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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198021636
Report Date: 03/11/2026
Date Signed: 03/11/2026 01:46:56 PM

Document Has Been Signed on 03/11/2026 01:46 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
MONTEREY PARK CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME:CHILDREN'S MONTESSORI CENTERFACILITY NUMBER:
198021636
ADMINISTRATOR/
DIRECTOR:		SHEELA DERANIYAGALAFACILITY TYPE:
860
ADDRESS:19 N HIDALGO AVETELEPHONE:
(310) 525-0924
CITY:ALHAMBRASTATE: CAZIP CODE:
91801
CAPACITY: 106TOTAL ENROLLED CHILDREN: 44CENSUS: 42DATE:
03/11/2026
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:15 AM
MET WITH:Director Eshani Malasekar TIME VISIT/
INSPECTION COMPLETED:
02:00 PM
NARRATIVE
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On Wednesday, March 11,2026 , Licensing Program Analyst (LPA) Staicy Perry conducted an unannounced case management- Incident inspection to follow up with an incident that was reported to the department. LPA Perry met with Director Eshani Malasekara, who guided LPA Perry on a tour of the facility. Per Director there are currently 44 children enrolled at the facility. Census was taken and LPA Perry observed 42 children in care at the time of inspection, which include infants and preschool.

During the investigation, interviews were conducted with staff, director and parents and pertinent documentation was reviewed and obtained regarding the incident with child #1. The incident was reported to the Department on 3/9/2026 (Monday) for an incident that occurred on 3/6/2026 (Friday) which is in within the required 24-hour period and written report (LIC624) was received by the Department on 3/9/2026. It was reported that Child #1 was provided breast milk belonging to another child, child#2. The facility reported that the breast milk bags and bottles brought from home were not labeled, which resulted in staff #1 providing the incorrect breast milk to Child #1.

According to the facility director, Child #1 was given approximately two ounces of another child’s breast milk, child #2’s breast milk, per staff #1. It was stated by Director that Staff #1 noticed when the mother of Child #1 picked up child #1 at pick up time, that the mother informed the staff member that that was not Child’s #1 bottle. The facility reported that the child did not show any signs of illness or distress and was reported to be fine. The facility stated that both parents of child #1 and child#2 were notified the same day the incident occurred. The director reported that the incident was discussed with the teacher responsible at the time and with the parents of the children involved.

LPA Perry conducted staff interviews. Staff #2 stated that staff #1 informed them that staff #1 had accidentally gave child #1 the wrong breast milk bottle and that bottle belonged to child #2. Staff #2 stated that child #2’s breast milk had been stored in the refrigerator from approximately one week prior, as child #2 had been absent due to an illness. Staff #2 stated that the breast milk had remained in the refrigerator for an unknown exact amount of time. Staff #2 stated that bottles were not properly labeled with names and dates, which contributed to the mix up. Additionally, Staff #1 informed Staff #2 of the situation. Staff #2 stated that Staff #1 needs to be told to the facility director.

NAME OF LICENSING PROGRAM MANAGER: Brandi VanOosten
NAME OF LICENSING PROGRAM ANALYST: Staicy Perry
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 03/11/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/11/2026
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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California Health & Human Services Agency
California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:
  • Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.
  • Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)
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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
MONTEREY PARK CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: CHILDREN'S MONTESSORI CENTER
FACILITY NUMBER: 198021636
VISIT DATE: 03/11/2026
NARRATIVE
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LPA Perry interviewed the facility director, the director acknowledged that the breast milk containers and bottles were not labeled according to Title 22 Regulations. The director stated that staff were reminded that all bottles and breast milk containers must be clearly labeled with the child’s name and date to prevent incidents from occurring. The facility also reported that parents were reminded of the importance of properly labeling all bottles and breast milk brought to the facility. It was also mentioned that parent on child#2 is currently taking medication. Parents interviewed state that parent of Child #1 is currently in communication with child's #1 pediatrician to ensure child #1 will be okay. Per parent #1, child #1 had no had an signs of illness.

During today’s visit, LPA Perry conducted an inspection of the bottles stored in the infant classroom refrigerator where the incident occurred and observed that multiple bottles were not labeled with the child’s name and date as required by Title 22 regulations, which poses a potential risk to the children in care.The facility did self report the incident and understood child#1 was under the supervision of staff #1and providing the wrong breast milk is a violation of a child's personal rights. It was disclosed to LPA Perry that staff#1 who was responsible for providing the bottle is no longer employed at the facility, as staff #1 voluntarily resigned following the incident. LPA Perry attempted to reach Staff #1 and was unsuccessful.

