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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198018356
Report Date: 09/18/2019
Date Signed: 09/18/2019 06:35:56 PM

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:L.A. FIRST MONTESSORI PRESCHOOLFACILITY NUMBER:
198018356
ADMINISTRATOR:CHOE, ESTHER INJAFACILITY TYPE:
850
ADDRESS:213 S. HOBART BLVD.TELEPHONE:
(949) 233-4215
CITY:LOS ANGELESSTATE: CAZIP CODE:
90004
CAPACITY:40CENSUS: 0DATE:
09/18/2019
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
05:40 PM
MET WITH:Esther Choe. TIME COMPLETED:
06:45 PM
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Licensing Program Analyst (LPA) Seung Lee conducted an unannounced case management inspection. Upon arrival LPA Lee met with Director Esther Choe.

The purpose of the inspection was to obtain information regarding an incident involving a staff member that occurred on 09/16/2019.

During the inspection LPA Lee conducted interviews, obtained documents, and made observations in regards to the incident that occurred at 09/16/2019.

At this time, there was observed to be no violation of title 22 regulations based on the information that was obtained during the unannounced inspection.

Exit interview conducted with Director Esther Choe. Appeal rights discussed and explained. The notice of site inspection must remain posted for a period of 30 days during hours of operation. Failure to maintain posting will result in a civil penalty of $100.00 dollars.

SUPERVISOR'S NAME: Guangorena ClaudiaTELEPHONE: (323) 981-3417
LICENSING EVALUATOR NAME: Seung LeeTELEPHONE: (323) 981-3382
LICENSING EVALUATOR SIGNATURE:

DATE: 09/18/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/18/2019
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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