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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198012252
Report Date: 01/02/2025
Date Signed: 01/02/2025 04:45:43 PM

Document Has Been Signed on 01/02/2025 04:45 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:CHILDREN'S MONTESSORI CENTERFACILITY NUMBER:
198012252
ADMINISTRATOR/
DIRECTOR:		CYNTHIA REIMERSFACILITY TYPE:
830
ADDRESS:19 N. HIDALGO AVENUETELEPHONE:
(626) 282-8258
CITY:ALHAMBRASTATE: CAZIP CODE:
91801
CAPACITY: 16TOTAL ENROLLED CHILDREN: 16CENSUS: 13DATE:
01/02/2025
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:30 AM
MET WITH:Dimanthi Deraniyagala, director. TIME VISIT/
INSPECTION COMPLETED:
05:15 PM
NARRATIVE
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On Thursday, January 2, 2025, Licensing Program Analysts (LPAs) Staicy Perry and Monica Ruiz conducted an unannounced annual inspection and met with Dimanthi Deraniyagala, Director who guided LPAs on a tour of the facility. Census was taken and LPA;s observed 13 children in care with 4 staff present.

This is an infant program that serves children ages 0 to 2 years. This program operates Monday to Friday 8:00 a.m. – 4:00 p.m. Sign in and out takes place at the main entrance area. Teacher and child ratio were observed, and present staff are fingerprinted cleared and at least one person present who is trained in pediatric first aid/CPR is present. There is also a preschool licensee on premises with facility #198012250. Currently the facility has an pending application with CAB unit for a change in ownership.



At approximately 11:00 am. LPAs entered the Bunnies classroom (0-12months). LPAs observed 6 infants with staff 2 staff present feeding the infants. LPA’s observed age-appropriate furniture and equipment to be in good condition, free of sharp, not loose, or pointed parts and age-appropriate toys accessible to children. LPA’s observed toy items (Baby Seat Bumbo, Snuga infant Swing) in the Bunnies classroom and informed director that these items have be recalled by the the Consumer Product Safety Commission and are not permitted in a licensed childcare facility. LPA’s informed Director that those items need to be removed immediately. LPA’s also informed Director of website www.CPSC.gov, for more information regarding recalled products. Director understood. LPAs did observe director remove those items during inspection, technical violation given. LPA’s observed cleaning solutions stored cabinet making it inaccessible for children to reach. LPAs observed the cribs to be free from bumper pads, pillows, toys, blankets, hanging above items. LPA’s observed trash bins with a lid, one for diapers and one for trash. At approximately 11:09am, LPAs did not observe the diapering changing table to be arm’s length to the handwashing sink, which poses a potential risk to the health and safety of the children in care. LPAs did observe a vinyl diapering mat to be cleaned and
SUPERVISORS NAME: Brandi VanOosten
LICENSING EVALUATOR NAME: Staicy Perry
LICENSING EVALUATOR SIGNATURE: DATE: 01/02/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/02/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 22
Document Has Been Signed on 01/02/2025 04:45 PM - It Cannot Be Edited


Created By: Staicy Perry On 01/02/2025 at 03:43 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: CHILDREN'S MONTESSORI CENTER
FACILITY NUMBER: 198012252

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/02/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type A
Section Cited
HSC
1597.16(a)(1)
Lead Testing
(1) A licensed child day care center, as defined in Section 1596.76, that is located in a building that was constructed before January 1, 2010, shall have its drinking water tested for lead contamination levels on or after January 1, 2020, but no later than January 1, 2023, and every five years after the date of the initial test.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observations, interview, record review, the licensee did not comply with the section cited above in, Lead testing was not observed to be completed, which poses an immediate health, safety or personal rights risk to persons in care.
POC Due Date: 01/03/2025
Plan of Correction
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Per director, she will email LPA conformation of scheduled a testing date by POC date and once facility is tested and results are available director will email LPA with LEAD results.
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.
SUPERVISOR'S NAME:Brandi VanOosten
LICENSING EVALUATOR NAME:Staicy Perry
LICENSING EVALUATOR SIGNATURE:
DATE: 01/02/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/02/2025


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Page: 2 of 22
Document Has Been Signed on 01/02/2025 04:45 PM - It Cannot Be Edited


