197494554-7-20-2021-30-CC-DMIA-C54V79-20210720161047

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 197494554
Report Date: 07/20/2021
Date Signed: 07/20/2021 04:10:52 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME:	BURBANK MONTESSORI ACADEMY		FACILITY NUMBER:	197494554
ADMINISTRATOR:	KITHMINI CURRY		FACILITY TYPE:	850
ADDRESS:	217 N HOLLYWOOD WAY		TELEPHONE:	(818) 848-8226
CITY:	BURBANK	STATE: CA	ZIP CODE:	91505
CAPACITY:	45	CENSUS: 42	DATE:	07/20/2021
TYPE OF VISIT:	POC	UNANNOUNCED	TIME BEGAN:	01:51 PM
MET WITH:	Mona Paguia, Lead Teacher		TIME COMPLETED:	04:12 PM

NARRATIVE

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On 07/20/2021 at 1:51pm, Licensing Program Analyst (LPA) Denise Miranda and (LPA) Claudia Escobedo arrived at Burbank Montessori Academy located at 217 Hollywood Way, Burbank, CA 91505, for the purpose of a Case Management-Plan of Correction Visit.

LPA met with Ms. Martin and Ms. Mona Paguia, Lead Teachers. Ms. Paguia is who guided Analysts on a tour of the facility. During this visit, Director was not present.

LPAs observed 42 children present being supervised by 7 staff members and additional 5 children. Per Ms. Mona, the additional 5 children that were present at the premises came for a child’s birthday party.

Per Ms. Mona the three adults present with the 5 children at the facility are the mothers of the children. LPAs observed when the three adults (female) left the facility with the five children.

On 07/15/2021, the facility was cited in violation of Title 22 CCR Title 22, Division 12 Chapter 1 Article 02. Licensing 101161 – Limitations on Capacity and a repeat violation was cited on 7/16/2021.

This report shall be made available to the public upon request. LIC 9213 Notice of Site Visit is provided and required to be posted for 30 days.
An exit interview was conducted with Ms. Mona Paguia. A copy of this report being provided to Ms. Paguia.

SUPERVISOR'S NAME: Peter Flores	TELEPHONE: (424) 301-3077
LICENSING EVALUATOR NAME: Denise Miranda	TELEPHONE: (424) 301-3055
LICENSING EVALUATOR SIGNATURE:	DATE: 07/20/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/20/2021

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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