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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197750070
Report Date: 10/19/2023
Date Signed: 10/19/2023 10:51:36 AM

Document Has Been Signed on 10/19/2023 10:51 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
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME:GRANADA HILLS MONTESSORI PRESCHOOLFACILITY NUMBER:
197750070
ADMINISTRATOR:VILLALOBOS, GLADYSFACILITY TYPE:
850
ADDRESS:11451 WOODLEY AVETELEPHONE:
(818) 360-7448
CITY:GRANADA HILLSSTATE: CAZIP CODE:
91344
CAPACITY: 75TOTAL ENROLLED CHILDREN: 75CENSUS: 59DATE:
10/19/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
10:15 AM
MET WITH:Director / Gladys VillalobosTIME COMPLETED:
11:15 AM
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Licensing Program Analyst (LPA) Joe Katrdzhyan conducted an unannounced Case Management Visit to this facility.

LPA met with Director / Gladys Villalobos, who guided LPA on a tour of the facility. There were 59 children with 9 staff observed present.

LPA Katrdzhyan discovered that the facility did not report an incident that took place on 10/11/23, where Child 1 (C1) sustained a cut on the left eye. Director / Gladys Villalobos, disclosed to LPA during an interview that she is aware that the facility failed to report the incident to CCL, per Title 22 Reporting Requirements, Section 101212.

Per Director / Gladys Villalobos, an Unusual Incident/Injury Report will be submitted to CCL by no later than the end of business day on 10/19/23.

An Advisory Note - Technical Violation was issued during today's visit stating that Title 22 Regulations Section 101212 was discussed with Director / Gladys Villalobos and an In-service Training will be conducted and copies of the training along with signatures of all attendees will be submitted to CCL by the end of business day on 10/25/23.

The Notice of Site Visit was provided and 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 $100.00.
Exit interview was conducted with Gladys Villalobos and Appeals Rights provided.
SUPERVISORS NAME: Rita Ramos
LICENSING EVALUATOR NAME: Joe Katrdzhyan
LICENSING EVALUATOR SIGNATURE: DATE: 10/19/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/19/2023
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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