198013166-9-7-2023-33-CC-CTUA-CVFU6C-20230907151806

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198013166
Report Date: 09/07/2023
Date Signed: 09/07/2023 03:18:09 PM

Document Has Been Signed on 09/07/2023 03:18 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:	MONTESSORI ACADEMY OF LA PUENTE		FACILITY NUMBER:	198013166
ADMINISTRATOR:	MEGHA SAHNI		FACILITY TYPE:	850
ADDRESS:	846 N. ORANGE AVENUE		TELEPHONE:	(626) 917-3638
CITY:	LA PUENTE	STATE: CA	ZIP CODE:	91744
CAPACITY:	138	CENSUS: 50	DATE:	09/07/2023
TYPE OF VISIT:	Case Management - Incident	UNANNOUNCED	TIME BEGAN:	01:30 PM
MET WITH:	Yolanda Vela & Melissa Villareal		TIME COMPLETED:	03:25 PM

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On September 7, 2023, Licensing Program Analyst (LPA) Carolyn Tuba conducted a case management inspection due to an incident that occurred at the facility on 5/11/2023. LPA met with Infant Director, Yolanda Vela and 5 minutes later Preschool Director, Melissa Villareal arrived and guided LPA on a tour to obtain the census of 50 children with 9 staff during nap time. LPA conducted interviews with Directors and staff who witnessed the incident. LPA was provided the incident report given to parents.

The incident was reported to the Department within the required 24 hours of occurrence. The incident consisted with a child having an injury that required medical attention.

At approximately 4:45 pm on 5/11/2023 an incident occurred at the playground at the above facility. LPA conducted interviews with the staff who observed the incident and the Infant Director who assisted with medical attention. Child who sustained injury was not available, as they no longer attend the school. There were 7 to 8 children present and 1 staff. Staff witnessed child walking up the play structure steps and lost footing and tripped on the steps that lead towards the slide. This caused the child to bump near his forehead and sustained a cut that was close to an inch over the left eyebrow. There was bleeding and pressure was placed. The office staff called 911 and EMTs arrived at approximately at 4:50 pm. Parent of the child was also called and since parent had not arrived yet, EMTs suggested to have child transported to the local Hospital. Infant Director rode with the child in the ambulance and assisted at the hospital until parent arrived. LPA took a photo of the play structure. Child received 3 stitches and hospital would be removing stitches after 7 days. Parent decided to keep child home. Based on all the information obtained, LPA found that the incident was an accident, and the child has recovered after injury.

No deficiencies were cited regarding today’s inspection.

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

Exit interview conducted and report was reviewed with the Preschool Director, Melissa Villareal.
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SUPERVISOR'S NAME: Ana Chico	TELEPHONE: (323) 981-3374
LICENSING EVALUATOR NAME: Carolyn Tuba	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:	DATE: 09/07/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/07/2023

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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