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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198014360
Report Date: 08/04/2022
Date Signed: 08/04/2022 01:03:32 PM

Document Has Been Signed on 08/04/2022 01:03 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:ARIA MONTESSORI SCHOOLFACILITY NUMBER:
198014360
ADMINISTRATOR:SCHOFIELD-SMITH, G.FACILITY TYPE:
850
ADDRESS:693 S. EUCLID AVENUETELEPHONE:
(626) 793-3741
CITY:PASADENASTATE: CAZIP CODE:
91106
CAPACITY: 72TOTAL ENROLLED CHILDREN: 72CENSUS: 39DATE:
08/04/2022
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
11:48 AM
MET WITH:Yvette Salazar - Assistant DirectorTIME COMPLETED:
01:10 PM
NARRATIVE
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Licensing Program Analyst (LPA) Nolan Tcheng conducted an unannounced Case Management inspection for the purpose of conducting a staff file review for staff present during an annual inspection, on 07/26/2022. Upon arrival at 11:48am, LPA was met by Assistant Director Yvette Salazar, to whom the purpose for today's inspection was explained. At 11:53am, LPA was provided a tour of the facility. There were 39 children present during today's inspection.

LPA conducted file review on seven staff files. During the file review, LPA observed that 6 of 7 staff files did not have staff immunization records for Pertussis, Measles, and Influenza. LPA discussed with Assistant Director the importance of having these records on file if the staff members are working directly with the children in care. While reviewing education and training requirements, LPA observed that 6 of 7 staff files did not have proof of current Mandated Reporter Child Care Provider (AB1207) Training completion. LPA explained that the training needs to be renewed every two years.

The deficiencies listed on the following pages were observed by the LPA and are being cited in accordance with California Code of Regulations Title 22. Please see attached LIC 809D for deficiencies that are being cited and need to be cleared to protect the children’s health & safety.

The Notice of Site Visit (LIC 9213) – must remain posted for 30 days during the hours of operation after each site visit by a licensing representative.



Exit interview was conducted with Assistant Director Yvette Salazar, at 12:57pm and Plan of Corrections were reviewed and developed. Copy of Report provided.

END OF REPORT.
SUPERVISORS NAME: Claudia Guangorena
LICENSING EVALUATOR NAME: Nolan Tcheng
LICENSING EVALUATOR SIGNATURE: DATE: 08/04/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/04/2022
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 08/04/2022 01:03 PM - It Cannot Be Edited


Created By: Nolan Tcheng On 08/04/2022 at 12:41 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: ARIA MONTESSORI SCHOOL
FACILITY NUMBER: 198014360

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/04/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
08/11/2022
Section Cited
HSC
1596.8662(d)(1)

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1596.8662(d)(1) Health and Safety Code
a person who is a licensed child care provider... of a licensed child day care facility shall complete the mandated reporter training, complete renewal... every two years following the date on which he or she completed...
This requirement was not met as evidenced by:
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Per Assistant Director, they will have all staff do Mandated Reporter Child Care Provider (AB1207) following their staff meeting Tuesday and will submit proof of completion to LPA by POC
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Based on interview and record review, the licensee did not ensure that Staff #1-6 had renewed their Mandated Reporter Child Care Provider (AB1207) Training. This poses an potential health, safety, or personal rights risk to children in care
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Type B
09/06/2022
Section Cited
HSC1596.7995(c)

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1596.7995(c) Health and Safety Code
the day care center shall maintain documentation of the required immunizations or exemptions from immunization, as set forth in this section, in the person’s personnel record that is maintained by the day care center.
This requirement was not met as evidenced by:
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Per Assistant Director, they will have staff submit proof of immunzation for Pertussis, Measles, and Influenza. They will submit to LPA by POC date.
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Based on interview and record review, the licensee did not ensure that the personnel files for Staff #1-6 had immunization records for Pertussis, Measles, and Influenza. This poses an potential health, safety, or personal rights 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:Claudia Guangorena
LICENSING EVALUATOR NAME:Nolan Tcheng
LICENSING EVALUATOR SIGNATURE:
DATE: 08/04/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/04/2022


LIC809 (FAS) - (06/04)
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