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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198011043
Report Date: 03/19/2024
Date Signed: 03/19/2024 04:26:37 PM


Document Has Been Signed on 03/19/2024 04:26 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: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: 9DATE:
03/19/2024
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
01:30 PM
MET WITH:Gabriela DominguezTIME COMPLETED:
02:45 PM
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On 03/19/2024 at 1:30 pm, Licensing Program Analysts (LPAs) Crystal Green and Roxana Lopez conducted an unannounced case management other inspection. Licensing staff met with the Facility Representative Gabriela Dominguez and Zafira Firdosy. A census was obtained.

The reason for today’s inspection is due to the Monterey Park Regional Office received an application request to change the licensed capacity. During this inspection, Licensing staff inspected the facility licensed areas and consulted with facility representatives regarding compliance. Licensing staff also obtained measurements of the existing licensed areas. LPA Green informed facility representative that the application is still under review.

An exit interview was conducted, and the report was reviewed with the Facility Representative, Gabriella Dominguez.

A notice of site visit was given to the facility representative and must remain posted on, or immediately adjacent to, the interior side of the main door for 30 days.
SUPERVISOR'S NAME: Monica CuddyTELEPHONE: (916) 936-5444
LICENSING EVALUATOR NAME: Crystal GreenTELEPHONE: (323) 980-4930
LICENSING EVALUATOR SIGNATURE:
DATE: 03/19/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/19/2024
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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