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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198013942
Report Date: 05/10/2024
Date Signed: 05/10/2024 11:22:29 AM

Document Has Been Signed on 05/10/2024 11:22 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
CCLD Regional Office, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME:MONTESSORI OF WALNUTFACILITY NUMBER:
198013942
ADMINISTRATOR/
DIRECTOR:		CHRISTINA GREGORYFACILITY TYPE:
850
ADDRESS:20121 E. ALISU COURTTELEPHONE:
(909) 598-9267
CITY:WALNUTSTATE: CAZIP CODE:
91789
CAPACITY: 178TOTAL ENROLLED CHILDREN: 178CENSUS: 51DATE:
05/10/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:00 AM
MET WITH:Laura WingerTIME VISIT/
INSPECTION COMPLETED:
11:25 AM
NARRATIVE
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Case management inspection conducted by Licensing Program Analyst (LPA) Jennifer Hua and Office Staff Youle Qi (OS). LPA and OS met with director Laura Winger. The purpose of the visit was announced. The purpose of the visit is to follow up on the incident that was reported on 4/29/24. The self reported incident is regarding personal rights.

During this inspection, children were interviewed.

Child #1 (C1) disclosed that staff mentioned hit him on the face because child did not want to take a nap. (C1) also demonstrated by hitting OS on the face and also pointing to their face. C2, C3, C4 made no disclosures.
Staff #1(S1) denied slapping child on the face and spanking child or witnessed any staff slapped or spanked child. S2 denied slapping child on the face or spanking child. According to S2, have never witnessed any staff slapped or spanked child.

Based on the above, deficiency is cited on attached 809D.

Upon receipt of this report, the licensee shall post any licensing report documenting a type “A” citation and/or a substantiated complaint. This must remain posted for 30 days during the hours of operation. In addition to posting this report, the licensee will also provide copies to the parents of the children enrolled and any newly enrolled children in care for up to one year.

A copy of the LIC 9224 - Acknowledgement of Receipt of Licensing Reports was provided.

A Notice of Site was provided and must remain posted for 30 days.

Exit interview conducted with Laura Winger, Director. Appeal Rights explained and provided.
SUPERVISORS NAME: Ana Chico
LICENSING EVALUATOR NAME: Jennifer Hua
LICENSING EVALUATOR SIGNATURE: DATE: 05/10/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/10/2024
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 05/10/2024 11:22 AM - It Cannot Be Edited


Created By: Jennifer Hua On 05/10/2024 at 10:33 AM
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: MONTESSORI OF WALNUT
FACILITY NUMBER: 198013942

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/10/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Request Denied: Appeal Not Submitted Timely
Type A
05/17/2024
Section Cited
CCR
101223(a)(3)

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Personal Rights. The licensee shall ensure that each child is accorded the following personal rights: To be free from corporal or unusual punishment, infliction of pain, humiliation, intimidation, ridicule, coercion, threat, mental abuse or other actions of a
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Per director, will retrain all staff on personal rights, and have all staff watch the Licensing video focusing on personal rights. Will submit training agenda and staff sign in sheet to LPA by POC due date of 5/17/24.
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punitve nature. The requirement is not met as evidenced by: C1 disclosed and also demonstrated that staff hit him on the face when child did not want to nap. This is poses an immediate health and safety risk to the 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:Ana Chico
LICENSING EVALUATOR NAME:Jennifer Hua
LICENSING EVALUATOR SIGNATURE:
DATE: 05/10/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/10/2024


LIC809 (FAS) - (06/04)
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