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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198002864
Report Date: 11/08/2023
Date Signed: 11/08/2023 04:01:46 PM


Document Has Been Signed on 11/08/2023 04:01 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
MONTEREY PARK CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754



FACILITY NAME:MONTESSORI CHILDREN'S WORLDFACILITY NUMBER:
198002864
ADMINISTRATOR:PIERIS, NILOUFERFACILITY TYPE:
850
ADDRESS:4371 EAGLE ROCK BOULEVARDTELEPHONE:
(323) 256-2215
CITY:LOS ANGELESSTATE: CAZIP CODE:
90041
CAPACITY:75CENSUS: DATE:
11/08/2023
TYPE OF VISIT:Required - 3 YearUNANNOUNCEDTIME BEGAN:
10:07 AM
MET WITH:Director Niloufer PierisTIME COMPLETED:
04:15 PM
NARRATIVE
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Licensing Program Analyst (LPA) Veronica Martinez Garza conducted an unannounced 3-year required inspection at the above facility on 11/08/23 at 10:07 a.m. Upon arrival, LPA met the fire inspector who conducted an inspection as well. LPA met with Niloufer Pieris, Director who guided LPA on a tour of the facility. This is a preschool age program with an attached toddler component, licensed for 75 children. Maximum toddlers permitted is 15 and Maximum 60 preschoolers. The components are conducted in physically separate areas indoors. The facility operates Monday – Friday from 6:30 AM – 6:00 PM. Per the Director, there are 26 children enrolled. Per Director, there are waivers on file for restrooms and outdoor activity space. Copies of waivers do not match the facility license number. LPA observed license #191803182 was granted for outdoor activity space and restrooms for the above address. Waiver for the toddler component does reflect the current license number. Waivers were not observed to be posted; however, the Director immediately posted the waiver with the correct facility number by the facility entrance next to the facility license.

All areas identified on the Facility Sketch were inspected. The following staff were present during this inspection: 15 children with 2 staff in the preschool classroom and 6 children with 2 staff in the toddler room. Teacher-child ratios were observed to be in accordance with Title 22 Regulations. Staff names were recorded on the attached LIC859. All children were observed to be under supervision, including visual supervision, of a teacher at all times. The licensed facility is within the conditions, limitations, and capacity specified on the license.

LPA observed the facility to be clean, sanitary and in good repair. All indoor classrooms were inspected to ensure that the floors have a surface that is safe and clean. Furniture and equipment are in good condition, free of sharp, loose, or pointed parts. LPA observed a changing table in the toddler room that is not within an arm’s reach of a sink; this is a potential risk to the health and safety of children in care.
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SUPERVISOR'S NAME: Ana ChicoTELEPHONE: (323) 981-3374
LICENSING EVALUATOR NAME: Veronica Martinez-GarzaTELEPHONE: (323) 981-3386
LICENSING EVALUATOR SIGNATURE:
DATE: 11/08/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/08/2023
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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Document Has Been Signed on 11/08/2023 04:01 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
MONTEREY PARK CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754


FACILITY NAME: MONTESSORI CHILDREN'S WORLD
FACILITY NUMBER: 198002864

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/08/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
HSC
1596.8662(b)(1)
Administration of Child Day Care Licensing
(1) On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child day care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training provided pursuant to paragraphs (2) and (3) of subdivision (a), and shall complete renewal mandated reporter training every two years following the date on which he or she completed the initial mandated reporter training.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, the licensee did not comply with the section cited above in [count] out of Staff 2 (S2) has a Mandated Reporter Training that expired on 07/01/23, which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 11/10/2023
Plan of Correction
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Per the director, S2 will complete the Mandated Reporter Training immediately and submit proof to LPA by POC due date.
Type B
Section Cited
HSC
1596.7995(a)(1)
General Provisions and Definitions
(1) Commencing September 1, 2016, a person shall not be employed or volunteer at a day care center if he or she has not been immunized against influenza, pertussis, and measles. Each employee and volunteer shall receive an influenza vaccination between August 1 and December 1 of each year.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, the licensee did not comply with the section cited above in Staff 1 (S1) , S2, S3, S4 and S5 are missing proof of influenza. S4 and S4 are missing proof of MMR and Tdap, which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 12/08/2023
Plan of Correction
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Per the Director, she will ask for all staff to submit proof of influenza vaccines, declination letter, and proof of MMR, and Tdap to LPA by POC due date.
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: Ana ChicoTELEPHONE: (323) 981-3374
LICENSING EVALUATOR NAME: Veronica Martinez-GarzaTELEPHONE: (323) 981-3386
LICENSING EVALUATOR SIGNATURE:
DATE: 11/08/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/08/2023
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 11/08/2023 04:01 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
MONTEREY PARK CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754


FACILITY NAME: MONTESSORI CHILDREN'S WORLD
FACILITY NUMBER: 198002864

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/08/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
101216(g)(1)
Personnel Requirements
(1) Except as specified in (3) below, good physical health shall be verified by a health screening, including a test for tuberculosis, performed by or under the supervision of a physician not more than one year prior to or seven days after employment or licensure.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, the licensee did not comply with the section cited above in Staff 4 (S4) and S5 do not have a completed LIC 503, which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 12/08/2023
Plan of Correction
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Per the director, she will provide staff with LIC 503 and will submit proof to LPA by POC due date.
Type B
Section Cited
CCR
101217(a)(12)
Personnel Records
(a) The licensee shall ensure that personnel records are maintained on the licensee, administrator and each employee. Each personnel record shall contain the following information: (12) Tuberculosis test documents as specified in Section 101216(g).

