198021692-5-13-2025-33-CC-CGRN-DGMR9L-20250513124944

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198021692
Report Date: 05/13/2025
Date Signed: 05/13/2025 12:49:53 PM

Document Has Been Signed on 05/13/2025 12:49 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:	OAKS MONTESSORI PRESCHOOL, THE		FACILITY NUMBER:	198021692
ADMINISTRATOR/ DIRECTOR:	DUMINDRA DE ZOYSA		FACILITY TYPE:	860
ADDRESS:	4817 EAGLE ROCK BLVD		TELEPHONE:	(323) 257-3709
CITY:	LOS ANGELES	STATE: CA	ZIP CODE:	90041
CAPACITY: 45	TOTAL ENROLLED CHILDREN: 12	CENSUS: 12	DATE:	05/13/2025
TYPE OF VISIT:	Prelicensing	ANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	10:00 AM
MET WITH:	Dumindra De Zoysa		TIME VISIT/ INSPECTION COMPLETED:	01:00 PM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	On 5/13/2025 at 10:00 am, Licensing Program Analyst (LPA), Crystal Green conducted an announced Pre-Licensing inspection for a Change of Ownership. Upon arrival, LPA met with Applicant Representative, Dumindra De Zoysa. Applicant, The Oaks Montessori Preschool, LLC, is requesting to be licensed for 44 children: (24) Infants from ages 0 to 24 months in Infant Room #1 and #2; and (20) Preschoolers from ages 2 to 5 years old in Preschool Room #1. Hours of operation will be Monday to Friday from 6:30am to 6pm. This location is currently licensed as American Montessori Preschool under (2) separate licenses; an Infant Program (198016696) with a capacity of 24 children from ages 0 to 24 months and a Preschool Program (198020003) with a capacity of 20 children from ages 2 to 5. Present during today’s inspection were 12 children: (3) Infants with (1) staff member and (9) Preschoolers with (2) staff members. Appropriate ratios and supervision were observed. All indoor and outdoor activity space utilized for the children was inspected today. LPA informed applicant representative that staff are required to maintain direct visual supervision of the children at all times during indoor and outdoor activities. When medications are on site, applicant stated that they will be in a higher cabinet located in the Director office. A fully equipped first aid kit is located within the preschool classroom. There is an operational carbon monoxide detector on site located near the kitchen area. All required licensing documents were observed posted near the entrance of the Director Office. Children will be signed in and out near the entrance gate of the facility. LPA observed the Infant and Preschool programs to have separate entrances.

NAME OF LICENSING PROGRAM MANAGER: Monica Cuddy
NAME OF LICENSING PROGRAM ANALYST: Crystal Green
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 05/13/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/13/2025

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: OAKS MONTESSORI PRESCHOOL, THE	FACILITY NUMBER: 198021692
	VISIT DATE: 05/13/2025

NARRATIVE

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LPA continued to tour the facility and measured all indoor and outdoor activity space. Total Infant indoor activity space measured 870.46 square footage, which is sufficient to accommodate the requested capacity of infant children. Total preschool indoor activity space measured 961.19 square footage, which is sufficient to accommodate the requested capacity of preschool children.
LPA observed all indoor activity space to be complete with safe, age-appropriate furniture and equipment, including tables, chairs, cubbies, napping cots/mats, bookshelves, and other activity supplies for the children. Drinking water is available in the classrooms via filter water dispenser. LPA observed all hazardous items to be inaccessible to children. There are no bodies of water or weapons on the property. