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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198015235
Report Date: 03/17/2022
Date Signed: 03/17/2022 02:20:06 PM


Document Has Been Signed on 03/17/2022 02:20 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:PENNSYLVANIA AVENUE MONTESSORI PRESCHOOLFACILITY NUMBER:
198015235
ADMINISTRATOR:VARDUHI HAREYANFACILITY TYPE:
850
ADDRESS:3966 PENNSYLVANIA AVENUETELEPHONE:
(818) 231-5605
CITY:LA CRESCENTASTATE: CAZIP CODE:
91214
CAPACITY:56CENSUS: 25DATE:
03/17/2022
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
02:00 PM
MET WITH:Sondra Wise. Director/LienseeTIME COMPLETED:
02:30 PM
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Licensing Program Analyst (LPA) Anomeh Eivazian conducted an unannounced case management inspection on 3/17/2022 at 2:00 PM to ensure that the Type B deficiencies cited on 03/03/2022 have been cleared. LPA met with Sondra Wise, licensee who guided analyst tour of the facility. Total of 25 preschoolers with 6 staff were present during this inspection. The following has been observed:
  • LPA observed staff#4 completed mandated reporter training on 03/14/2022, certificate on file.
  • Staff#2 has criminal record clearance on Licensing Information System (LIS).
  • Staff#5 has health screening form LIC503 on file.

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

LPA cleared deficiencies on this date and provided a copy of the Licensing Report to Sondra Wise, Licensee, and issued POC clearance letter.

At this time, the licensee is in compliance with California Title 22 Regulations. Therefore, there are no citations being issued today from the areas that were inspected today.

Exit interview conducted and report was reviewed with the Licensee, Sondra Wise 2:30 p.m.
SUPERVISOR'S NAME: Christina GabelmanTELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Anomeh EivazianTELEPHONE: (323) 981-3391
LICENSING EVALUATOR SIGNATURE:
DATE: 03/17/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/17/2022
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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