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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198015474
Report Date: 06/10/2021
Date Signed: 06/10/2021 11:24:44 AM

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:MONTROSE CHRISTIAN MONTESSORI SCHOOLFACILITY NUMBER:
198015474
ADMINISTRATOR:RIMA CHRISTINA DIBIEFACILITY TYPE:
850
ADDRESS:2545 HONOLULU AVENUETELEPHONE:
(818) 249-2319
CITY:MONTROSESTATE: CAZIP CODE:
91020
CAPACITY:105CENSUS: 27DATE:
06/10/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
08:40 AM
MET WITH:Rima Dibie - DirectorTIME COMPLETED:
11:30 AM
NARRATIVE
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Licensing Program Analyst (LPA) Nolan Tcheng conducted an unannounced random inspection. Upon arrival at 8:40AM LPA met with Office Manager Lucy Thompson. This is a preschool program which consists of 4 classrooms. At 8:45am, LPA was met by Director Rima Dibie. All areas were identified on the Facility Sketch were inspected. The following staff were observed during this visit: Room A: 6 children with 1 staff member, Room B: 10 children with 1 staff member, Room C: 8 children with 1 staff member, Room D: 3 children with 1 Staff member. Teacher-child ratios were observed to be in accordance with Title 22 regulations. Staff names were recorded. All children were observed to be under visual supervision of a teacher during tour. Licensing staff observed all required forms/publications to be posted in the office. The Licensee is within the conditions, limitations, and capacity specified on the license. Hours of operation for this facility are 7am-5:30pm, Monday to Friday.

PHYSICAL PLANT:


At 8:50am, LPA was led on a tour of the facility. Disinfectants, cleaning solutions, medication and other items that are dangerous to children, were inaccessible to children. Furniture and equipment are in good condition, free of sharp, loose, or pointed parts. All toilets, hand washing, and bathing facilities are safe, sanitary and are operating properly. All floors are clean and safe. At 8:55am, Facility was observed to have a functioning carbon monoxide detector that meets statutory requirements. At this time, due to COVID-19 precautions, children are bringing and providing their own meals and snacks. All storage containers for solid waste, including moveable bins shall have tight-fitting covers that are kept on, and in good repair. Trash cans used to discard food have tight fitting lids. LPA observed drinking water is readily available in each classroom and outdoors. The facility was observed to be free of flies, other insects and rodents. Sufficient individual storage space for children was observed and each child has a cubby. Napping equipment was observed to be in a storage closet in each classroom. At this time, the front office is used as an isolation area. A mat is available for an ill child to rest on. First Aid supplies are available and complete in each classroom. Director states there are no weapons, firearms, or bodies of water on the premises. PAGE 1 of 3
SUPERVISOR'S NAME: Christina GabelmanTELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Nolan TchengTELEPHONE: (323) 240-6201
LICENSING EVALUATOR SIGNATURE:

DATE: 06/10/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/10/2021
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC809 (FAS) - (06/04)
Page: 1 of 4
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: MONTROSE CHRISTIAN MONTESSORI SCHOOL
FACILITY NUMBER: 198015474
VISIT DATE: 06/10/2021
NARRATIVE
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OUTDOORS: Outdoor playground equipment is in safe condition, free of sharp, loose or pointed parts. The surface of the outdoor activity space is maintained in a safe condition and is free of hazards. All areas around or under high climbing equipment, swings, slides, and similar equipment are cushioned with material that absorbs a fall. There is one outside play space that has available play structures. Another outside play space observed was the grass area near classroom A and D.

FACILITY RECORDS- Sign in and out sheets were reviewed to ensure that the person who signs the child in and out uses their full legal signature and records the time of the day. These were observed outside of each classroom before entry. Staff files were reviewed for a health screening report and immunizations that meet regulatory requirements. At 9:30am, LPA observed Staff #1, 2, 3, 4, and 5 files did not have an up to date Mandated Reporter Training complete. Criminal Record Clearance for adults and verification of CPR/First Aid and health preventative practices documentation was reviewed. The name of the child care center director or fully qualified teacher(s) designated to act in the director's absence is on file. Educational background, training, and/or experience for each staff present are on file and were reviewed. A random sample of Children’s Records were reviewed to ensure that they are complete.

Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. When any IMS is provided, an updated Plan of Operation that includes IMS must be submitted to the Department. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice)/ (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm



LPA observed that a COVID-19 Technical Assistance call had been made on 07/10/2020. LPA observed health and safety practices being conducted at facility.

The deficiencies listed on the following pages were observed by the LPA and are being cited in accordance with California Code of Regulations Title 22. Please see attached LIC 809D for deficiencies that are being cited and need to be cleared to protect the children’s health & safety.

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SUPERVISOR'S NAME: Christina GabelmanTELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Nolan TchengTELEPHONE: (323) 240-6201
LICENSING EVALUATOR SIGNATURE:

DATE: 06/10/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/10/2021
LIC809 (FAS) - (06/04)
Page: 2 of 4
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: MONTROSE CHRISTIAN MONTESSORI SCHOOL
FACILITY NUMBER: 198015474
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/10/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
06/24/2021
Section Cited

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On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child care provider, administrator, or employee of a licensed child day care facility...shall complete renewal mandated reporter training every two years following the date on which he or she completed the initial mandated reporter training.
This requirement was not met as evidenced by:
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Based on evidence and observation, Staff #1, 2, 3, 4,and 5 have mandated reproter certificates in their file that expired in 2020. This poses a potential risk to the health, safety, and personal rights of children 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: Christina GabelmanTELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Nolan TchengTELEPHONE: (323) 240-6201
LICENSING EVALUATOR SIGNATURE:
DATE: 06/10/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/10/2021
LIC809 (FAS) - (06/04)
Page: 3 of 4
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: MONTROSE CHRISTIAN MONTESSORI SCHOOL
FACILITY NUMBER: 198015474
VISIT DATE: 06/10/2021
NARRATIVE
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The Notice of Site Visit (LIC 9213) – must remain posted for 30 days during the hours of operation after each site visit by a licensing representative. Failure to maintain posting as required will result in a civil penalty of $100.00.

Exit interview was conducted with Director Rima Dibie at 11:10am, including, but not limited to Provider Rights, Appeal Procedures and Agency’s Consultative Role.
SUPERVISOR'S NAME: Christina GabelmanTELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Nolan TchengTELEPHONE: (323) 240-6201
LICENSING EVALUATOR SIGNATURE:

DATE: 06/10/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/10/2021
LIC809 (FAS) - (06/04)
Page: 4 of 4