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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198011043
Report Date: 10/27/2023
Date Signed: 10/27/2023 03:36:35 PM


Document Has Been Signed on 10/27/2023 03:36 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:TELSTAR MONTESSORI CHILD CARE CENTERFACILITY NUMBER:
198011043
ADMINISTRATOR:GABRIELA DOMINGUEZFACILITY TYPE:
830
ADDRESS:9320 TELSTAR AVENUETELEPHONE:
(626) 569-2640
CITY:EL MONTESTATE: CAZIP CODE:
91731
CAPACITY:15CENSUS: 10DATE:
10/27/2023
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
02:00 PM
MET WITH:Director Gabby Dominguez TIME COMPLETED:
02:30 PM
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Licensing Program Analysts (LPA) Roxana Lopez conducted an unannounced poc (plan of correction) inspection to insured that the 2 Type A's deficiencies cited and 1 Type B deficiency cited on 10/10/2023 have been cleared.

LPA met with Gabby Dominguez, Director who guided analyst on a tour of the facility. There were 10 children present during this inspection. The following was observed:

- No loose items on cribs were observed

- No infants in care were swaddled- or laying on boppy pillows

- Sleeping infants were observed to be sleeping in designated sleeping area

- Signed LIC 9224 Acknowledgment forms available for review

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

LPA cleared deficiency on this date and provided a copy of the Licensing Report to Gabby Dominguez, Director. LPA’s issued POC clearance letter during the visit.

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 Gabby Dominguez. --------------------------------------------------- pg. 1 of 1 ----------------------------------------------------------------

SUPERVISOR'S NAME: Brandi VanOostenTELEPHONE: (323) 981-3365
LICENSING EVALUATOR NAME: Roxana LopezTELEPHONE: (323) 854-5073
LICENSING EVALUATOR SIGNATURE:
DATE: 10/27/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/27/2023
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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