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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198011204
Report Date: 09/28/2023
Date Signed: 09/28/2023 03:46:59 PM

Document Has Been Signed on 09/28/2023 03:46 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:INTERNATIONAL MONTESSORI PRESCHOOLFACILITY NUMBER:
198011204
ADMINISTRATOR:LAURIE SEGURAFACILITY TYPE:
850
ADDRESS:211 E. ARROW HWYTELEPHONE:
(909) 399-9222
CITY:CLAREMONTSTATE: CAZIP CODE:
91711
CAPACITY: 48TOTAL ENROLLED CHILDREN: 26CENSUS: 14DATE:
09/28/2023
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
03:15 PM
MET WITH:Yolanda MenaTIME COMPLETED:
03:55 PM
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On 9/28/2023 Licensing Program Analyst (LPA), Carolyn Tuba conducted an unannounced POC (plan of correction) inspection to clear the deficiency that was cited on 9/20/2023. A COVID risk assessment was conducted. LPA met with Director, Yolanda Mena. LPA observed 14 children and 4 staff present at the facility.

During the visit LPA observed that chime had been installed on the door that leads into the playground and additional staff support will be implemented in the near future. LPA referred the facility to Technical Support Program (TSP) on 9/27/2023. LPA advised that they should be contacted Director by phone or email.

LPA cleared the deficiency on this date and provided a copy of the Licensing Report to the Director. LPA also issued POC clearance letter.

At this time, the facility is in compliance with California Code of Regulations Title 22. Therefore, no deficiencies are being cited.

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

Exit interview conducted and report was reviewed with the Director, Yolanda Mena.

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SUPERVISORS NAME: Ana Chico
LICENSING EVALUATOR NAME: Carolyn Tuba
LICENSING EVALUATOR SIGNATURE: DATE: 09/28/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/28/2023
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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