198013166-11-18-2020-33-CC-MGAA-BVH459-20201118174735

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198013166
Report Date: 11/18/2020
Date Signed: 11/18/2020 05:47:41 PM

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: 36	DATE:	11/18/2020
TYPE OF VISIT:	Case Management - Incident	ANNOUNCED	TIME BEGAN:	03:24 PM
MET WITH:	Director, Megha Sahni		TIME COMPLETED:	03:45 PM

NARRATIVE

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On November 18, 2020 at 3:24 p.m., Licensing Program Analyst (LPA) Mireya Garcia contacted the facility via telephone due to COVID 19 and precautionary measures in order to conduct a Case Management inspection due to an incident that occurred on/or around September 14, 2020. This inspection was conducted with Director, Megha Sahni via a tele-inspection by use of Facetime. During this tele-inspection the Director took this LPA on a virtual tour of the facility. Census was taken. The purpose of this report is to address concerns regarding Reporting Requirements.

A day care child sustained injuries on/or around September 14, 2020. The facility did not report this to the Department until September 28, 2020. During the course of the investigation, interviews were conducted with facility staff, children and other possible witnesses. A facility roster and identifying information was obtained during a subsequent visit to the facility.

During the investigation of this incident it was found that staff were not aware of how the child’s sustained questionable injuries. Facility staff failed to properly supervise child in care. Specifically, facility staff failed to notify the facility administration and the child’s authorized representative of how the child in question received injuries. A laps in communication between staff and facility administration resulted in the facility not reporting this incident as required to the Department. The facility is therefore being cited for failure to report this incident to the Department within the required 24 hours.

The deficiency listed on the following page is being cited in accordance with California Code of Regulations Title 22. Please see attached LIC 809d.

Deficiency that is being cited needs to be cleared to protect the children’s health & safety.

Report continues on next page 1 of 2.

SUPERVISOR'S NAME: Valarie Cook	TELEPHONE: (323) 981-3362
LICENSING EVALUATOR NAME: Mireya Garcia	TELEPHONE: (323) 558-2192
LICENSING EVALUATOR SIGNATURE:	DATE: 11/18/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/18/2020

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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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
	VISIT DATE: 11/18/2020

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A Notice of Site Visit was not provided to Director, Megha Sahni since a physical inspection was not conducted.

Exit interview was conducted with Director, Megha Sahni via tele-inspection, during which Appeal Rights were verbally explained to Director. A copy of this report has been signed by LPA García. This report, along with a copy of the Appeal Rights (LIC 9058) will be scanned via e-mail to Director Megha, who understands that an electronic “Read Receipt” and/or confirmation of receipt of the e-mail confirms receipt of the report and constitutes an electronic signature.

Report ends here page 2 of 2.

SUPERVISOR'S NAME: Valarie Cook	TELEPHONE: (323) 981-3362
LICENSING EVALUATOR NAME: Mireya Garcia	TELEPHONE: (323) 558-2192
LICENSING EVALUATOR SIGNATURE:	DATE: 11/18/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/18/2020

LIC809 (FAS) - (06/04)

Page: 2 of 3

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: 11/18/2020

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 11/25/2020 Section Cited	1 2 3 4 5 6 7	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 during its normal business hours. In addition, a written report containing the information specified in (d)(2) below shall be submitted to the Department within seven days following the occurrence of such event. (1) Events reported shall include the following:(B) Any injury to any child that requires medical treatment.
	8 9 10 11 12 13 14	This requirement is not met by LPA's investigation findings reveal that a day care child sustained injuries on/or around September 14, 2020. The facility did not report this to the Department until September 28, 2020. This poses a potential health and safety risk.	8 9 10 11 12 13 14
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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: Valarie Cook	TELEPHONE: (323) 981-3362
LICENSING EVALUATOR NAME: Mireya Garcia	TELEPHONE: (323) 558-2192
LICENSING EVALUATOR SIGNATURE:	DATE: 11/18/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/18/2020

LIC809 (FAS) - (06/04)

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