Created By: Staicy Perry On 01/02/2025 at 03:43 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: CHILDREN'S MONTESSORI CENTER
FACILITY NUMBER: 198012252

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/02/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
101239(n)
Fixtures, Furniture, Equipment and Supplies
(n) Furniture and equipment shall be maintained in good condition, free of sharp, loose or pointed parts.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observations, the licensee did not comply with the section cited above in, outdoor trash bin with lid did not work and was observed to be broken and food being discarded in a trash bin with no lid, which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 02/03/2025
Plan of Correction
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Per director trash bins will be replaced and a photo to LPA via email will be sent by POC date.
Type B
Section Cited
CCR
101439(h)(4)
Infant Care Center Fixtures, Furniture, Equipment and Supplies
(h) Infant changing tables shall: (4) While in use, be placed within arm's reach of a sink.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observations, the licensee did not comply with the section cited above, the diapering changing table was not in arm’s length to the handwashing sink, which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 02/03/2025
Plan of Correction
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Per director diaper changing table will be placed near a handwashing sink and will submit photos to LPA Perry via email by POC date.
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:Staicy Perry
LICENSING EVALUATOR SIGNATURE:
DATE: 01/02/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/02/2025


LIC809 (FAS) - (06/04)
Page: 3 of 22
Document Has Been Signed on 01/02/2025 04:45 PM - It Cannot Be Edited


Created By: Staicy Perry On 01/02/2025 at 03:43 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: CHILDREN'S MONTESSORI CENTER
FACILITY NUMBER: 198012252

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/02/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
101238.2(d)(2)
Outdoor Activity Space
(d) The surface of the outdoor activity space shall be maintained: (2) Free of hazards including, but not limited to, holes, broken glass and other debris, and dry grasses that pose a fire hazard.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observations, the licensee did not comply with the section cited above, the infant outdoor play equipment to have visible cob webs with spiders as well as debris which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 02/03/2025
Plan of Correction
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Per director a daily outdoor inspection log will be completed prior to the children playing out side. Director will send LPA a copy of 1 weeks worth of daily outdoor inspection log via email by POC date.
Type B
Section Cited
CCR
101429(a)(2)(B)(3)(a)
Responsibility for Providing Care and Supervision for Infants
(B) Staff shall physically check on sleeping infant(s) every 15 minutes and document the following: (3) Infants up to 12 months of age who are sleeping in a position other than on their back. (a) If the infant’s Individual Infant Sleeping Plan [LIC 9227 (3/20)] does not have Section C completed, staff shall return the infant to their back for sleeping.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observations, interviews and record review, the licensee did not comply with the section cited above in infant sleep logs not being completed daily which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 02/03/2025
Plan of Correction
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Per director, 15 minute sleep log documentation will be completed and documented on form that was provided by LPAs. LPAs also obtained a declaration from director stating that she will ensure 15 minute logs are being completed daily during naptime. Director will also hold a staff meeting to review all infant safe sleep regulations. Staff will watch CCLD video on website on safe sleep and document what they learned. Director will submit training agenda, staff sign in and out sheets of who attended and staff documentation on their understanding of infant safe sleep to LPA by POC date via email.
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:Staicy Perry
LICENSING EVALUATOR SIGNATURE:
DATE: 01/02/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/02/2025


LIC809 (FAS) - (06/04)
Page: 4 of 22
Document Has Been Signed on 01/02/2025 04:45 PM - It Cannot Be Edited


Created By: Staicy Perry On 01/02/2025 at 03:43 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: CHILDREN'S MONTESSORI CENTER
FACILITY NUMBER: 198012252

