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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 300600679
Report Date: 09/30/2019
Date Signed: 09/30/2019 04:41:32 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: 0DATE:
09/30/2019
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
03:50 PM
MET WITH:Administrator Shirani PereraTIME COMPLETED:
04:50 PM
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An unannounced Case Management- POC inspection was conducted today following the Annual inspection conducted on September 19th 2019.
On today's inspection LPA Desai observed the front play yard, still has a barrier tape across it making it inaccessible to children as the remolding project is in progress. Licensee has send out a notification letter as a part of POC to the Department.
Several of the deficiencies are being cleared on this inspection conducted today.
No children were present.

No deficiencies cited on today's inspection.

Upon receipt, Director Sharani Perara posted the Notice of Site Visit. The Notice of Site Visit shall be posted for thirty (30) consecutive days.

Failure to maintain posting as required will result in a $100 civil penalty.

An exit interview has been conducted with, and a copy of this report has been signed by and provided to Director.

Appeal Rights provided and explained to the Director.

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

DATE: 09/30/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/30/2019
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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