITYSTATE: CAZIP CODE:
90230
CAPACITY: 72TOTAL ENROLLED CHILDREN: 72CENSUS: 38DATE:
04/23/2025
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:15 PM
MET WITH:Stephen CallTIME VISIT/
INSPECTION COMPLETED:
04:40 PM
NARRATIVE
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On 4/23/25 Licensing Program Analyst (LPA) Ranita Richmond and Chartrice Johnson conducted an unannounced case management incident inspection at Pacifica Montessori School located at 6585 Green Valley Circle, Culver City, Ca 90230, for the purpose of following up on the unusual incident that was self reported by the facility. The El Segundo Child Care Regional Office received the report on 4/11/2025.

Upon arrival, LPA met with administrator Stephen Call and discussed the purpose of the visit.

According to the incident report from 4/11/2025, on 4/09/2025 a teacher received a communication from a parent stating her child while playing with peers during school was asked to pull down his pants and let him lick his private. Teachers observed children in the play house area during outdoor play time. Teachers observed a child pulling up his pants inside of the play house during outdoor play time.

During today's inspection, LPA conducted interviews with facility staff and children. Based on the interviews which were conducted and recorded the evidence showed that children engaged in inappropriate activities due to a lack of supervision. Type A citation cited. See LIC 809D. Per title 22 Children are to be supervised at all times and an based on the above children were not provided proper supervision.

LPA Richmond informed administrator Stephen Call that this report dated 4/23/25 documents one Type A citation. One Type A citation which shall be posted for 30 consecutive days as there is immediate risk to the health, safety, or personal rights of children in care.

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Claudia EscobedoTELEPHONE: (424) 301-3044
Ranita RichmondTELEPHONE: (424) 301-3065
DATE: 04/23/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/23/2025
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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California Health & Human Services Agency
California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:
  • Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.
  • Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)
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Document Has Been Signed on 04/23/2025 04:30 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO CC RO, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245


FACILITY NAME: PACIFICA MONTESSORI INC.
FACILITY NUMBER: 191604893

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/23/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
04/30/2025
Section Cited
CCR
101229(a)(1)

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101229 Responsibility for Providing Care and Supervision(a) The licensee shall provide care and supervision...
(1) No child(ren) shall be left without the supervision of a teacher at any time... include visual observation.This requirement was not met as evidence by:
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The Director will hold a meeting with staff to discuss the importance of providing care and suprvision, submit roster of attendees & view the videos with staff on CCL website: https://ccld.childcarevideos.org/child-care-center-operators/supervising-children-in-child-care-centers/
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Per LPA interviews that have been conducted and recorded with facility staff and children. The evidence showed that children engaged in inappropriate activities due to a lack of supervision.
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Director will provide a written plan of action on how care and supervision will be carried out on a daily basis to include visual supervision at all times during childcare hours.

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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
Claudia EscobedoTELEPHONE: (424) 301-3044
Ranita RichmondTELEPHONE: (424) 301-3065

DATE: 04/23/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/23/2025

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 RO, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: PACIFICA MONTESSORI INC.
FACILITY NUMBER: 191604893
VISIT DATE: 04/23/2025
NARRATIVE
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Also, LPA Richmond informed the administrator Stephen Call to provide a copy of this licensing report dated 4/23/25 that documents any Type A citation to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification.

An exit interview was conducted, a copy of this report and appeal rights was read and provided to administrator Stephen Call.


Notice of Site Visit was provided and required to be posted for 30 days.

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SUPERVISOR'S NAME: Claudia EscobedoTELEPHONE: (424) 301-3044
LICENSING EVALUATOR NAME: Ranita RichmondTELEPHONE: (424) 301-3065
LICENSING EVALUATOR SIGNATURE:

DATE: 04/23/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/23/2025
LIC809 (FAS) - (06/04)
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