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, the licensee did not comply with the section cited above in Staff 5 does not have a TB test which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 12/08/2023
Plan of Correction
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Per the director, she will have S5 obtain a current TB test and will submit to LPA by POC due date
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: Ana ChicoTELEPHONE: (323) 981-3374
LICENSING EVALUATOR NAME: Veronica Martinez-GarzaTELEPHONE: (323) 981-3386
LICENSING EVALUATOR SIGNATURE:
DATE: 11/08/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/08/2023
LIC809 (FAS) - (06/04)
Page: 3 of 9


Document Has Been Signed on 11/08/2023 04:01 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
MONTEREY PARK CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754


FACILITY NAME: MONTESSORI CHILDREN'S WORLD
FACILITY NUMBER: 198002864

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/08/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type A
Section Cited
CCR
101216(i)(e)


This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, the licensee did not comply with the section cited above in Staff 2 (S2) has not been associated to the facility, which poses an immediate health, safety or personal rights risk to persons in care.
POC Due Date: 11/08/2023
Plan of Correction
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Per Director, transfer request form was submitted to the Regional Office; however, director did not follow up to ensure that S2 was associated to the facility. LPA observed the director complete and prepare to mail S2 transfer request.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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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: Ana ChicoTELEPHONE: (323) 981-3374
LICENSING EVALUATOR NAME: Veronica Martinez-GarzaTELEPHONE: (323) 981-3386
LICENSING EVALUATOR SIGNATURE:
DATE: 11/08/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/08/2023
LIC809 (FAS) - (06/04)
Page: 8 of 9


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: MONTESSORI CHILDREN'S WORLD
FACILITY NUMBER: 198002864
VISIT DATE: 11/08/2023
NARRATIVE
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Drinking water was readily available indoors/outdoors via water dispensers/jugs and disposable cups. LPA observed children bring their own water bottles and are refilled as needed. LPA observed stacks for cots stored as napping equipment in each classroom. All toilets and hand washing facilities are safe, sanitary and are operating properly. At this time, the "office" is used as an isolation area. A cot is available for an ill child to rest on. Disinfectants, cleaning solutions, medication and other items that are dangerous to children, were inaccessible to children. All storage containers for solid waste, including moveable bins shall have tight-fitting covers that are kept on, and in good repair. Trash cans used to discard food have tight fitting lids. The facility was observed to be free of flies, other insects, and rodents.

LPA observed all required forms/publications to be posted in the entrance. Snack menus were reviewed to ensure that they are being posted at least one week in advance and visible to an authorized representative. Snacks were reviewed for availability, quantity, and appropriateness to children in care. The facility provides AM and PM snacks. Children bring their own lunch. All food prep and storage areas are clean, free of litter, rubbish, and rodents/vermin. All food is protected from contamination.

First Aid supplies are available and complete. LPA observed a functioning carbon monoxide detector that meets statutory requirements. LPA observed a fire extinguisher located near the entrance that indicates fully charged and was serviced on 12/28/20 as indicated on service tag. Per the fire inspector, the director can contact the current fire extinguisher vendor to request service or contact a new vendor to service the fire extinguisher.

At 10:35 a.m. the outdoor play equipment was observed to be in good condition, free of sharp, lose or pointed parts. Outdoor activity space surface is maintained in a safe condition as is free of hazards. Outdoor areas around and/or under climbing equipment have cushioning material to absorb a fall. The Director states that there are no bodies of water on the premises and LPA did not observe any bodies of water during this visit. The director states there are no weapons or firearms on the premises. There is adequate shade in the play yard.

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SUPERVISOR'S NAME: Ana ChicoTELEPHONE: (323) 981-3374
LICENSING EVALUATOR NAME: Veronica Martinez-GarzaTELEPHONE: (323) 981-3386
LICENSING EVALUATOR SIGNATURE:

DATE: 11/08/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/08/2023
LIC809 (FAS) - (06/04)
Page: 4 of 9
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: MONTESSORI CHILDREN'S WORLD
FACILITY NUMBER: 198002864
VISIT DATE: 11/08/2023
NARRATIVE
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Sign in and out sheets were reviewed to ensure that the person who signs the child in and out uses their full legal signature and records the time of the day. Children’s Records were reviewed to ensure that Identification and Emergency form and a medical assessment are on file. Children's files were observed to be complete.

