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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198019813
Report Date: 03/30/2023
Date Signed: 03/30/2023 07:16:51 PM

Document Has Been Signed on 03/30/2023 07:16 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
L.A. DAY CARE-EAST, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME:PRIMANTI MONTESSORI ACADEMYFACILITY NUMBER:
198019813
ADMINISTRATOR:HARSHINI GUNASEKARAFACILITY TYPE:
830
ADDRESS:10947 VALLEY HOME AVETELEPHONE:
(562) 943-0246
CITY:WHITIERSTATE: CAZIP CODE:
90603
CAPACITY: 54TOTAL ENROLLED CHILDREN: 0CENSUS: 33DATE:
03/30/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
02:45 PM
MET WITH:Director, Maribeth PeraltaTIME COMPLETED:
07:30 PM
NARRATIVE
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 Licensing Program Analyst (LPA) Lilli Babcock conducted an unannounced annual inspection. A risk assessment was conducted upon entry and appropriate PPE was used. LPA met with Director Maribeth Peralta to whom the reason for the visit was explained. Director guided analyst on tour of the facility. This facility operates Monday-Friday from 6:30am-6:30 pm. This is an infant program with a toddler component that is licensed for 54 children. There is also a preschool on site license #19801019814.

The following was observed during the tour of facility:
All areas identified on the Facility Sketch were inspected. The infant program consists of 1 classroom, and the toddler component has one classroom. LPA observed the Infant classroom had 15 children with 4 staff and the toddler room had 18 children with 4 staff. All adults present have obtained a criminal record clearance or exemption on file.

PHYSICAL PLANT
Disinfectants, cleaning solutions, medication and other items that are dangerous to children, were inaccessible to children. Director, states that there are no poisons in the facility. Furniture and equipment are in good condition, free of sharp, loose, or pointed parts. All toilets and hand washing facilities are safe, sanitary and are operating properly. All floors are clean and safe.

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SUPERVISORS NAME: Claudia Guangorena
LICENSING EVALUATOR NAME: Lilli Babcock
LICENSING EVALUATOR SIGNATURE: DATE: 03/30/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/30/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.

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Document Has Been Signed on 03/30/2023 07:16 PM - It Cannot Be Edited


Created By: Lilli Babcock On 03/30/2023 at 06:11 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: PRIMANTI MONTESSORI ACADEMY
FACILITY NUMBER: 198019813

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/30/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type A
Section Cited
CCR
101429(a)(1)
Responsibility for Providing Care and Supervision for Infants
(1) Each infant shall be constantly supervised and under direct visual observation and supervision by a staff person at all times. Under no circumstances shall ANY infant be left unattended.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation the licensee did not comply with the section cited above in 2 out of 15 infants present who were not visually supervised while sleeping at all times which poses an immediate health, safety or personal rights risk to persons in care.
POC Due Date: 03/31/2023
Plan of Correction
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Director will meet with staff and develop a plan where 2 staff will be assigned to directly supervise sleeping infants. Director will email LPA a plan to supervise sleeping infants signed by all infant staff.
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:Claudia Guangorena
LICENSING EVALUATOR NAME:Lilli Babcock
LICENSING EVALUATOR SIGNATURE:
DATE: 03/30/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/30/2023


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Document Has Been Signed on 03/30/2023 07:16 PM - It Cannot Be Edited


Created By: Lilli Babcock On 03/30/2023 at 06:11 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: PRIMANTI MONTESSORI ACADEMY
FACILITY NUMBER: 198019813

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/30/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
101429(a)(2)(B)
Responsibility for Providing Care and Supervision for Infants
(B) Staff shall physically check on sleeping infant(s) every 15 minutes and document the following:

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, interview, and record review, the licensee did not comply with the section cited above in 15 out of 15 Sleep Logs for Infants and for all toddlers under 2 years of age, which were not completed which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 03/31/2023
Plan of Correction
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Director will meet with staff and 2 staff daily will be in charge of filling out the infant sleep logs and turning into director at the end of the day. Director will send LPA a copy of the meeting agenda signed by all infant and toddler staff.
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:Claudia Guangorena
LICENSING EVALUATOR NAME:Lilli Babcock
LICENSING EVALUATOR SIGNATURE:
DATE: 03/30/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/30/2023


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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
L.A. DAY CARE-EAST, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: PRIMANTI MONTESSORI ACADEMY
FACILITY NUMBER: 198019813
VISIT DATE: 03/30/2023
NARRATIVE
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All kitchen areas/food preparation areas and food storage areas are kept clean and are free of litter, rubbish and rodents and/or any other vermin.

