191605026-8-13-2025-54-CC-RDEO-DKHTM7-20250813145039

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 191605026
Report Date: 08/13/2025
Date Signed: 08/13/2025 02:51:03 PM

Document Has Been Signed on 08/13/2025 02:51 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 SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME:	MONTESSORI SCHOOL-EUREKA		FACILITY NUMBER:	191605026
ADMINISTRATOR/ DIRECTOR:	PIJPAERT, PIETERNELLA		FACILITY TYPE:	850
ADDRESS:	5306 E. ARBOR RD		TELEPHONE:	(562) 980-2589
CITY:	LONG BEACH	STATE: CA	ZIP CODE:	90808
CAPACITY: 56	TOTAL ENROLLED CHILDREN: 29	CENSUS: 19	DATE:	08/13/2025
TYPE OF VISIT:	Required - 3 Year	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	09:30 AM
MET WITH:	Sub Director - Sandra Acuna		TIME VISIT/ INSPECTION COMPLETED:	03:30 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 Analyst (LPA) Randy Derraco conducted an unannounced annual inspection on 08/13/25 at 9:30 AM. LPA met with Sandra Acuna, Substitute Director, who guided analyst on a tour of the facility. This is a preschool program which consists of 4 classrooms, of which 2 are currently being used. Facility operation hours are Monday to Friday from 7:00 AM to 6:30 PM. All areas identified on this report were inspected. Upon arrival, the following staff were present during this inspection: Room 1: Staff: S1 with 12 children; Napping Room: Staff: S3 with 7 children. No additional qualified adults were observed on the premises. LPA observed that S1 would need to leave Room 1 in order to guide analyst on a tour and answer the front door. LPA advised S1 that a citation under California Code of Regulation (CCR) section 101229(a)(1) will be issued. The following was observed during the tour of the facility: Children's roster was reviewed and is current. The center has recently began using the Brightwheel Application which allows authorized representatives to sign children in and out electronically. Children present were signed in. Disaster drill log was not available during inspection. S1 states that a fire drill and inspection was completed earlier in the year but the event was not logged. LPA advised S1 that a citation under CCR section 101174(d)(2) will be issued. LPA observed required licensing documents posted on bulletin board in hallway. Furniture and equipment were inspected for age appropriateness and good repair. LPA observed material and equipment are free of sharp, loose, or pointed parts. Telephone service, heating, lighting and

NAME OF LICENSING PROGRAM MANAGER: Denise Gibbs
NAME OF LICENSING PROGRAM ANALYST: Randy Derraco
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 08/13/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/13/2025

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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California Health & Human Services Agency

California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:

Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.

Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)

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Document Has Been Signed on 08/13/2025 02:51 PM - It Cannot Be Edited

Created By: Randy Derraco On 08/13/2025 at 02:10 PM

Link to Parent Document Below:

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: MONTESSORI SCHOOL-EUREKA	FACILITY NUMBER: 191605026
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 08/13/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

101174(d)(2)

Disaster and Mass Casualty Plan

(d) Disaster drills shall be conducted at least every six months. (2) The drills shall be documented. This documentation shall be kept in the child care center for at least one year. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on observation, interview and record review, the center did not document disaster drills conducted every 6 months which poses a potential Health, safety and/or personal rights risk to persons in care.
	POC Due Date: 08/22/2025
	Plan of Correction
1 2 3 4	POC Visit

Type B

Section Cited

CCR

101229(a)(1)

Responsibility for Providing Care and Supervision

(a) The licensee shall provide care and supervision as necessary to meet the children's needs. (1) No child(ren) shall be left without the supervision of a teacher at any time, except as specified in Sections 101216.2(e)(1) and 101230(c)(1). Supervision shall include visual observation. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on observation, interview and record review, S1 left children with supervision during LPA's arrival which poses a potential Health, safety and/or personal rights risk to persons in care.
	POC Due Date: 08/22/2025
	Plan of Correction
1 2 3 4	S1 states she will create a schedule where and qualified teacher will

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

	Denise Gibbs
NAME OF LICENSING PROGRAM MANAGER:

	Randy Derraco
NAME OF LICENSING PROGRAM ANALYST:

LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 08/13/2025

I acknowledge receipt of this form and understand my appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/13/2025

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 08/13/2025 02:51 PM - It Cannot Be Edited

Created By: Randy Derraco On 08/13/2025 at 02:10 PM

Link to Parent Document Below:

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: MONTESSORI SCHOOL-EUREKA	FACILITY NUMBER: 191605026
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 08/13/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

101227(a)(6)

Food Service

(6) Menus shall be in writing and shall be posted at least one week in advance in an area accessible for review by the child's authorized representative. Copies of the menus as served shall be dated and kept on file for at least 30 days. Menus shall be made available for review by the child's authorized representative and the Department upon request. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on observation, interview and record review, S1 did not post a menu one week in advance which poses a potential Health, safety and/or personal rights risk to persons in care.
	POC Due Date: 08/22/2025
	Plan of Correction
1 2 3 4	S1 states she will update and post menu and email LPA a copy.

