198018405-5-2-2025-33-CC-LBAK-DGAV8N-20250502161302

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198018405
Report Date: 05/02/2025
Date Signed: 05/02/2025 04:13:10 PM

Document Has Been Signed on 05/02/2025 04:13 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
L.A. DAY CARE-EAST, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME:	KEYSTONE MONTESSORI PRESCHOOL		FACILITY NUMBER:	198018405
ADMINISTRATOR/ DIRECTOR:	NOHELLY RIOS		FACILITY TYPE:	850
ADDRESS:	7056 WASHINGTON AVE.		TELEPHONE:	(562) 303-7273
CITY:	WHITTIER	STATE: CA	ZIP CODE:	90602
CAPACITY: 53	TOTAL ENROLLED CHILDREN: 20	CENSUS: 16	DATE:	05/02/2025
TYPE OF VISIT:	Case Management - Deficiencies	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	02:30 PM
MET WITH:	Director, Nohelly Rios		TIME VISIT/ INSPECTION COMPLETED:	04:30 PM

NARRATIVE

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Licensing Program Analyst (LPA) Lilli Babcock conducted a Case Management-Deficiencies visit on 5/2/25 to address deficiencies revealed during a complaint investigation. A COVID risk assessment was conducted. LPA met with Director, Nohelly Rios, to whom the reason for the visit was explained. LPA observed six (6) children and two (2) staff present at the facility during this inspection.

On 5/2/25 LPA Babcock visited the facility to deliver findings for a complaint investigation. This facility has a preschool license and has a Toddler Component added to the preschool license for a maximum of eight toddlers.

Upon arrival at 8:40 am, LPA observed six children with two staff in Room 117. LPA asked Staff #2 for the names of the children in the room and the names were recorded. Staff #2 confirmed two of the six children present were enrolled in the toddler class and four of the children were enrolled in the preschool classes. Staff interviews conducted during the complaint investigation revealed the preschool facility has been comingling preschool children with the toddler children.

During interviews Staff #2 and Staff #3 stated the toddler children and preschool children are comingled in the morning for a half hour until the second staff arrives, and Staff #3 stated the toddler, and preschool children have napped in the same room.

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NAME OF LICENSING PROGRAM MANAGER: Brandi VanOosten
NAME OF LICENSING PROGRAM ANALYST: Lilli Babcock
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 05/02/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/02/2025

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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California Health & Human Services Agency

California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:

Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.

Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)

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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
L.A. DAY CARE-EAST, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: KEYSTONE MONTESSORI PRESCHOOL	FACILITY NUMBER: 198018405
	VISIT DATE: 05/02/2025

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Based on LPA observation and staff interviews, the following deficiency listed on the attached LIC 809D (deficiency page) is being cited in accordance with California Code of Regulations Title 22.

Deficiencies that are being cited need to be cleared to protect the children’s health and safety.

A notice of site visit was given and must remain posted for 30 days.
Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

Exit interview conducted and report was reviewed with Director, Nohelly Rios.

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NAME OF LICENSING PROGRAM MANAGER: Brandi VanOosten
NAME OF LICENSING PROGRAM ANALYST: Lilli Babcock
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 05/02/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/02/2025

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 05/02/2025 04:13 PM - It Cannot Be Edited

Created By: Lilli Babcock On 05/02/2025 at 02:43 PM

Link to Parent Document Below:

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: KEYSTONE MONTESSORI PRESCHOOL	FACILITY NUMBER: 198018405
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 05/02/2025

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 06/02/2025 Section Cited CCR 101216.4(a)(2)	1 2 3 4 5 6 7	101216.4 PRESCHOOL PROGRAM WITH TODDLER COMPONENT(a)...(2)The toddler program shall be conducted in areas physically separate from those used by older or younger children... This requirement is not met as evidenced by:	1 2 3 4 5 6 7	Director stated they will have a meeting with staff to review separation at all times between toddler and preschool children. Director will submit the agenda and what was discussed at the meeting signed by all staff who have attended and acknowledging understanding of the regulations.
	8 9 10 11 12 13 14	Based on observation and interview, the licensee did not comply with the section cited above as toddler and preschool children were observed in the same room, which poses/posed a potential health, safety or personal rights risk to persons in care.	8 9 10 11 12 13 14
	1 2 3 4 5 6 7		1 2 3 4 5 6 7
	1 2 3 4 5 6 7		1 2 3 4 5 6 7

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

	Brandi VanOosten
NAME OF LICENSING PROGRAM MANAGER:

	Lilli Babcock
NAME OF LICENSING PROGRAM ANALYST:

LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 05/02/2025

I acknowledge receipt of this form and understand my appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/02/2025

LIC809 (FAS) - (06/04)

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