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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 300600679
Report Date: 10/01/2019
Date Signed: 10/01/2019 05:33:41 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: DATE:
10/01/2019
TYPE OF VISIT:OfficeUNANNOUNCEDTIME BEGAN:
03:15 PM
MET WITH:Shirani PereraTIME COMPLETED:
05:45 PM
NARRATIVE
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An In Office Meeting was conducted by Regional Manger, Bertha Manzanares , Licensing Program Manager Patricia Magana and Licensing Program Analysts Ketki Desai and Ryan Chan.

The purpose for the Office Meeting was to addressed issues that arose during Non-compliance meeting.

During the meeting Licensee indicated she operates a private school under the name of Montessori House of Children that has been operating since 1972. Licensee has been the Teacher for the private school since 2000, the hours of operation for the private school is 9:00 a.m. to 2:30 p.m. Licensee is the Teacher from the private school from 9:00 a.m. to 2:30 p.m..

Licensee also considers herself to be a Director & Teacher for the preschool; however does acknowledge that during the hours of 9:00 a.m. to 2:30 p.m. there is no Director for the Preschool. The only staff in the Preschool during 9:00 a.m. to 2:30 p.m is Staff #1.

During the meeting the Licensee also acknowledge she does not provide snacks to the day-care children. According to Licensee the Parents are responsible in bring their own snacks. According to Licensee since 2014 is when Parents began bring snacks for their children.

The following are being cited in accordance to Title 22 regulations and California Health & Safety Code.
SUPERVISOR'S NAME: Patricia MaganaTELEPHONE: (714) 703-2821
LICENSING EVALUATOR NAME: Ketki DesaiTELEPHONE: (714) 743-8635
LICENSING EVALUATOR SIGNATURE:

DATE: 10/01/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/01/2019
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC809 (FAS) - (06/04)
Page: 1 of 4
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: 10/01/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
10/03/2019
Section Cited

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Food Services: Full-day programs shall offer a midmorning and a midafternoon snack.
The above requirement is not met by evidence of Facility being a full day program does not serve the Mid morning or Mid Afternoon snacks. This is a potential risk to H&S 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: 10/01/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/01/2019
LIC809 (FAS) - (06/04)
Page: 2 of 4
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: 10/01/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
10/15/2019
Section Cited

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Child Care Director: The child care center director shall not accept outside employment that interferes with the duties specified in this chapter.
The above requirement is not met by evidence of Licensee who is the Director for the Preschool Child care center is ,
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also a teacher in the Private school held on the same premises, during the operating hrs (9.00- 2.30PM) This is an immediate 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: 10/01/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/01/2019
LIC809 (FAS) - (06/04)
Page: 3 of 4
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
VISIT DATE: 10/01/2019
NARRATIVE
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1) Provide a copy of this report 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).
2) Obtain signature and date from the child's parent/guardian on the Acknowledgement of Receipt of Licensing Reports LIC 9224.
3) Keep a record immediately upon receipt of the completed and signed LIC 9224 acknowledging receipt of this report in the child's file.
4)Copies of this Non-Compliance Summary shall be provided to parents/guardians of children in care at the facility and to parents/guardians of children newly enrolled at the facility during the next 12 months.
The Acknowledgment of receipt form (LIC9224) shall be given to and signed by each parent with copies maintained in each child's file.
SUPERVISOR'S NAME: Patricia MaganaTELEPHONE: (714) 703-2821
LICENSING EVALUATOR NAME: Ketki DesaiTELEPHONE: (714) 743-8635
LICENSING EVALUATOR SIGNATURE:

DATE: 10/01/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/01/2019
LIC809 (FAS) - (06/04)
Page: 4 of 4