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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 191224296
Report Date: 10/26/2022
Date Signed: 10/26/2022 01:11:15 PM

Document Has Been Signed on 10/26/2022 01:11 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
CCLD Regional Office, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME:PARK MONTESSORI CHILDREN'S CTR.FACILITY NUMBER:
191224296
ADMINISTRATOR:PARK, GRACEFACILITY TYPE:
850
ADDRESS:13130 HERRICK AVE.TELEPHONE:
(818) 367-5483
CITY:SYLMARSTATE: CAZIP CODE:
91342
CAPACITY: 75TOTAL ENROLLED CHILDREN: 75CENSUS: 30DATE:
10/26/2022
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
12:40 PM
MET WITH:Hannah Park TIME COMPLETED:
01:25 PM
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On 10/26/22 Licensing Program Analyst (LPA) Justin Dorsey conducted an inspection at Park Montessori Children's Center. The purpose of the inspection was a Plan of Correction visit to review the deficiency cited on 10/20/22. LPA met with Director Hannah Park and toured the facility.

The following was observed:
1.) LPA Dorsey observed Staff Member #1 was not present at the facility. Per Director Staff Member #1 has been live scanned, LPA Dorsey observed the fingerprints to be pending. Director was reminded that Staff Member #1 can not be present at the facility until their fingerprints are cleared.

Exit interview conducted a copy of this report, Notice of Site Visit and Deficiency Clearance Letter was emailed to Director Hannah Park.
SUPERVISORS NAME: Claretta Yates
LICENSING EVALUATOR NAME: Justin Dorsey
LICENSING EVALUATOR SIGNATURE: DATE: 10/26/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/26/2022
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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