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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198018405
Report Date: 07/31/2020
Date Signed: 07/31/2020 04:02:24 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:KEYSTONE MONTESSORI PRESCHOOLFACILITY NUMBER:
198018405
ADMINISTRATOR:BHAGYA WIJEWARDANEFACILITY TYPE:
850
ADDRESS:7056 WASHINGTON AVE.TELEPHONE:
(562) 303-7273
CITY:WHITTIERSTATE: CAZIP CODE:
90602
CAPACITY:45CENSUS: 5DATE:
07/31/2020
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
02:15 PM
MET WITH:Bhagya WijewardaneTIME COMPLETED:
04:15 PM
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Licensing Program Analyst (LPA) Seung Lee and Michelle Sanchez conducted a case management inspection. LPAs met with Director Bhagya Wijewardane who provided a tour of the facility.

The purpose of the inspection was to measure the additional indoor and outdoor activity space added. The facility has a pending capacity increase application. The facility is adding a toddler component with 15 children to the existing license. Fire clearance for the additional space has been approved and was received by the Monterey Park Regional office.

LPAs observed that the indoor and outdoor activity space had its own entry and exit. The additional space was 1 classroom and a small yard that is fenced. The Director stated that she will ensure that the toddler component does not commingle with the existing preschool program. The toddler classroom was observed to have a toilet for children that are potty training. The changing table was within arms reach of the sink inside the classroom..

During the inspection the indoor activity space came out have enough space for 11 children, the outdoor space came out to 8 children, The classroom had 1 sink and 1 toilet which allows for 15 children. Fire clearance has been approved for 15 children. Based on the measurements taken during the inspection the additional capacity of 8 toddlers will be granted to the existing license. The Director understands that the facility will need to wait for the application to be approved before operating under the new capacity.

Exit interview conducted with Director Bhagya Wijewardane. 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: 07/31/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/31/2020
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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