Staff Records were reviewed to ensure that appropriate documentation of education credits is on file. Criminal Records Clearance for adults and verification of CPR/First Aid and health preventative practices documentation was reviewed. Proof of immunization against influenza, pertussis and measles for staff was readily available during today's inspection. LPA observed S2 Mandated Reporter Training expired 07/01/23. S4 and S5 do not have LIC 503 on file. LPA observed director's Pediatric CPR/FA and was not able to determine expiration date. Pediatric CPR/FA copy has the date of 08/09/22. LPA requested for director to submit a better copy of the Pediatric CPR/FA card.

SB792 (Immunization Requirements for Staff and Employees) was discussed with the Director. LPA observed S1, S2, S3, S4, S5 do not have proof of Influenza vaccine. S4 does not have proof of MMR and Tdap vaccines. S5 does not have proof of MMR, Tdap, and TB vaccines.



AB1207 Mandated Child Abuse Reporting – On or before March 30, 2018, any person who works in a child care facility shall complete the training and renew the training every 2 years. Website provided: https://www.mandatedreporterca.com/training/child-care-providers.

Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02-CCP. When any IMS is provided, an updated Plan of Operation that includes IMS must be submitted to the Department. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice) or (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA are available at: https://www.ada.gov/resources/child-care-centers/.

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SUPERVISOR'S NAME: Ana ChicoTELEPHONE: (323) 981-3374
LICENSING EVALUATOR NAME: Veronica Martinez-GarzaTELEPHONE: (323) 981-3386
LICENSING EVALUATOR SIGNATURE:

DATE: 11/08/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/08/2023
LIC809 (FAS) - (06/04)
Page: 5 of 9
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: MONTESSORI CHILDREN'S WORLD
FACILITY NUMBER: 198002864
VISIT DATE: 11/08/2023
NARRATIVE
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Director was reminded that all adults 18 and over, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, 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 for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated. LPA observed that S2 is not on associated to the facility. According to the director, transfer request was mailed to the office, however, director did not follow up with the Regional Office to ensure that the employee was transferred to the facility. LPA observed the director had the transfer request form and placed it in an envelope ready to be mailed to the Regional Office. Director also faxed in the transfer request form to the Regional Office.

To improve the quality and value of the new inspection process, a survey may 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 CARE tools, please send email inquiries to inspectionprocess@dss.ca.gov. 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/inspection-proces.

Director was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

CCC DID NOT COMPLETE TESTING PRIOR TO THEIR DEADLINE

LPA referred the Administrator to the Department website for lead: Lead Toxicity Prevention and Water Testing Information. According to the director, the facility does not use any sinks or water fountains prior to 2020. Director stated that the facility has always used sparklett's services and provides water via water dispensers/jugs and that fruits are rinsed using sparkeltt's water.

The deficiencies listed on the following pages were observed by the LPA and are being cited in accordance with California Code of Regulations Title 22. Please see attached LIC 809D for deficiencies that are being cited and need to be cleared to protect the children’s health & safety.

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

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SUPERVISOR'S NAME: Ana ChicoTELEPHONE: (323) 981-3374
LICENSING EVALUATOR NAME: Veronica Martinez-GarzaTELEPHONE: (323) 981-3386
LICENSING EVALUATOR SIGNATURE:

DATE: 11/08/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/08/2023
LIC809 (FAS) - (06/04)
Page: 6 of 9
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: MONTESSORI CHILDREN'S WORLD
FACILITY NUMBER: 198002864
VISIT DATE: 11/08/2023
NARRATIVE
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Exit interview conducted and report was reviewed with the Director, Niloufer Pieris.

Type A citation
LPA Veronica Martinez Garza informed Director, Niloufer Pieris that this report dated 11/08/23 document(s) (1) Type A citation(s) which shall be posted for 30 consecutive days as there is/are immediate risk(s) to the health, safety, or personal rights of children in care.

Also, LPA Veronica Martinez Garza informed the Director, Niloufer Pieris to provide a copy of this licensing report dated 11/08/23 that documents any Type A citation(s) 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.

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SUPERVISOR'S NAME: Ana ChicoTELEPHONE: (323) 981-3374
LICENSING EVALUATOR NAME: Veronica Martinez-GarzaTELEPHONE: (323) 981-3386
LICENSING EVALUATOR SIGNATURE:

DATE: 11/08/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/08/2023
LIC809 (FAS) - (06/04)
Page: 7 of 9
Document Has Been Signed on 11/08/2023 04:01 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
MONTEREY PARK CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754


FACILITY NAME: MONTESSORI CHILDREN'S WORLD
FACILITY NUMBER: 198002864

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/08/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
101439(h)(4)


This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, the licensee did not comply with the section cited above in LPA observed a changing table in the toddler room that is not within arm's reach of a sink, which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 11/22/2023
Plan of Correction
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Per Director, this is how the toddler component was licensed. LPA observed facility was previously cited for the above mentioned in 2006 and 2019. Per director, she will request for a portable sink and place it next to the changing table by POC due date.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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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: Ana ChicoTELEPHONE: (323) 981-3374
LICENSING EVALUATOR NAME: Veronica Martinez-GarzaTELEPHONE: (323) 981-3386
LICENSING EVALUATOR SIGNATURE:
DATE: 11/08/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/08/2023
LIC809 (FAS) - (06/04)
Page: 9 of 9