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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197401129
Report Date: 01/16/2024
Date Signed: 01/16/2024 02:28:02 PM


Document Has Been Signed on 01/16/2024 02:28 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:CRENSHAW MONTESSORI ACADEMYFACILITY NUMBER:
197401129
ADMINISTRATOR:AUDRY L. REEMSFACILITY TYPE:
850
ADDRESS:4914 CRENSHAW BLVD.TELEPHONE:
(323) 296-4611
CITY:LOS ANGELESSTATE: CAZIP CODE:
90043
CAPACITY:45CENSUS: 29DATE:
01/16/2024
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
01:00 PM
MET WITH:Audry Reems, Licensee TIME COMPLETED:
02:35 PM
NARRATIVE
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Licensing Program Analyst (LPA) Lilia Hernandez conducted an unannounced inspection to the above facility on 01/16/2024. LPA arrived at the facility at 09:30AM and met with Staff #1, who guided LPA on tour of the facility. There were 3 staff and 29 children in care upon arrival. LPA was later met by Audry Reem, Licensee.

The purpose of the visit is to address deficiencies that were discovered during the course of an investigation conducted by the Department.

On 10/26/2023, during an inspection, Licensee was not able to provide the Department a current facility roster upon LPA's request. During today's inspection, Licensee was not able to provide LPA with a current facility roster upon request.

Based on interviews conducted and disclosures made, Licensee did not report an injury of a child that occurred on 10/17/2023 to their parents/guardians and did not report the injury to the Department.

The following deficiencies listed on the attached deficiency pages are being cited in accordance with California Code of Regulations Title 22.

A copy of this report shall be provided to the parent/guardian of children currently enrolled by the next business day or immediately upon return. A copy of this report shall also be provided to the parent/guardian of any newly enrolled children for the next 12 months (1 year). The Acknowledgement form must be maintained in each child’s file immediately upon receipt from parent. Licensee/Director was provided with a copy of the parent Acknowledgement of Receipt of Licensing Reports Form during this visit. --Page 1 of 2
SUPERVISOR'S NAME: Rita RamosTELEPHONE: (424) 301-3061
LICENSING EVALUATOR NAME: Lilia HernandezTELEPHONE: 424-301-3071
LICENSING EVALUATOR SIGNATURE:
DATE: 01/16/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/16/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 4


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: CRENSHAW MONTESSORI ACADEMY
FACILITY NUMBER: 197401129
VISIT DATE: 01/16/2024
NARRATIVE
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The Notice of Site Visit must remain posted for 30 days during the hours of operation after each site visit by a licensing representative. Failure to maintain posting as required will result in a civil penalty of $100.00.

Exit interview was conducted with Audry Reems, Licensee.
SUPERVISOR'S NAME: Rita RamosTELEPHONE: (424) 301-3061
LICENSING EVALUATOR NAME: Lilia HernandezTELEPHONE: 424-301-3071
LICENSING EVALUATOR SIGNATURE:

DATE: 01/16/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/16/2024
LIC809 (FAS) - (06/04)
Page: 2 of 4
Document Has Been Signed on 01/16/2024 02:28 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 NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245


FACILITY NAME: CRENSHAW MONTESSORI ACADEMY
FACILITY NUMBER: 197401129

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/16/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
01/18/2024
Section Cited
CCR
101212(d)(1)

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Reporting Requirements (d) Upon the occurrence, during the operation of the child care center ...a report shall be made to the Department by telephone...next working day and during its normal business hours. In addition, a written report...submitted to the Department within seven days following the occurrence of such event. (1) Events reported shall include the following...(B)Any injury to any child that requires medical treatment. (C)Any unusual incident or child absence that threatens the physical or emotional health or safety of any child...
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Per Licensee, meeting will be conducted with staff regarding reporting requirements to the Department. Licensee will submit corrections to LPA via email by POC due date.
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This requirement was not met as evidenced by interviews conducted and disclosures made indicating that Licensee did not report an injury of a child that occurred on 10/17/2023 to their parents/guardians and did not report the injury to the Department which poses an immediate health, safety, and personal rights risk to children in care.
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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.
SUPERVISOR'S NAME: Rita RamosTELEPHONE: (424) 301-3061
LICENSING EVALUATOR NAME: Lilia HernandezTELEPHONE: 424-301-3071
LICENSING EVALUATOR SIGNATURE:
DATE: 01/16/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/16/2024
LIC809 (FAS) - (06/04)
Page: 3 of 4


Document Has Been Signed on 01/16/2024 02:28 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 NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245


FACILITY NAME: CRENSHAW MONTESSORI ACADEMY
FACILITY NUMBER: 197401129

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/16/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
02/06/2024
Section Cited
HSC
1596.841

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Each child day care facility shall maintain a current roster of children who are provided care in the facility. The roster shall include the name, address, and daytime telephone number of the child's parent or guardian, and the name and telephone number of the child's physician. This roster shall be available to the licensing agency upon request.
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Per Licensee, a complete facility roster will be submitted to LPA via email by the POC due date.
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This requirement was not met as evidenced by On 10/26/2023, during an inspection, Licensee was not able to provide the Department a current facility roster upon LPA's request. During today's inspection, Licensee was not able to provide LPA with a current facility roster upon request which poses a potential health and safety risk to children in care.

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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.
SUPERVISOR'S NAME: Rita RamosTELEPHONE: (424) 301-3061
LICENSING EVALUATOR NAME: Lilia HernandezTELEPHONE: 424-301-3071
LICENSING EVALUATOR SIGNATURE:
DATE: 01/16/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/16/2024
LIC809 (FAS) - (06/04)
Page: 4 of 4