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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 503603196
Report Date: 06/26/2019
Date Signed: 06/26/2019 03:21:26 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1310 E. SHAW AVE,
FRESNO, CA 93710
FACILITY NAME:MONTESSORI SCHOOL OF MODESTOFACILITY NUMBER:
503603196
ADMINISTRATOR:SEGURA, EVAFACILITY TYPE:
850
ADDRESS:3501 SAN CLEMENTE AVE.TELEPHONE:
(209) 567-1115
CITY:MODESTOSTATE: CAZIP CODE:
95356
CAPACITY:140CENSUS: 16DATE:
06/26/2019
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
03:00 PM
MET WITH:Daisy HuertaTIME COMPLETED:
04:00 PM
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LPA Claudia Henley conducted a case management visit today. I was met by teacher Ms. Huerta. The director was not present during today's visit. The purpose of the visit today was to inspect the two main glass doors that exit and enter the child care center to see if it was completed. On 3/1/19, an incident had occurred when a vehicle drove through the front glass door entrance to the child care center after day care hours of operation.

The main glass doors of the center have been installed. Staff and parent or parent representatives are now able to enter and exit through the doors. The door installation is complete and the doors are in working order. Ms. Huerta states that they are waiting upon installation of the key pad which is currently on order. Currently the staff are near the entrance doors to assist parents when they arrive to pick up their children.

Licensee to inform the department when the key pad has been installed. Send photographs to the department once completed.

No deficiencies were cited. Site Visit Notice posted.
Exit interview was conducted.
SUPERVISOR'S NAME: Alice JuarezTELEPHONE: (559) 650-7857
LICENSING EVALUATOR NAME: Claudia HenleyTELEPHONE: (559) 341-5776
LICENSING EVALUATOR SIGNATURE:

DATE: 06/26/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/26/2019
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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