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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198019433
Report Date: 12/09/2025
Date Signed: 12/09/2025 03:16:31 PM

Document Has Been Signed on 12/09/2025 03:16 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 SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME:HONEYCOMB MONTESSORIFACILITY NUMBER:
198019433
ADMINISTRATOR/
DIRECTOR:		THAMARA WITHANAFACILITY TYPE:
850
ADDRESS:20126 PIONEER BLVDTELEPHONE:
(562) 402-8111
CITY:CERRITOSSTATE: CAZIP CODE:
90703
CAPACITY: 19TOTAL ENROLLED CHILDREN: 14CENSUS: 14DATE:
12/09/2025
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:55 AM
MET WITH:Facility RepresentativeTIME VISIT/
INSPECTION COMPLETED:
03:35 PM
NARRATIVE
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On 12/09/2025, at 8:55am, Licensing Program Analyst (LPA) Jonnisha Culbert conducted an unannounced inspection at the facility noted above. LPA met with facility representative, provided them with an Entrance Checklist – Child Care Centers (LIC 125), and stated the purpose of the visit. The purpose of today’s visit is to conduct an annual/random inspection. The facility is licensed to serve 19 children. Per facility representative, the program operates Monday through Friday from 7:30 am to 5:30 pm. Present at the time of today’s inspection were facility representative, teacher, and 14 children.

The following documents are posted in a prominent, publicly accessible area: Facility License, Menu, Child Passenger Restraint System Poster (PUB 269), Notification of Parents' Rights (PUB 393), Emergency Disaster Plan (LIC 610), Personal Rights (LIC 613A), and Daily Activity Schedule. LPA reminded facility representative to include the the date on the menus.

Furniture and equipment were inspected for age appropriateness and good repair. LPA observed age-appropriate chairs, tables, and learning material. Telephone service, heating, lighting, and ventilation were evaluated to ensure that a comfortable environment can be provided. Sinks and toilets were inspected for availability and good repair. General sanitation was observed. Per facility representative, when children become ill, they isolate them from the rest of the children until they are picked up by parents. LPA observed that there is a separate restroom for staff that may be used if an ill child requires it.

Availability of indoor and outdoor drinking water was observed in the classroom via water jug. Per representative, water is provided through water bottles. LPA observed two accessible water bubblers in the back of the classroom near the restroom. LPA verified water lead testing results and observed that the water

NAME OF LICENSING PROGRAM MANAGER: Warren Birks
NAME OF LICENSING PROGRAM ANALYST: Jonnisha Culbert
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 12/09/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/09/2025
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.

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Document Has Been Signed on 12/09/2025 03:16 PM - It Cannot Be Edited


Created By: Jonnisha Culbert On 12/09/2025 at 12:54 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 CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: HONEYCOMB MONTESSORI
FACILITY NUMBER: 198019433

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/09/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type A
Section Cited
HSC
1597.16(a)(1)
Lead Testing
(1) A licensed child day care center, as defined in Section 1596.76, that is located in a building that was constructed before January 1, 2010, shall have its drinking water tested for lead contamination levels on or after January 1, 2020, but no later than January 1, 2023, and every five years after the date of the initial test.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on interview and observation, the licensee did not comply with the section cited above and the drinking water was not tested for lead contamination levels. Per facility representative, they sometimes use the water from the bubbler. This poses an immediate health, safety or personal rights risk to persons in care.
POC Due Date: 12/09/2025
Plan of Correction
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Per facility representative, they will cover the bubbler until the water is tested. LPA observed that a plastic bag was placed over the bubbler to prevent people from accessing the water.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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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.
Warren Birks
NAME OF LICENSING PROGRAM MANAGER:
Jonnisha Culbert
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 12/09/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/09/2025


LIC809 (FAS) - (06/04)
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Document Has Been Signed on 12/09/2025 03:16 PM - It Cannot Be Edited


Created By: Jonnisha Culbert On 12/09/2025 at 12:54 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 CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: HONEYCOMB MONTESSORI
FACILITY NUMBER: 198019433

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/09/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
HSC
1596.8662(b)(1)
Administration of Child Day Care Licensing
(1) On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child day care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training provided pursuant to paragraphs (2) and (3) of subdivision (a), and shall complete renewal mandated reporter training every two years following the date on which he or she completed the initial mandated reporter training.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on record review and interview, the licensee did not comply with the section cited above in one out of three staff file’s reviewed was missing a valid mandated reporter completion certificate. During file review, LPA observed that staff 1’s mandated reporter certificate expired on 03/26/2025. Per staff 1, they cannot remember when they completed the training. This poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 01/09/2026
Plan of Correction
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Per staff 1, they will email a valid mandated reporter completion certificate to LPA J. Culbert by plan of correction date.
Type B
Section Cited
HSC
1596.7995(a)(1)
General Provisions and Definitions
(1) Commencing September 1, 2016, a person shall not be employed or volunteer at a day care center if he or she has not been immunized against influenza, pertussis, and measles. Each employee and volunteer shall receive an influenza vaccination between August 1 and December 1 of each year.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on interview and observation, the licensee did not comply with the section cited above in one out of three staff members who were missing the required immunizations. During record review, LPA observed that staff 2 was missing immunization against pertussis and measles. This poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 01/09/2026
Plan of Correction
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Per staff 2, they will obtain their immunization records that include immunization against pertussis and measles and email them to LPA J. Culbert by plan of correction date.
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
Warren Birks
NAME OF LICENSING PROGRAM MANAGER:
Jonnisha Culbert
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 12/09/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/09/2025


