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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 304371166
Report Date: 06/25/2020
Date Signed: 06/25/2020 12:56:35 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 SCHOOL OF SAN CLEMENTE, LLCFACILITY NUMBER:
304371166
ADMINISTRATOR:ROUSH, JAIMEE LYNNFACILITY TYPE:
830
ADDRESS:1141 PUERTA DEL SOLTELEPHONE:
(949) 276-4160
CITY:SAN CLEMENTESTATE: CAZIP CODE:
92673
CAPACITY:40CENSUS: 13DATE:
06/25/2020
TYPE OF VISIT:Case Management - Licensee InitiatedANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Administrator Karen McGrory TIME COMPLETED:
11:45 AM
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Licensing Program Analyst (LPA) Ketki Desai conducted an on-site prelicensing inspection at the above facility. LPA met with Facility Administrator Ms Karen McGrogy and toured the two infant classrooms.
On the pre-licensing inspection conducted in 2017, facility had four designated classrooms for infants ( Room # 1,2,3,4) and on today's inspection the capacity for infants is being decreased as the 2 rooms ( Room # 3 and 4) transformed into one big room as room # 3 which is now being added to the Pre-school license for the requested addition of Toddler option. Licensee is decreasing the Infant capacity. Only room 1 and 2 shall now provide care and supervision to infants.
Measurements of the two infant rooms and yard is as follows:
Room Length Width Area Encumbered Total space
1 7 X 11.92 83.44 275.85
15.75 X 15 236 214.17(Crib)
2 22 X 22.58 496 16.83 (cabinet) 713.44

Total indoor space: 989 divided by 35 = 28.27

Infant Yard : 39.42 X 800 = 31536 divided by 75= 420.

Based on today's measurements, facility has sufficient space for the requested capacity of 21 infants serving ages 6 weeks to 2 years old. Monday to Friday 6.30 am to 6.00 pm.

Fire clearance from Orange County Fire Authority has been received and approved for requested capacity.

Exit interview conducted. Notice of Site Visit was posted. Director was informed that the Notice of Site Visit must be posted for 30 consecutive days. Failure to post will result in civil penalties of $100.
SUPERVISOR'S NAME: Thuy HoTELEPHONE: (714) 287-8515
LICENSING EVALUATOR NAME: Ketki DesaiTELEPHONE: (714) 743-8635
LICENSING EVALUATOR SIGNATURE:

DATE: 06/25/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/25/2020
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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