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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198015474
Report Date: 07/22/2021
Date Signed: 07/22/2021 11:49:34 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: 33DATE:
07/22/2021
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
09:40 AM
MET WITH:Lucy Thompson, Office ManagerTIME COMPLETED:
12:10 PM
NARRATIVE
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Licensing Program Analyst (LPA), Anomeh Eivazian, conducted an unannounced case-management inspection to the above facility on 07/22/2021 at 9:37 a.m.. LPA met with Lucy Thompson, office manager who guided LPA on a tour of the facility. During this inspection there were total of 33 children present in the facility. During this inspection Rima Dibie, director was also present. Currently Rima Dibie is a teacher in Kindergarten classroom.

On 06/24/2021 between 8:15 a.m. and 8:45 a.m. , LPA Eivazian observed Elementary children, Kindergartners and preschoolers commingled in RM A.

Based on staff#1, staff#2, and staff #3 interviews conducted on 06/24/2021, elementary children and kindergarteners commingled with preschoolers early in the morning between 8:00 a.m. to 8:30 a.m., until each classroom teachers came to take their students to their classrooms.

The following are being cited in accordance to Title 22 of the California Code of Regulations. Please refer to 809D for cited deficiencies.



Upon receipt of this report, the Licensee shall post the Notice of Site visit and any licensing report documenting a type “A” deficiency. The report and the Notice of Site visit shall be posted for 30 consecutive days. Failure to maintain posting as required, will result in an immediate $100 civil penalty. A copy of this report shall be provided to the parent/guardian of children currently enrolled by the next business day or immediately upon return. A copy of this report shall also be provided to the parent/guardian of any newly enrolled children for the next 12 months (1 year). The Acknowledgement form must be maintained in each child’s file immediately upon receipt from parent. Licensee was provided with a copy of the parent Acknowledgement of Receipt of Licensing Reports Form during this visit. A copy of the Parent Notification Requirements was also provided to the licensee
Exit interview was conducted with Rima Dibi, director at 12:10 p.m.. Appeal Rights procedures explained.
SUPERVISOR'S NAME: Christina GabelmanTELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Anomeh EivazianTELEPHONE: (323) 981-3391
LICENSING EVALUATOR SIGNATURE:

DATE: 07/22/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/22/2021
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: MONTROSE CHRISTIAN MONTESSORI SCHOOL
FACILITY NUMBER: 198015474
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/22/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
07/22/2021
Section Cited

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Indoor Activity Space for School-Age Children.
In combination programs, indoor activity space provided for school-age child care center children shall be physically separated etc...

This requirement was not met as evidenced by…
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Based on LPA Eivazian observation on 06/24/21 and staff interviews, school age children commingled with preschoolers in RM A between 8:00 a.m. to 8:30 a.m..
This poses an immediate health and safety risk to the 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: Anomeh EivazianTELEPHONE: (323) 981-3391
LICENSING EVALUATOR SIGNATURE:
DATE: 07/22/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/22/2021
LIC809 (FAS) - (06/04)
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