LIC809 (FAS) - (06/04)
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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
MONTEREY PARK SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: HONEYCOMB MONTESSORI
FACILITY NUMBER: 198019433
VISIT DATE: 12/09/2025
NARRATIVE
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test was not completed in accordance with written directive outlined in Provider Information Notification (PIN) 21-21.1-CCP. Per facility representative, they have not scheduled a date for the test. This is an immediate risk to health, safety, or personal rights to persons in care.

Disinfectants, cleaning solutions, and other items that are hazardous to children, were made inaccessible. Disinfectants and cleaning solutions are inside of an inaccessible cabinet in the restroom. Per facility representative, there is no medication on the premises. LPA did not observe poisons such as bug spray and weed killers. Per facility Representative, an exterminator comes once a month on the weekend to spray. LPA reminded the facility representative that if poisons are purchased, they are to remain in an area that is locked and inaccessible to children.

LPA checked for safety items. The facility has carbon monoxide and smoke detectors that were tested and are operable. The fire extinguisher is fully charged, and the disaster drill log is posted. LPA observed that the last drill was conducted on 07/11/2025. LPA reminded facility representative that drills are to be conducted and logged every six months. First Aid supplies were observed and are kept inside of a backpack in the classroom.

The playground was evaluated. LPA observed all areas around and under high climbing equipment, and similar equipment are cushioned with rubber chips. The playground has adequate shade. Availability of outdoor drinking water was observed. Per facility representative, there are no pools or bodies of water at the premises.

Menus are posted where it is visible by the child's authorized representative. Per facility representative, parents provide their children with snacks and meals. LPA reminded facility representative that Full-day programs shall offer midmorning and a midafternoon snack.

Children’s files and records were reviewed for completeness. During file review, LPA observed that two out of two children’s files reviewed were complete. Children's roster was reviewed and is current. LPA observed that parents sign children in and out on sign in sheets.

Staff files were reviewed for completeness. During file review, LPA observed that required documents were missing from staff files. Staff 1 was missing a valid mandated reporter completion certificate and health

NAME OF LICENSING PROGRAM MANAGER: Warren Birks
NAME OF LICENSING PROGRAM ANALYST: Jonnisha Culbert
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 12/09/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/09/2025
LIC809 (FAS) - (06/04)
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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
MONTEREY PARK SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: HONEYCOMB MONTESSORI
FACILITY NUMBER: 198019433
VISIT DATE: 12/09/2025
NARRATIVE
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screening form (Lic 503). Staff 2 was missing immunizations. This is a potential health and safety risk to persons in care.

Facility Representative was reminded that all adults 18 and over, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a Child Care Center. A civil penalty of $100.00 minimum/day for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.

Assembly Bill (AB) 2370, Chapter 676, Statutes of 2018, requires all licensed Child Care Centers (CCCs) constructed before January 1, 2010, to test their water (used for drinking and food preparation) for lead contamination before January 1, 2023, and then every 5-years after the date of the first test.

For child care center licenses issued after July 1, 2022, the licensee shall test their water for lead within 180 days of licensure pursuant to Written Directives section 101700 (PIN 21-21.1- CCP).

CCC DID NOT COMPLETE TESTING PRIOR TO THEIR DEADLINE.

Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN22-02-CCP. When any IMS is provided, a Plan for Providing IMS must be submitted to the Department. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA information Line at (800)514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/resources/child-care-centers/.

LPA Jonnisha Culbert informed facility representative to provide a copy of this licensing report dated 12/09/2025 that documents one Type A citation which shall be posted for 30 consecutive days as there is immediate risk to the health, safety, or personal rights of children in care.

Also, LPA Jonnisha Culbert informed the facility representative to provide a copy of this licensing report dated 12/09/2025 that documents one Type A citation to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardian for 12

NAME OF LICENSING PROGRAM MANAGER: Warren Birks
NAME OF LICENSING PROGRAM ANALYST: Jonnisha Culbert
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 12/09/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/09/2025
LIC809 (FAS) - (06/04)
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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
MONTEREY PARK SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: HONEYCOMB MONTESSORI
FACILITY NUMBER: 198019433
VISIT DATE: 12/09/2025
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months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification.

The facility representative was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

To improve the quality and value of the new inspection process, a survey may be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or CARE tools, please send email inquiries to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/inspection-process.

LPA provided the facility representative with appeal rights.

A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with the facility representative.

NAME OF LICENSING PROGRAM MANAGER: Warren Birks
NAME OF LICENSING PROGRAM ANALYST: Jonnisha Culbert
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 12/09/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/09/2025
LIC809 (FAS) - (06/04)
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