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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 191200283
Report Date: 10/09/2024
Date Signed: 10/09/2024 01:27:55 PM

Document Has Been Signed on 10/09/2024 01:27 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME:MONTROSE PRESCHOOL & INFANT CAREFACILITY NUMBER:
191200283
ADMINISTRATOR/
DIRECTOR:		ERICA PATTERSONFACILITY TYPE:
850
ADDRESS:2700 MONTROSE AVENUETELEPHONE:
(818) 249-4048
CITY:MONTROSESTATE: CAZIP CODE:
91020
CAPACITY: 65TOTAL ENROLLED CHILDREN: 65CENSUS: 30DATE:
10/09/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:30 AM
MET WITH:Lisa Castaneda TIME VISIT/
INSPECTION COMPLETED:
02:00 PM
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On 10/09/24 ,at 10:30 am ,Licensing Program Analyst (LPA) Shushanik Safaryan conducted an unannounced Case Management Inspection regarding the incident reported to the Department. Upon arrival, LPA met with Facility Representative , LIsa Castaneda , to whom the reason of the visit was explained.

Census was taken. There were 30 children and 4 staff members.

On 08/19/24 an unusual incident report was submitted to the Department regarding child having an allergic reaction on the facility grounds .During the visit , LPA toured the facility , talked to the parent , staff members , obtained paperwork from the date of incident .



Due to insufficient information available at this time the above incident needs further investigation.

Exit interview conducted with Facility Representative ,LIsa Castaneda and Appeal Rights explained.

The Notice of Site Visit (LIC 9213) – must remain posted for 30 days during the hours of operation after each site visit by a licensing representative. Failure to maintain posting as required will result in a civil penalty of $100.
SUPERVISORS NAME: Brandi VanOosten
LICENSING EVALUATOR NAME: Shushanik Safaryan
LICENSING EVALUATOR SIGNATURE: DATE: 10/09/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/09/2024
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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