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/02/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
HSC
1596.7995(a)(1)
General Provisions and Definitions
(1) Commencing September 1, 2016, a person shall not be employed or volunteer at a day care center if he or she has not been immunized against influenza, pertussis, and measles. Each employee and volunteer shall receive an influenza vaccination between August 1 and December 1 of each year.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observations, interviews and record review, the licensee did not comply with the section cited above in, 3 out of 5 staff files did not have immunizations on file which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 02/03/2025
Plan of Correction
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Director stated that staff will obtain their immunizations and provide LPA Perry with copies via email by POC date.
Type B
Section Cited
CCR
101216(g)(1)
Personnel Requirements
(1) Except as specified in (3) below, good physical health shall be verified by a health screening, including a test for tuberculosis, performed by or under the supervision of a physician not more than one year prior to or seven days after employment or licensure.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observations, interviews and record review the licensee did not comply with the section cited above in 3 out of 5 staff files did not have LIC 503 which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 02/03/2025
Plan of Correction
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Director stated that staff will obtain their forms and provide LPA Perry with copies via email by POC date.
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:Staicy Perry
LICENSING EVALUATOR SIGNATURE:
DATE: 01/02/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/02/2025


LIC809 (FAS) - (06/04)
Page: 5 of 22
Document Has Been Signed on 01/02/2025 04:45 PM - It Cannot Be Edited


Created By: Staicy Perry On 01/02/2025 at 03:43 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: CHILDREN'S MONTESSORI CENTER
FACILITY NUMBER: 198012252

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/02/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
101216.1(b)(1)
Teacher Qualifications and Duties
(1) A teacher shall have completed, with passing grades, at least six postsecondary semester or equivalent quarter units of the education requirement specified in (c)(1) below; or shall have obtained a Child Development Assistant Permit issued by the California Commission on Teacher Credentialing.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observations, interviews and record reviews, the licensee did not comply with the section cited above in which 3 out of 5 staff files did not have the above requirements which pposes a potential health, safety or personal rights risk to persons in care.
POC Due Date: 02/03/2025
Plan of Correction
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Director stated that she will have staff provided missing form and send LPA via email by POC date.
Type B
Section Cited
CCR
101215.1(m)
Child Care Center Director Qualifications and Duties
(m) A child care center director shall complete 16 hours of health and safety training if necessary pursuant to Health and Safety Code Section 1596.866.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observations, interviews and record reviews, the licensee did not comply with the section cited above in directors Pediatric First Aid/CPR certification on file but is not EMSA approved, which poses a potential risk to the health and safety of the children in care.
POC Due Date: 02/03/2025
Plan of Correction
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Director will submit directors package to LPA via email by POC date.
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:Staicy Perry
LICENSING EVALUATOR SIGNATURE:
DATE: 01/02/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/02/2025


LIC809 (FAS) - (06/04)
Page: 6 of 22
Document Has Been Signed on 01/02/2025 04:45 PM - It Cannot Be Edited


Created By: Staicy Perry On 01/02/2025 at 03:43 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: CHILDREN'S MONTESSORI CENTER
FACILITY NUMBER: 198012252

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/02/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
HSC
1596.8662(b)(1)
Administration of Child Day Care Licensing
(1) On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child day care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training provided pursuant to paragraphs (2) and (3) of subdivision (a), and shall complete renewal mandated reporter training every two years following the date on which he or she completed the initial mandated reporter training.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observations and record reviews, the licensee did not comply with the section cited above in,3 out of 5 staff did not have current Mandated Reporter Training, which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 02/04/2025
Plan of Correction
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Director will submit certification from training to LPA via email by POC date.
Type B
Section Cited
CCR
101427(h)
Infant Care Food Services
(h) Infants who are unable to hold a bottle shall be held by a staff person or other adult for bottle feeding. At no time shall a bottle be propped for an infant. An infant shall not be allowed to carry a bottle while ambulatory. A bottle given to an infant able to hold his/her own bottle shall be unbreakable.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observations and interviews, the licensee did not comply with the section cited above in one infant on a highchair drinking a bottle propped up by a blanket with no supervision which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 02/03/2025
Plan of Correction
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Director will hold a staff meeting regarding infant feeding with all infant staff. Director will subit meeting agenda along with signatures of staff who attened as well as a summary of what they learned to LPA Perry via email by POC date.
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:Staicy Perry
LICENSING EVALUATOR SIGNATURE:
DATE: 01/02/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/02/2025


