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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198013166
Report Date: 02/09/2024
Date Signed: 02/09/2024 03:30:29 PM


Document Has Been Signed on 02/09/2024 03:30 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 PUENTEFACILITY NUMBER:
198013166
ADMINISTRATOR:MEGHA SAHNIFACILITY TYPE:
850
ADDRESS:846 N. ORANGE AVENUETELEPHONE:
(626) 917-3638
CITY:LA PUENTESTATE: CAZIP CODE:
91744
CAPACITY:138CENSUS: 58DATE:
02/09/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
12:25 PM
MET WITH:Melissa VillarealTIME COMPLETED:
03:50 PM
NARRATIVE
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On February 9, 2024, Licensing Program Analyst (LPA) Carolyn Tuba conducted a case management inspection due to an incident that occurred at the facility on 1/23/2024. LPA met with Director, Melissa Villareal who guided LPA on a tour to obtain the census of 58 children with 6 staff during nap time. LPA conducted interviews with Director and Staff #1 (S1) who witnessed the incident and Child #1 (C1).

The facility had self-reported the incident to the Department, however the incident was not reported to the Department within the required 24 hours of occurrence, as the date of the incident was on 1/23/2024 and Unusual Incident Report (UIR) was received via email on 1/26/2024. The incident consisted with a child having been grabbed by the arm by a staff member in a rough manner, but there were no injuries sustained that required medical attention.


LPA conducted interviews with the S1 who observed the incident and with C1 and both collaborated regarding the incident. Staff #2 (S2) who was involved with the incident was not available to interview. Director stated that they conducted their own internal investigation and had placed S2 on administrative leave. S2 decided to resign from the facility on 1/24/2024. Director and S1 both confirmed that a discussion was conducted with each staff member on 1/24/2024 on the Licensing Regulations of Children’s Personal Rights and the Hands-off Policy of the school.


The following deficiency listed on the attached LIC 809 (deficiency page) are being cited in accordance with California Code of Regulations Title 22. Deficiency that are being cited 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.

Exit interview conducted and report was reviewed with the Preschool Director, Melissa Villareal.
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SUPERVISOR'S NAME: Ana ChicoTELEPHONE: (323) 981-3374
LICENSING EVALUATOR NAME: Carolyn TubaTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:
DATE: 02/09/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/09/2024
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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Document Has Been Signed on 02/09/2024 03:30 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
CCLD Regional Office, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754


FACILITY NAME: MONTESSORI ACADEMY OF LA PUENTE
FACILITY NUMBER: 198013166

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/09/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
02/09/2024
Section Cited
CCR
101212

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101212 Reporting Requirements (d) Upon the occurrence, during the operation of the child care center of any of the events specified in (d) (1) below, a report shall be made to the Department by telephone or fax within the Department's next working day and
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LPA had a consultation with the Director and went over reporting requirements. Reporting 24 hours by telephone, email or fax.
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during its normal business hours...... This requirement was not met as evidence by record review. The facility sent the report via email on 1/26/2024 and the incident occurred on 1/23/2024, which poses/posed a potential health, safety or personal rights risk to persons in care.
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Type B
02/09/2024
Section Cited
CCR101223

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101223 Personal Rights (3) To be free from corporal or unusual punishment, infliction of pain, humiliation, intimidation, ridicule, coercion, threat, mental abuse or other actions of a punitive nature including but not limited to: interference....
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Director conducted discussion with each staff member on 1/24/2024 on the Licensing Regulations of Children’s Personal Rights and the Hands-off Policy of the school. LPA were send Director additional training videos on Personal Rights.
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 This requirement was not met as evidence by interviews. Staff memebr grabbed a child by the arm in a forceful way, which poses/posed a potential health, safety or personal rights risk to persons in care.
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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: Carolyn TubaTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:
DATE: 02/09/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/09/2024
LIC809 (FAS) - (06/04)
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