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

	Denise Gibbs
NAME OF LICENSING PROGRAM MANAGER:

	Randy Derraco
NAME OF LICENSING PROGRAM ANALYST:

LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 08/13/2025

I acknowledge receipt of this form and understand my appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/13/2025

LIC809 (FAS) - (06/04)

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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: MONTESSORI SCHOOL-EUREKA	FACILITY NUMBER: 191605026
	VISIT DATE: 08/13/2025

NARRATIVE

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ventilation were evaluated and are operable. Children have their own cubby to store their belongings. Linens are taken home each Friday and brought back on Monday. The center has spare linens in case child forgets to bring linens back. Napping equipment (cots) were observed in separate storage areas. Per S1, the isolation area is located in the office while they await parent pick up. Age appropriate sinks and toilets were inspected for availability and good repair in all restrooms. General sanitation was observed.

Disinfectants, cleaning solutions, and other items that are dangerous to children, were observed to be inaccessible in a locked closet in the hallway. According to the S1, medication is only administered to a child when accompanied with a doctor's note. Medication is stored in the Director's office in a cabinet where it is inaccessible to children in care. S1 understands that storage areas for poisons must be locked, not just made inaccessible. Facility has one or more functioning carbon monoxide detectors that meet statutory requirements. First Aid supplies were observed in the classroom.

Menus were reviewed to ensure that they are being posted at least one week in advance and visible to an authorized representative. LPA observed that the menu posted was for July 2025. LPA advised S1 that a citation under CCR section 101227(a)(6) will be issued. The facility provides one snack during the day. Children bring their lunches from home. LPA observed children lunches to be individually labeled and properly stored or refrigerated. LPA observed that water is readily available indoors via water jugs. Water jugs are filled using tap water from the sink. Children bring their own cups to school and are filled by teachers as needed.

All kitchen areas/food preparation areas and food storage areas are kept clean and are free of litter, rubbish, rodents, and/or any other vermin. All storage containers for solid waste, including moveable bins have tight-fitting covers that are kept on, and in good repair. All foods/beverages are stored in covered containers at 45˚ (F) or less.

Outdoor play equipment was observed to be in good condition, free of sharp, loose or pointed parts. Outdoor activity space surface is maintained in a safe condition and is free of hazards. Areas around and/or under climbing equipment, swings and slides have cushioning material to absorb a fall. The outdoor area had adequate shade. LPA observed that water is readily available outdoors via a water fountain and water cups that are brought outside. S1 states that there are no bodies of water on the premises and LPA did not observe any bodies of water during this visit. S1 states there are no weapons or firearms on the premises.

NAME OF LICENSING PROGRAM MANAGER: Denise Gibbs
NAME OF LICENSING PROGRAM ANALYST: Randy Derraco
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 08/13/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/13/2025

LIC809 (FAS) - (06/04)

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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: MONTESSORI SCHOOL-EUREKA	FACILITY NUMBER: 191605026
	VISIT DATE: 08/13/2025

NARRATIVE

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All individuals present have obtained a criminal record clearance or criminal record exemption. There is at least one person trained in CPR and Pediatric First Aid present during this inspection.

Children’s and Staff’s Records were reviewed and are complete.

Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02-CCP. When any IMS is provided, an updated Plan of Operation that includes IMS must be submitted to the Department. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice) or (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA are available at: https://www.ada.gov/resources/child-care-centers/.

S1 was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

LPA advised the S1 to access forms, regulations and quarterly updates on the Child Care Licensing website at: www.cdss.ca.gov

The following deficiencies listed on the attached deficiencies page (LIC809D) are being cited in accordance with California Code of Regulations Title 22.

Notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with substitute Director, Sandra Acuna.

NAME OF LICENSING PROGRAM MANAGER: Denise Gibbs
NAME OF LICENSING PROGRAM ANALYST: Randy Derraco
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 08/13/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/13/2025

LIC809 (FAS) - (06/04)

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