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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198006504
Report Date: 04/24/2025
Date Signed: 04/24/2025 03:20:39 PM

Document Has Been Signed on 04/24/2025 03:20 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:OAK KNOLL KINDERHAUS MONTESSORI SCHOOLFACILITY NUMBER:
198006504
ADMINISTRATOR/
DIRECTOR:		CORRINA VASQUEZFACILITY TYPE:
850
ADDRESS:1200-1212 N. LAKE AVENUETELEPHONE:
(626) 345-9929
CITY:PASADENASTATE: CAZIP CODE:
91104
CAPACITY: 54TOTAL ENROLLED CHILDREN: 43CENSUS: 36DATE:
04/24/2025
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:15 AM
MET WITH:Director Korina NavarroTIME VISIT/
INSPECTION COMPLETED:
03:45 PM
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On 04/24/2025 at 9:05am, Licensing Program Analysts (LPAs) Stephanie Li and Monica Ruiz conducted an unannounced annual inspection. Upon arrival, LPA met with Director Korina Navarro, who led LPAs on a tour of the facility. This facility is a preschool license with a toddler component. The entrance to the facility is located through a parking lot on Lake Street. There are currently 43 children enrolled. There were 7 toddlers, 29 preschooler children and 7 staff present during today’s inspection. Hours of operation are Monday-Friday 8:00am -5:30pm.
All areas identified on the Facility Sketch were inspected. The facility consists of 3 classrooms, 3 children’s bathrooms, staff restroom, and 2 outdoor playgrounds. Staff names were recorded. Teacher-child ratios were observed to be in accordance with Title 22 regulations. The Licensee is within the conditions, limitations, and capacity specified on the license. All children were observed to be under active/visual supervision of a teacher during the tour.

Licensing staff observed disinfectants, cleaning solutions, medication and other items that are dangerous to children were not accessible to children. Classroom furniture and equipment are in good condition, free of sharp, loose, or pointed parts. All floors are clean and safe. Napping equipment cots and bedding were inspected for good condition, appropriate storage, and cleanliness. Parents bring home bedding to wash every weekend. Storage for children's belongings were inspected. All toilets and washing facilities are in safe and sanitary operating conditions. First Aid supplies are available and complete. Drinking water was readily available indoors. There is Sparklet’s water in jugs is readily available in each classroom. There is an Air Stream Trailor in the parking lot of the center, and it is used a breakroom and an isolation area for sick children. Teachers use a staff bathroom in the Barn Owl classroom. There is a Floater on-site to relieve teachers for bathroom breaks, allowing teachers to stay in ratio. page 1
NAME OF LICENSING PROGRAM MANAGER: Christina Gabelman
NAME OF LICENSING PROGRAM ANALYST: Stephanie Li
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 04/24/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/24/2025
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		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: OAK KNOLL KINDERHAUS MONTESSORI SCHOOL
FACILITY NUMBER: 198006504
VISIT DATE: 04/24/2025
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Licensing staff observed forms/publications to be posted by the front entrance. Snack menus were reviewed to ensure that they are being posted one week in advance where it is visible by the child's authorized representative. Menus for the past 30 days are available upon request. Facility provides two snacks am and pm. Lunch is brought from home. All storage containers for solid waste, including moveable bins shall have tight-fitting covers that are kept on, and in good repair. Trash cans used to discard food have tight fitting lids. The facility was observed to be free of flies, other insects, and rodents.

Licensing staff observed the required 2A10BC fire extinguisher indicates fully charged and was serviced on 6/10/2024 on service tag. Per State Fire Marshall standards, fire extinguishers shall be serviced annually. Facility has a functioning carbon monoxide and smoke detectors that meets statutory requirements, and both were operable on this day. Director states there are no weapons, firearms, or bodies of water on the premises. The last Disaster drill was conducted in 3/12/2025.

At 10:00 am, licensing staff reviewed the outdoor play area. The playgrounds equipment is in safe condition, free of sharp, loose or pointed parts. The surface of the outdoor activity space is maintained in a safe condition and is free of hazards. In the preschool play yard, LPAs observed a garden, bicycle track and several riding cars, tricycles, and a large play structure with a rope ladder, rock climbing structure, and a slide. LPAs advised Director to install padding around the rough edges of the structure, specifically near the rope ladders, to prevent injury to children. There is a 2 foot gap between rope ladder and play structure. LPAs observed there was a moveable rock climbing structure 3 feet away from a cement ledge. LPA’s advised that fall zones around climbing structures need to be 6 foot. Director moved rock climbing structure to center of open yard to meet the 6 foot fall zone. Per Director, she will order bumper padding to cushion the play structure with the rope ladder. In the toddler yard, LPAs observed a dome play structure not meeting the 3 feet and observed Director move dome to middle of yard to meet the 3 foot spacing. LPAs observed a fully enclosed single jumper Trampoline, which allows only one child to jump at a time. LPA advised for teachers to maintain constant active supervision while child is using trampoline. LPA’s observed a sand box with a lid in the toddler yard. Drinking water is readily available outdoors in the form of sippy cups and filtered water jugs.

