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

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 191201656
Report Date: 07/14/2022
Date Signed: 07/14/2022 10:29:38 AM

Document Has Been Signed on 07/14/2022 10:29 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, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME:CASA MONTESSORI, INCFACILITY NUMBER:
191201656
ADMINISTRATOR:CONSUELO VALERAFACILITY TYPE:
850
ADDRESS:17633 LASSEN STREETTELEPHONE:
(818) 886-7922
CITY:NORTHRIDGESTATE: CAZIP CODE:
91324
CAPACITY: 72TOTAL ENROLLED CHILDREN: 42CENSUS: 31DATE:
07/14/2022
TYPE OF VISIT:Case Management - COVID-19UNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Director, Consuelo ValeraTIME COMPLETED:
10:40 AM
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
On 7/14/2022 at 9:00 am, Licensing Program Analyst (LPA) Deborah Lowe conducted an unannounced Case Management – COVID-19 inspection for the purpose of following up on 4 Unusual Incident Reports (UIR) submitted on 7/04/2022, 07/07/2022, 07/12/2022, and 07/14/2022. LPA Lowe met with Director, Consuelo Valera, who toured LPA through the inside and outside of the facility. LPA observed 31 children in care with 4 staff. Staff present were observed to have their criminal record clearances.

According to the UIR, on 7/04/2022 - 2 children were reported as testing positive for COVID-19.

According to the UIR, on 7/07/2022 – 1 staff member was reported as testing positive for COVID-19.

According to the UIR, on 7/12/2022 – 1 child was reported as testing positive for COVID-19.

According to the UIR, on 7/14/2022 – 1 child was reported as testing positive for COVID-19.

Director stated all of the children and staff who were reported positive COVID have all isolated, 2 children and 1 staff member have retuned with negative COVID test. Two children are still in quarantine.

During visit LPA Lowe observed children arriving for the day. LPA observed staff requesting children to wash their hands upon arrival into classroom. Parent’s were observed to sign children in just outside the classroom. Pens and hand sanitizer was observed with the sign in sheets. Parents were not observed walking into classrooms.

LPA Lowe observed COVID-19 signage at the classroom doors about COVID-19 protocols and testing. At the front entrance LPA Lowe observed signs advising, visitor policy. Hand washing signs were posted in the bathrooms.

LPA interviewed director, staff, and review of documents LPA found the facility offers weekly COVID-19 testing, social distancing is encouraged, masks are encouraged, parents are notified of positive COVID cases. Classrooms each have lunch in their classrooms spaced out by tables.

SUPERVISORS NAME: Lisa Rios
LICENSING EVALUATOR NAME: Deborah Lowe
LICENSING EVALUATOR SIGNATURE: DATE: 07/14/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/14/2022
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 2
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: CASA MONTESSORI, INC
FACILITY NUMBER: 191201656
VISIT DATE: 07/14/2022
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
26
27
28
29
30
31
32
LPA Lowe observed facility supply of PPE COVID supplies as gloves, liquid hand sanitizer, masks, and thermometers.

LPA Lowe discussed with Director current COVID-19 resources and guidance.

No deficiencies are cited, per Title 22, Division 12, Chapter 3, of the California Code of Regulations.

An exit interview was conducted and a copy of this report (LIC 809) and Notice of Site Visit were provided to Director, Consuelo Valera.

SUPERVISORS NAME: Lisa Rios
LICENSING EVALUATOR NAME: Deborah Lowe
LICENSING EVALUATOR SIGNATURE:

DATE: 07/14/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/14/2022
LIC809 (FAS) - (06/04)
Page: 2 of 2