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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198016871
Report Date: 05/16/2024
Date Signed: 05/16/2024 05:07:50 PM


Document Has Been Signed on 05/16/2024 05:07 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:MCKINLEY MONTESSORI ACADEMYFACILITY NUMBER:
198016871
ADMINISTRATOR:RACHEL CORDOVAFACILITY TYPE:
850
ADDRESS:217 E. MCKINLEY AVENUETELEPHONE:
(909) 620-8400
CITY:POMONASTATE: CAZIP CODE:
91767
CAPACITY:75CENSUS: 32DATE:
05/16/2024
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
01:00 PM
MET WITH:Director Rachel CordovaTIME COMPLETED:
05:30 PM
NARRATIVE
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On 5/16/24 at 1:00pm, Licensing Program Analyst (LPA) Stephanie Li conducted a Case Management inspection to follow up on a UIR regarding a child wandering away from the above facility. LPA met with Director Rachel Cordova who led LPA on a tour of the facility. Census was 32 and 5 teachers.

Incident report was received stating that child had wandered away from facility at 9:20am and returned to the facility by police officer at 9:45am. Per interview with police officer Jacky Gonzalez, two bystanders noticed the child near the freeway around 9:30am and called for service. Per officer when she arrived on the scene, the child and bystanders were in the facility parking lot. Per Officer Gonzalez, mother stated that her child was special and the police car would scare him and requested her child be brought back to the school and left in their care. Officer stated, school teachers refused to talk to the officer when they received the child.

Per interview with Bystander #2, Bystander #1 stopped and got out to get the child while she called 911 (a call for service) Per Bystander #2, child ran back towards center when bystander #1 got out of vehicle. She stated child was across the street from the freeway on ramp.

According to interviews conducted, the child wandered out during transitions of teacher breaks and clean up time to breakfast. Per teacher interview, teacher #1 noticed child was missing around 9:33. When she noticed, she informed teacher #2 when teacher #2 returned from her 10 minute break. Immediately following, teacher #3 entered the room and announced that the child was in the parking lot with police officers and were asking for teacher #1.

Per interview with mother, the child exited the classroom through the staff door and out the facility through the staff only gate. Police contacted mother and child was returned to the facility at mother’s request. Facility self-reported the incident.
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SUPERVISOR'S NAME: Christina GabelmanTELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Stephanie LiTELEPHONE: (626) 366-3362
LICENSING EVALUATOR SIGNATURE:
DATE: 05/16/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/16/2024
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 3


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		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: MCKINLEY MONTESSORI ACADEMY
FACILITY NUMBER: 198016871
VISIT DATE: 05/16/2024
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LPA obtained copies of child’s records, documents and reports of incidents regarding child, and teacher records. Per teacher and director, child has history of behavioral incidents and has been requesting parent to have him assessed. Teacher stated mother has requested through her insurance and is on a waiting list. LPA took pictures of the door child exited through, the hallways leading to gate, and the staff gate child exited through. LPA took photos of route toward where Bystander #2 stated child was at when she called 911.

At this time, a Type-A deficiencies are being cited for lack of supervision and unqualified teacher. (See 809-D page) Deficiencies that are being cited need to be cleared to protect the children’s health & safety. Immediate civil penalties are being issued. (see page LIC421IM)

One (1) Type A - 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 notice of site visit was given to director and must remain posted for 30 days.

Exit interview was reviewed and appeal rights provided to Director Rachel Cordova.

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SUPERVISOR'S NAME: Christina GabelmanTELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Stephanie LiTELEPHONE: (626) 366-3362
LICENSING EVALUATOR SIGNATURE:

DATE: 05/16/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/16/2024
LIC809 (FAS) - (06/04)
Page: 2 of 3
Document Has Been Signed on 05/16/2024 05:07 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		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: MCKINLEY MONTESSORI ACADEMY
FACILITY NUMBER: 198016871

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/16/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
05/17/2024
Section Cited
CCR
101229(a)(1)

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(a) The licensee shall provide care and supervision as necessary to meet the children's needs. (1)No child(ren) shall be left without the supervision of a teacher at any time...
This requirement was not met evidenced by:
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Per director, teachers will be counting children before leaving for breaks and tranisitons. They will modify breaks so they are not during transitions. Director will email updated break schedule to LPA by 5/17/24.
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Based on incident report, interviews, and observations one child wandered away from facility and was brought back by police officer.
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Director will add door bells and alarms to the preschool doors and will add a baby gate restricting access to staff door and blind spot by 5/24/24 and send photos of installed devices via email by 5/24/24.
Type A
05/17/2024
Section Cited
CCR101216.1(c)(1)(a)

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(c) To be a fully qualified teacher...(1) Twelve...units...child development completed...include courses that cover... child growth; child, family and community... and program/curriculum.
This requirement was not met evidenced by:
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Per Director, she is not going to leave Teacher #1 alone with children. Director will send updated personnal report to LPA by 5/20/24. Per Director, she will register and pay for the teacher to complete the required course.
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Based on record review, one out of two teachers did not have the qualified units to be a fully qualified teacher. Teacher #1 was left alone with 12 children while Teacher #2 took a 10 minute break.
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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: Stephanie LiTELEPHONE: (626) 366-3362
LICENSING EVALUATOR SIGNATURE:
DATE: 05/16/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/16/2024
LIC809 (FAS) - (06/04)
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