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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 300600679
Report Date: 09/24/2019
Date Signed: 09/24/2019 03:48:11 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
FACILITY NAME:MONTESSORI HOUSE OF CHILDRENFACILITY NUMBER:
300600679
ADMINISTRATOR:SHIRANI PERERAFACILITY TYPE:
850
ADDRESS:1239 SOUTH MAGNOLIATELEPHONE:
(714) 761-3109
CITY:ANAHEIMSTATE: CAZIP CODE:
92804
CAPACITY:26CENSUS: 8DATE:
09/24/2019
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
01:30 PM
MET WITH:Director Shirani Perara TIME COMPLETED:
04:15 PM
NARRATIVE
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Licensing Program Analysts (LPA's) Ketki Desai and Andrea Taylor conducted an unannounced Case Management (other) inspection to follow up on the citations issued during the inspection conducted on 9-19-2019.
Deficiencies issued are not cleared as the corrections required are pending at the time of inspection today.

During the inspection LPA's observed 8 children in the designated Preschool classroom. Three of the eight children were preschool aged while the other five children were school aged ( 6-7 years of age) They were observed to be commingling and cleaning powder tin was observed accessible to children.

Type A deficiency is being cited per Title 22 section 101161(a) previously cited in 12/14/2016/ 11/25/2014 / 12/17/2010 and 12/2/1/2006. Licensee have been instructed repeatedly to ensure their is no commingling between School age and Preschool children at any given time.

Upon receipt of this report documenting a Type A deficiency, the licensee shall do the following:
1. Post the Notice of Site visit and any licensing report documenting a Type “A” deficiency.
2. The report and the Notice of Site visit shall be posted for 30 consecutive days. Failure to maintain posting as required, will result in an immediate $100 civil penalty.
3. 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).
4. The Acknowledgement form (LIC 9224) must be maintained in each child’s file immediately upon receipt from parent. A copy of the parent Acknowledgement of Receipt of Licensing Reports Form was provided during this visit.

Exit interview conducted and appeal rights were given to the Licensee.

SUPERVISOR'S NAME: Patricia MaganaTELEPHONE: (714) 703-2821
LICENSING EVALUATOR NAME: Ketki DesaiTELEPHONE: (714) 743-8635
LICENSING EVALUATOR SIGNATURE:

DATE: 09/24/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/24/2019
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME: MONTESSORI HOUSE OF CHILDREN
FACILITY NUMBER: 300600679
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/24/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
09/25/2019
Section Cited

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Limitations on Capacity and Ambulatory Status: The licensee shall not exceed the conditions, limitations and capacity specified in the license. The above requirement is not met by observing 5 school children with 3 preschool age children in the same classroom
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This is an immediate risk to Health and Safety to children in care. This is a repeated citation issued earlier in 2006/ 2010 /2014 and 2016.
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Type A
09/25/2019
Section Cited

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Building anf grounds: Disinfectants, cleaning solutions, poisons and other items that could pose a danger if readily available to children shall be stored where inaccessible to children.
The above requirement is not met by evidence of observing a cleaning supply
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(Comet powder) tin under the sink, which was unlocked and accessible to children. This is a potential risk to Health and Safety to children in care.
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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: Patricia MaganaTELEPHONE: (714) 703-2821
LICENSING EVALUATOR NAME: Ketki DesaiTELEPHONE: (714) 743-8635
LICENSING EVALUATOR SIGNATURE:
DATE: 09/24/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/24/2019
LIC809 (FAS) - (06/04)
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