LPA observed 2 trashcans without lids; one in the infant classroom and one in the toddler classroom. Drinking water is readily available both indoors and outdoors. The facility was observed to be free of flies, other insects and rodents. There is adequate shade in the play yard.



INFANT PROGRAM

Infant changing tables have a padded surface no less than one inch thick and are covered with washable vinyl or plastic and have raised sides at least three inches high. Toys were observed to be clean and safe. Infant napping equipment and cribs were observed. Clean sheets are provided by parents bi-weekly. Indoor activity space for this infant program is physically separate from the other components at this facility. Infant Needs and Services Plans are on file for each infant.

LPA discussed the safe sleep regulations with Director, Maribeth Peralta and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA observed there has been no sleep logs in the infant program for at least a month and Director did not know the toddler children needed a sleep log. LPA also observed 2 children unattended in the crib after waking up from a nap. LPA observed there were no staff visually supervising infants in the crib while sleeping on 2 occasions during the visit.

LPA also informed director of the importance of checking for recalled infant devices on the

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SUPERVISORS NAME: Claudia Guangorena
LICENSING EVALUATOR NAME: Lilli Babcock
LICENSING EVALUATOR SIGNATURE:

DATE: 03/30/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/30/2023
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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
L.A. DAY CARE-EAST, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: PRIMANTI MONTESSORI ACADEMY
FACILITY NUMBER: 198019813
VISIT DATE: 03/30/2023
NARRATIVE
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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.

All individuals present have obtained a criminal record clearance or criminal record exemption. There is at least one person trained in CPR and Pediatric First Aid present during this inspection.

In review of children’s records, files contain information 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.

LPA issued a copy of the LIC 857 Children’s Records Review and the LIC 859 Staff Records Review to the licensee during this inspection.

Children's roster was reviewed and is current. Children present were signed in. Disaster drill log was available, last drill was conducted on 3/7/23. LPA observed smoke detectors and carbon monoxide detectors to be functional.

Menus are posted one week in advance where it is visible by the child's authorized representative. Menus for the past 30 days are available upon request. Infants who are breast-feed or are bottle fed bring milk from home. The facility provides breakfast, AM snack, lunch, PM snack and evening snack for toddlers and older.

Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226.

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SUPERVISORS NAME: Claudia Guangorena
LICENSING EVALUATOR NAME: Lilli Babcock
LICENSING EVALUATOR SIGNATURE:

DATE: 03/30/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/30/2023
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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
L.A. DAY CARE-EAST, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: PRIMANTI MONTESSORI ACADEMY
FACILITY NUMBER: 198019813
VISIT DATE: 03/30/2023
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When any IMS is provided, an updated Plan of Operation that includes IMS must be submitted to the Department. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice)/ (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm

LPA advised the licensee to access forms, regulations, and quarterly updates on the Child Care Licensing website at: www.ccld.ca.gov

Director Maribeth Peralta, was reminded that all adults 18 and over, including employees and volunteers, 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 up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

The following deficiencies listed on the attached LIC 809 D deficiencies page are being cited in accordance with California Code of Regulations Title 22.

LPA Lilli Babcock informed facility representative, Mary Beth Peralta that this report dated 3/7/23 document(s) 1 Type A citation 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 Lilli Babcock informed the facility representative to provide a copy of this licensing report dated 3/7/23 that documents any Type A citation 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.

To improve the quality and value of the new inspection process, a survey will be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any

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SUPERVISORS NAME: Claudia Guangorena
LICENSING EVALUATOR NAME: Lilli Babcock
LICENSING EVALUATOR SIGNATURE:

DATE: 03/30/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/30/2023
LIC809 (FAS) - (06/04)
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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
L.A. DAY CARE-EAST, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: PRIMANTI MONTESSORI ACADEMY
FACILITY NUMBER: 198019813
VISIT DATE: 03/30/2023
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questions regarding the process or tools, please send them by email to inspectionprocess@dss.ca.gov. For 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.

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

Exit interview conducted and report was reviewed with Director, Maribeth Peralta

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SUPERVISORS NAME: Claudia Guangorena
LICENSING EVALUATOR NAME: Lilli Babcock
LICENSING EVALUATOR SIGNATURE:

DATE: 03/30/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/30/2023
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