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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 364842571
Report Date: 04/20/2022
Date Signed: 05/04/2022 10:10:33 AM


Document Has Been Signed on 05/04/2022 10:10 AM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501



FACILITY NAME:MONTESSORI KIDS LAND ACADEMYFACILITY NUMBER:
364842571
ADMINISTRATOR:BAKSHI, LALITAFACILITY TYPE:
830
ADDRESS:31587 ALTA VISTA DRIVETELEPHONE:
(909) 794-8530
CITY:REDLANDSSTATE: CAZIP CODE:
92373
CAPACITY:12CENSUS: 0DATE:
04/20/2022
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
11:10 AM
MET WITH:Lalita BakshiTIME COMPLETED:
11:25 AM
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On 04/20/2022, Licensing Program Analysts (LPAs) Laura Mejorado and Aman Sharma arrived at the facility to conduct a Case Management inspection to amend the report and citation that was issued to the facility on 02/11/2022. LPAs met with Director Lalita Bakshi. The facility was closed and no children were present.

An exit interview was conducted, and a copy of this report was provided to Director via email on 05/03/2022 due to a report not being left at the facility during the inspection. Director agrees to sign and return the report to LPA via email on 05/03/2022.
SUPERVISOR'S NAME: Kimberly WilliamsTELEPHONE: (951) 248-0228
LICENSING EVALUATOR NAME: Laura MejoradoTELEPHONE: 951-782-4200
LICENSING EVALUATOR SIGNATURE:
DATE: 05/03/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/03/2022
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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