<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 364845660
Report Date: 09/09/2019
Date Signed: 09/09/2019 12:51:27 PM

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:NADIAS MONTESSORI CHILD CAREFACILITY NUMBER:
364845660
ADMINISTRATOR:NADIA AMIR AHMEDFACILITY TYPE:
840
ADDRESS:5001 RIVERSIDE DR.TELEPHONE:
(909) 964-0442
CITY:CHINOSTATE: CAZIP CODE:
91710
CAPACITY:30CENSUS: 0DATE:
09/09/2019
TYPE OF VISIT:OfficeANNOUNCEDTIME BEGAN:
10:30 AM
MET WITH:Nadia Amir AhmedTIME COMPLETED:
12:30 PM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
Licensing Program Analysts (LPAs) Blanca Ruiz-Silva and Kim Leung conducted an application Review meeting with Applicant/Director, Nadia Amir Ahmed (Nadia’s Montessori Chino Care) for facility above.
The overall operation and involvement of the Nadia’s Montessori Chino Care center / staff was discussed.
Applicant was provided items to review and to revise. Applicants provided the following document during in office visit:
1. Operating Agreement for the LLC to include who are the owners, who manage the business, how decisions are made and who has the authority to apply for licenses.
2 Resubmit LIC 401 with budget for the requested capacity of 116 children

3. Job descriptions, hiring requirements, duty statement, responsibilities, qualification and requirements ( Lic 500 time and dates ), hiring requirements and reporting channels for each position listed on LIC 500;
4. Personnel Policies;
5.
Playground Sketch- Waiver written request require for sharing center's playground ( within preschool and school-age programs)
6. Complete LIC610 - Section I & II must be completed
7. List of furniture, equipment and supplies- incomplete
8.
Medication – Incidental Medical Services if planning to provide- Provide a copy of " School Medication Permission Form."
9. Daily Schedules and Curriculum; ( Current schedule is not consistent with hours of operation)
10. Sample Menu-
( Lunch sample provided during visit and Snack A.M. and P.M. pending to be submitted)/ (Grade vs age revision advised)
11.
LIC 404 Financial Verification ( Bank pending to respond)
12. Balance Sheet, Lic 403
13. Lic 500 -Need to be completed

Component II discussed during office visit . This report was discussed and copies provided.
SUPERVISOR'S NAME: Aaron RossTELEPHONE: (951) 320-2023
LICENSING EVALUATOR NAME: Blanca Ruiz-SilvaTELEPHONE: (951) 233-5594
LICENSING EVALUATOR SIGNATURE:

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

DATE: 09/09/2019
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 1