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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198009834
Report Date: 02/09/2023
Date Signed: 02/09/2023 04:03:46 PM


Document Has Been Signed on 02/09/2023 04:03 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
CCLD Regional Office, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754



FACILITY NAME:ANNEX MONTESSORI CHILDCARE CENTERFACILITY NUMBER:
198009834
ADMINISTRATOR:HAYDEE DIAZFACILITY TYPE:
830
ADDRESS:3400 AEROJETTELEPHONE:
(626) 569-2641
CITY:EL MONTESTATE: CAZIP CODE:
91731
CAPACITY:10CENSUS: 5DATE:
02/09/2023
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
03:45 PM
MET WITH:Director Anahi SalinasTIME COMPLETED:
04:15 PM
NARRATIVE
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Licensing Program Analyst (LPA) Roxana Lopez conducted an unannounced poc (plan of correction) inspection to insured that the Type A deficiencies cited on 1/23/2023 have been cleared. LPA met with Director Anahi Salinas, who guided analysts on a tour of the facility. Census was taken,
The following was observed:

- The report and notice of site visit issued on 1/23/2023 was posted in the entryway..
- LIC 9224 Acknowledgment of Receipt of Licensing Reports was signed and place in children's file.
- LPA observed 3 children sleeping- sleep regulation was being followed

LPA advised the licensee how to access forms, regulations and quarterly updates on the Child Care Licensing Website at: www.ccld.ca.gov

At this time, the licensee is in compliance with California Code of Regulations Title 22. Therefore, no deficiencies are being cited.

A notice of site visit was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

Exit interview conducted and report was reviewed with Director Anahi Salinas.

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SUPERVISOR'S NAME: Brandi VanOostenTELEPHONE: (323) 981-3365
LICENSING EVALUATOR NAME: Roxana LopezTELEPHONE: (323) 854-5073
LICENSING EVALUATOR SIGNATURE:
DATE: 02/09/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/09/2023
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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