LIC809 (FAS) - (06/04)
Page: 7 of 22
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: CHILDREN'S MONTESSORI CENTER
FACILITY NUMBER: 198012252
VISIT DATE: 01/02/2025
NARRATIVE
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in good condition but not to have raised sides at least 3 inches high. Per director, soiled clothing is not rinsed in the sink. It is placed in a plastic bag and the vinyl mat is disinfected with alcohol and water. LPAs observed children’s personal items to be in individual bins. At approximately 11:16am, LPAs observed infant bottles and food not to be labeled with children’s names and not dated 1/2/25 inside each child’s lunch bag with most having icepacks and not frigerated, per director a fridge was purchased during inspection and LPAs observed fridge purchase. Meanwhile, infant bottles will be placed in the kitchen fridge. At approximately 11:17am, LPAs did observe one infant on a highchair drinking a bottle propped up by a blanket with no supervision which poses a potential health and safety risk for the children in care. Per infant staff, they were informed that they can prop a bottle if infants were unable to hold bottle themselves. LPA’s did review regulations with director and staff, which poses an potential risk to the health and safety of the children in care. No bottles were observed to have infants name and date. At approximately 11:15am, LPAs observed the classroom to have 2 playpins with toys inside, hanging items and mobiles inside. LPA’s advised director that play pins shall only be used for sleeping. Per staff children play pins are not in use. Director understood. Technical provided.

LPA’s entered the Tigers classroom (1-2 years old). LPA’s observed 7 children with 2 staff present outside eating lunch. LPA’s observed age-appropriate furniture and equipment to be in good condition, free of sharp, not loose, or pointed parts and age-appropriate toys accessible to children. LPA’s observed cleaning solutions stored inside cabinet making it inaccessible for children to reach. LPA’s observed trash bins with a lid for diapers and one for trash. LPA’s observed the diapering changing table to be arm’s length to the handwashing sink and a vinyl diapering mat. Per director, the vinyl mat is disinfected with alcohol and water. LPA observed children’s personal items to be in individual bins.


LPA Perry observed restroom located in tigers classroom. LPA’s observed toddler toilets and handwashing sinks. LPA’s observed the restroom to be in good condition and free from hazards.

Heating, lighting and ventilation were evaluated by LPA’s. LPA’s observed central AC /heater and vents located on the ceiling. LPA’s observed the thermostat located in classrooms and the temperature to be at 60 degrees. LPA’s advised director a comfortable temperature for children shall be maintained at all times. Technical provided. LPA’s observed the fire extinguishers located in hallways and the valve on the required 2A10BC fire extinguishers indicating fully charged and serviced on 12/16/24. Smoke detectors were tested during this visit and were observed to be operable. The carbon monoxide detector was observed and LPA’s
SUPERVISORS NAME: Brandi VanOosten
LICENSING EVALUATOR NAME: Staicy Perry
LICENSING EVALUATOR SIGNATURE:

DATE: 01/02/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/02/2025
LIC809 (FAS) - (06/04)
Page: 17 of 22
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: CHILDREN'S MONTESSORI CENTER
FACILITY NUMBER: 198012252
VISIT DATE: 01/02/2025
NARRATIVE
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tested and heard the sound and is operable. The last emergency drill was not provided during inspection. Per director emergency drill log is misplaced and thinks one was done at the end of November but is unsure. Technical provided.

For the walking infants, LPA’s observed sleeping mats to be in good condition. First aid kits supplies are kept inside the classrooms and LPA’s observed the kits to be fully equipped with band aids, gauzes, adhesive bandages, and antiseptic wipes. During this visit, director stated currently has children with medication or severe food allergies. LPA ‘s reviewed medication and observed medication to be improperly stored ( in a Ziploc bag with a magnet in the kitchen area, door not locked). LPA’s advised director that medication shall be put made inaccessible to children. Director understood. LPAs observed director remove medication and place in director’s office cabinet. Technical provided. LPA’s asked if there were any poisons, firearms, weapons or bodies of water. The director stated no firearms, weapons, no poisons nor bodies of water. LPA did not observe firearms or weapons, poisons, nor bodies of water. Director stated the ill isolation area takes place in the director’s office and children utilize the staff restroom. Lead testing was not observed to be conducted, LPA’s did observe drinking fountains to be in classrooms and outside accessible to the children, which poses an immediate risk tot the health and safety of the children in care. Infant staff stated that they rinse the infant bottles using the sinks in the classrooms.

