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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198016502
Report Date: 11/18/2024
Date Signed: 11/18/2024 02:42:49 PM

Document Has Been Signed on 11/18/2024 02:42 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
MONTEREY PARK CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME:BEYOND THE CLASSROOM, INC.FACILITY NUMBER:
198016502
ADMINISTRATOR/
DIRECTOR:		SAMANTHA MONTESFACILITY TYPE:
840
ADDRESS:304 PASADENA AVENUETELEPHONE:
(323) 449-4058
CITY:SOUTH PASADENASTATE: CAZIP CODE:
91030
CAPACITY: 60TOTAL ENROLLED CHILDREN: 60CENSUS: 39DATE:
11/18/2024
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:58 PM
MET WITH:Sanantha Montes TIME VISIT/
INSPECTION COMPLETED:
03:00 PM
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On 11/18/24 , at 2:00 pm, Licensing Program Analyst(LPA) Shushanik Safaryan conducted an unannounced Case Management inspection to the above facility to ensure Type B deficiencies cited on 10/15/24 have been cleared. Upon arrival, LPA met with Facility Representative , Samantha Montes ,to whom the reason of the visit was explained . Tour was provided . During the tour ,LPA observed 39 children with 4 staff members .

During the visit, LPA toured the facility . During the tour LPA did not observed couch . Per Facility representative, couch was removed and not accessible to the children. Next LPA observed carpet with stains was removed and water dispenser was cleaned .

During the visit, LPA cleared deficiency cited on 10/15/24 and provided a copy of the Licensing Report to Licensee and issued POC clearance letter.


The Notice of Site Visit (LIC 9213) was given and must remain posted for 30 days.
Failure to comply with posting requirements shall result in an immediate civil penalty of $100.
Brandi VanOostenTELEPHONE: (323) 854-8930
Shushanik SafaryanTELEPHONE: (323) 981-3350
DATE: 11/18/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/18/2024
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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