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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198011041
Report Date: 10/10/2023
Date Signed: 10/10/2023 05:54:24 PM

Document Has Been Signed on 10/10/2023 05:54 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, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME:TELSTAR MONTESSORI CHILD CARE CENTERFACILITY NUMBER:
198011041
ADMINISTRATOR:GABRIELLA DOMINGUEZFACILITY TYPE:
850
ADDRESS:9320 TELSTAR AVENUETELEPHONE:
(626) 569-2640
CITY:EL MONTESTATE: CAZIP CODE:
91731
CAPACITY: 62TOTAL ENROLLED CHILDREN: 55CENSUS: 46DATE:
10/10/2023
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
04:00 PM
MET WITH:Director Gabby Dominguez TIME COMPLETED:
04:30 PM
NARRATIVE
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Licensing Program Analyst (LPA) Roxana Lopez conducted a Case Management-Deficiencies visit on this date to address deficiencies revealed during an inspection. A COVID risk assessment was conducted upon entry.

LPA initially arrived to the facility at 1:00 pm- and was guided on a tour of the facility. At 1:118 pm LPA observed the Lady Bugs Classroom to be out of ratio- 14 children with 1 teacher. Children were observed to be on their cots- 2 children were awake. This poses an immediate health and safety risk for children in care.

Based on LPA 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.

LPA Roxana Lopez informed facility representative Gabby Dominguez that this report dated 10/10/2023 document(s) 1 Type A citation(s) which shall be posted for 30 consecutive days as there is/are immediate risk(s) to the health, safety, or personal rights of children in care. Also, LPA Roxana Lopez informed the facility representative to provide a copy of this licensing report dated 10/10/2023 that documents any Type A citation(s) to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification.

A notice of site visit was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.



Exit interview conducted and report was reviewed with the facility representative Gabby Dominguez.
SUPERVISORS NAME: Brandi VanOosten
LICENSING EVALUATOR NAME: Roxana Lopez
LICENSING EVALUATOR SIGNATURE: DATE: 10/10/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/10/2023
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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Document Has Been Signed on 10/10/2023 05:54 PM - It Cannot Be Edited


Created By: Roxana Lopez On 10/10/2023 at 04:20 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: TELSTAR MONTESSORI CHILD CARE CENTER
FACILITY NUMBER: 198011041

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/10/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
10/10/2023
Section Cited
CCR
101230(c)

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101230 Activities(c) A teacher-child ratio of one teacher supervising 24 napping children is permitted provided that the remaining teachers necessary to meet the overall ratio specified in Section 101216.3(a) are immediately available at the center. This requirement was not met as evidenced by
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During inspection- Director had a teacher from another classroom join the Lady Bugs classroom to mantain ratio. Director will submit a written plan on how facility will maintain ratio in the classrooms at all time by 10/17/2023 and will inform teachers of regulation violated.
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Based on observation and interview the Licensee did not comply in section cited above in that Lady Bugs classroom was observed out of ratio with 14 children with 1 teacher. 2 of the children were observed to be awake. which poses an immediate health and safety risk to children in care.
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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.
SUPERVISOR'S NAME:Brandi VanOosten
LICENSING EVALUATOR NAME:Roxana Lopez
LICENSING EVALUATOR SIGNATURE:
DATE: 10/10/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/10/2023


LIC809 (FAS) - (06/04)
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