At approximately 11: 26 a.m. LPA’s entered the outdoor play area. LPA’s observed the playground to be fenced all around. LPA’s observed the equipment not to be in a safe condition. LPA’s did observe the toys to be free of sharp, no lose or pointed parts. The surface of the outdoor activity space is not maintained in a safe condition and is not free of hazards. At Approximately 11:26 am LPA’s observed the outdoor play equipment to have visible cob webs with spiders as well as debris that can potentially pose a danger to the health and safety of the children in care. LPA’s observed a trash bin with a lid that was broken and food being discarded in a trash bin with no lid, which poses a potential risk to the health and safety of the children in care. For outdoor water drinking, children bring their own water bottles and is filled up by facility if needed.

This program does not provide meals to the children in care. All meals are provided by parents daily. LPA’s informed director that any food brought from the children's homes, the container shall be labeled with the child's name and properly stored or refrigerated. For water drinking, LPA’s observed drinking faucets in the classrooms. LPA’s did review the kitchen and observed the food preparation area to be clean and free of litter, rubbish, rodents, and/or any other vermin and storage containers for solid waste, including movable

SUPERVISORS NAME: Brandi VanOosten
LICENSING EVALUATOR NAME: Staicy Perry
LICENSING EVALUATOR SIGNATURE:

DATE: 01/02/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/02/2025
LIC809 (FAS) - (06/04)
Page: 18 of 22
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: CHILDREN'S MONTESSORI CENTER
FACILITY NUMBER: 198012252
VISIT DATE: 01/02/2025
NARRATIVE
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bins with tight-fitting covers that are kept on, and in good repair. Per director no meals are prepared on site. The facility was observed to be free of flies, other insects and rodents.


The following documents were posted in a prominent, publicly area front lobby: Facility License, Notification of Parents' Rights (PUB 393), Personal Rights (LIC 613A), Menu, and PUB 269 Child Passenger System Poster, and Daily Schedule.

LPA Perry reviewed the children’s roster, children’s files, staff files and sign in/out sheets were not observed to have signatures just times. Technical provided. LPA’s informed director that signatures on sign in and out sheets must be signed for each child. Director understood. Upon review of 15-minute sleep logs, it was observed that no sleep checks were being conducted unless their was an issue, which poses an potential risk to the health and safety of the children in care. Upon review of staff records 4 out of 5 staff records were incomplete, which poses a potential risk to the health and safety of the children in care. Childrens records were reviewed and of 3 out of 6 children’s files were incomplete, missing LIC9227 form, which poses a potential risk to the health and safety of the children in care.

LPAs observed Dimanthi Deraniyagala, Director file and was observed to be incomplete. LPA’s reviewed directors Pediatric First Aid/CPR certification on file but is not EMSA approved, which poses a potential risk to the health and safety of the children in care. LPA’s did observe CCLD orientation dated September 18th 2024. LPAs did not observe directors Preventative Health and Safety with nutrition and lead component completed, which poses a potential risk to the health and safety of the children in care. Director does not have proof of immunization against Pertussis, MMR and Influenza declination, which poses a potential risk to the health and safety of the children in care. Director has completed the mandated reporter (AB 1207) training which expires on 9/11/26. Director was advised that the mandated reporter training must be completed every 2 years and is available at www.mandatedreporterca.com.


The following was also discussed with director:
1. The following items are zero tolerance by Licensing: Refused Entry to a Facility or Any Part of a Facility is a violation of Section 1596.852, 1596.853 or 1597.09. Regulations 101238 (g) (2), The Presence of an Excluded Individual, Fire Clearance Violations, Accessible Bodies of Water, Accessible Firearms, Ammunition or Both

2. Breakfast/Lunch/Snack Menus: Menus are required to be posted one week in advance where it is visible

SUPERVISORS NAME: Brandi VanOosten
LICENSING EVALUATOR NAME: Staicy Perry
LICENSING EVALUATOR SIGNATURE:

DATE: 01/02/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/02/2025
LIC809 (FAS) - (06/04)
Page: 19 of 22
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: CHILDREN'S MONTESSORI CENTER
FACILITY NUMBER: 198012252
VISIT DATE: 01/02/2025
NARRATIVE
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by the child's authorized representative. Menus for the past 30 days must also be available upon request.