Sign in and out sheets were reviewed to ensure that the person who signs the child in and out uses their full legal signature and records the time of the day. Facility uses School Cues for sign in and out, paperwork, parent notices, and communication. page 2

NAME OF LICENSING PROGRAM MANAGER: Christina Gabelman
NAME OF LICENSING PROGRAM ANALYST: Stephanie Li
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 04/24/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/24/2025
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 CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: OAK KNOLL KINDERHAUS MONTESSORI SCHOOL
FACILITY NUMBER: 198006504
VISIT DATE: 04/24/2025
NARRATIVE
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Staff records and children’s records were reviewed for completeness and documented on LIC857 and LIC859. There is at least one person trained in CPR and Pediatric First Aid present during this inspection. All children’s records were up to date. Staff records were complete.

Facility is currently providing IMS. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. 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)/ (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm

LPA’s reviewed medication and observed that parent consent form for epi-pen was provided to facility. No IMS was observed to be on file and epi-pen did not have it’s original label and instructions. Parent’s home burnt down and family is displaced so unable to provide original packaging. Medication was provided for a possible allergy due to fever symptoms. Parents are bringing child back to doctors to complete allergy testing and will be picking up the medication. Medication was observed to be picked up during this inspection. A deficiency is being issued for prescription medication, see page LIC809D. LPA’s reviewed IMS plan with director and provided sample form. A technical violation is being issued for IMS.

Teachers were reminded that all adults 18 and over, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a Child Care Center. A civil penalty of $100.00 minimum/day for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.

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NAME OF LICENSING PROGRAM MANAGER: Christina Gabelman
NAME OF LICENSING PROGRAM ANALYST: Stephanie Li
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 04/24/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/24/2025
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 CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: OAK KNOLL KINDERHAUS MONTESSORI SCHOOL
FACILITY NUMBER: 198006504
VISIT DATE: 04/24/2025
NARRATIVE
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To improve the quality and value of the new inspection process, a survey may be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or CARE tools, please send email inquiries to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/inspection-process

Assembly Bill (AB) 2370, Chapter 676, Statutes of 2018, requires all licensed Child Care Centers (CCCs) constructed before January 1, 2010, to test their water (used for drinking and food preparation) for lead contamination before January 1, 2023, and then every 5-years after the date of the first test. For childcare center licenses issued after July 1, 2022, the licensee shall test their water for lead within 180 days of licensure pursuant to Written Directives section 101700 (PIN 21-21.1-CCP). The facility has completed lead testing and is in the process of remediating lead exceedances. LPA referred facility representative to the Department website for lead: Lead Toxicity Prevention and Water Testing Information.

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

Based on Licensing staff observations and records review, the following deficiencies listed on the attached LIC 809D (deficiency page) are being cited in accordance with California Code of Regulations Title 22. Deficiencies that are being cited need to be cleared to protect the children’s health and safety. A technical advisory are being issued, see page LIC9102.

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

Exit interview conducted and report was reviewed with Director Korina Navarro.

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NAME OF LICENSING PROGRAM MANAGER: Christina Gabelman
NAME OF LICENSING PROGRAM ANALYST: Stephanie Li
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 04/24/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/24/2025
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 04/24/2025 03:20 PM - It Cannot Be Edited


Created By: Stephanie Li On 04/24/2025 at 02:37 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 CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: OAK KNOLL KINDERHAUS MONTESSORI SCHOOL
FACILITY NUMBER: 198006504

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/24/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
101226(e)(3)(A)
Health-Related Services
(3) Prescription medications may be administered if all of the following conditions are met: (A) Prescription medications shall be administered in accordance with the label directions as prescribed by the child's physician.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation and record review, the licensee did not comply with the section cited above in 1 out of 1 child's prescription medications did not have original prescription label or instructions for dispensing medication which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 04/30/2025
Plan of Correction
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LPAs observed medication picked up by parent during visit. Per director, parent is taking child for allergy testing on Monday and will notify school if child has true allerg by Tuesday April 29, 2025. If child does have allergy, director will submit an IMS plan by Wednesday April 30, 2025.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
Christina Gabelman
NAME OF LICENSING PROGRAM MANAGER:
Stephanie Li
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 04/24/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/24/2025


LIC809 (FAS) - (06/04)
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