Based on information obtained, the facility failed to ensure that breast milk was properly labeled prior to being provided to child#1, resulting in child #1 receiving child #2’s breast milk, which poses immediate risk to the health and safety of the children in care. Due to the facility acknowledging that the incident occurred and the Department confirming through LPAs investigation, the incident is deemed to have happened.

Currently the facility is not in compliance with Title 22 regulations, and the deficiencies are being cited today for the safety of the children in care.

The deficiencies listed on the following page was observed by the LPA Perry and is being cited in accordance with California Code of Regulations Title 22. One type A deficiency is being issued today and (1) Type B deficiency is being issued today. 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. The following is being cited in accordance to Title 22 of the California Code of Regulations and Health and Safety Code of the State of California.

Exit interview conducted with Director Ashani. Copy of this report provided Director Ashani. Appeal rights were provided and explained. Notice of Site visit posted. Notice of Site Visit shall be posted for 30 consecutive days. Failure to maintain posting as required will result in a $100 civil penalty.

NAME OF LICENSING PROGRAM MANAGER: Brandi VanOosten
NAME OF LICENSING PROGRAM ANALYST: Staicy Perry
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 03/11/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/11/2026
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 03/11/2026 01:46 PM - It Cannot Be Edited


Created By: Staicy Perry On 03/11/2026 at 11:41 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: CHILDREN'S MONTESSORI CENTER
FACILITY NUMBER: 198021636

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/11/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
03/12/2026
Section Cited
CCR
101223(a)(3)

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101223 Personal Rights
(3) To be free from corporal or unusual punishment,... including but not limited to: interference with functions of daily living including eating, sleeping or toileting....

This requirement is not met as evidenced by:
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The facility director will have a meeting with staff on personal rights. Director will have staff watch the CCLD video on the department’s website. Director stated she will conduct an all staff meeting to go over
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Based on observation, interview, record review, the licensee did not comply with the section cited above Child #1 was given Child #2's brest milk which poses an immidiate risk to the health and safety of children in care.
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Personal Rights and provide LPA Perry with meeting agenda, along with staff signatures of those attended by POC date to LPA Perry.

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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.
Brandi VanOosten
NAME OF LICENSING PROGRAM MANAGER:
Staicy Perry
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 03/11/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/11/2026


LIC809 (FAS) - (06/04)
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Document Has Been Signed on 03/11/2026 01:46 PM - It Cannot Be Edited


Created By: Staicy Perry On 03/11/2026 at 11:53 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: CHILDREN'S MONTESSORI CENTER
FACILITY NUMBER: 198021636

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/11/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
03/20/2026
Section Cited
CCR
101427(j)

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101427 (J) Infant Care and Food Service..
(j) Bottles, dishes and containers of food brought by the infant's authorized representative shall be labeled with the infant's name and the current date.

This was not evidanced by:
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The facility director will submit a declaration on ensuring that all bottles and breast milk containers brought from home are clearly labeled with the child’s name and date prior to being stored or served to the child, in accordance with Title 22 regulations. The facility director will review
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LPA Perry did not observe infant bottles to be labed and dated during inspection as well as during the investigation it was setermined that bottles of child #1 and Child #2 were not dated, which poses a poential danger to the children in care.
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 proper labeling, and storage procedures with all infant classroom staff to ensure staff verify that bottles are labeled before placing them in the refrigerator and prior to feeding a child. Director will have staff read and sign off on Title 22 regulation on Infant Care and Food Service. Staff will also be reminded to check labels before providing any bottle to a child. The facility will also send a written reminder to all infant program parents informing them that all breast milk and bottles must be labeled with the child’s name and date before being brought to the facility. Moving forward, the director or designated staff will conduct daily checks of the refrigerator to ensure that all bottles are properly labeled and stored appropriately. The facility will submit proof of staff training and parent notification to the Department by the POC date via email to LPA Perry.

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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.
Brandi VanOosten
NAME OF LICENSING PROGRAM MANAGER:
Staicy Perry
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 03/11/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/11/2026


LIC809 (FAS) - (06/04)
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