3. Current Children’s Roster: Each childcare facility shall maintain a current roster of children who are provided care in the facility. The roster shall include the name, address, and daytime telephone number of the child's parent or guardian, and the name and telephone number of the child's physician. This roster shall be available to the licensing agency upon request.



4.LIC 125 Entrance Checklist provided, and LPA informed that forms, regulations and quarterly updates can be accessed on the Child Care Licensing website at: www.ccld.ca.gov.

5.Pediatric First Aid and CPR: At least one person trained in Pediatric First Aid and CPR and EMSA approved must be present.

6.Designated Staff: The name of the childcare center director or fully qualified teacher(s) designated to act in the director's absence must be on file.

7.Qualifications: Educational background, training, and/or experience for each staff present must be available for review.

8. Immunization Requirements: Commencing September 1, 2016, a person shall not be employed or volunteer at a day care center if he or she has not been immunized against influenza, pertussis, and measles or influenza declination

9.Children’s Records: must be available for review; including but not limited to, the following: Name, address and telephone number of the child's authorized representative and of relatives or others who can assume responsibility for the child if the authorized representative cannot be reached when necessary.

10. Staff Records: must be available for review; background clearance, LIC 503 Health Screening report, LIC 9108 Statement Acknowledging Requirement to Report Child Abuse, Staff Qualifications, LIC 9050 Employee Rights, LIC 501 Personnel Record, AB 1207 Mandated Child Abuse Certification, MMR, TDAP, TB, influenza or influenza declination.

SUPERVISORS NAME: Brandi VanOosten
LICENSING EVALUATOR NAME: Staicy Perry
LICENSING EVALUATOR SIGNATURE:

DATE: 01/02/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/02/2025
LIC809 (FAS) - (06/04)
Page: 20 of 22
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: CHILDREN'S MONTESSORI CENTER
FACILITY NUMBER: 198012252
VISIT DATE: 01/02/2025
NARRATIVE
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Director was 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.

LPA’s referred licensee to the Department website for lead: Lead Toxicity Prevention and Water Testing Information.



LPAs discussed the safe sleep regulations with director and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-andresources/safe-sleep as an additional resource. LPA also informed director of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

facility provides Incidental Medical Services – IMS. LPA reviewed storage of “medication and equipment/supplies, and reviewed children’s, personnel, and administrative records.

For IMS information see PIN 22-02-CCP. 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-carecenters/.

Director 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.

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
SUPERVISORS NAME: Brandi VanOosten
LICENSING EVALUATOR NAME: Staicy Perry
LICENSING EVALUATOR SIGNATURE:

DATE: 01/02/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/02/2025
LIC809 (FAS) - (06/04)
Page: 21 of 22
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: CHILDREN'S MONTESSORI CENTER
FACILITY NUMBER: 198012252
VISIT DATE: 01/02/2025
NARRATIVE
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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.

The deficiency listed on the following page was observed by the LPAs and is being cited in accordance with California Code of Regulations Title 22 or Health and Safety code. One type A deficiency is being issued today for rtoday. Please see attached LIC 809-D for citation. Deficiencies that are being cited need to be cleared to protect the children’s health & safety. A copy of this report shall be provided to the parent/guardian of children currently enrolled by the next business day or immediately upon their return. A copy of this report shall also be provided to the parent/guardian of any newly enrolled child for the next 12 months. A signed Acknowledgement of Receipt (LIC9224) shall be in each child’s file, acknowledging receipt. As well as Ten (10) Type B deficiency. Please see deficency listed on the following page was observed by LPAs and is being cited in accordance with California Code of Regulations Title 22 or Health and Safety code. Please see attached LIC 809-D for citation.

A notice of site visit was given and must remain posted for 30 days. Failure to maintain posting as required will result in a $100.00 civil penalty. Appeal rights were provided and discussed.

Exit interview conducted and report was reviewed with Dimanthi Deraniyagala, director.
SUPERVISORS NAME: Brandi VanOosten
LICENSING EVALUATOR NAME: Staicy Perry
LICENSING EVALUATOR SIGNATURE:

DATE: 01/02/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/02/2025
LIC809 (FAS) - (06/04)
Page: 22 of 22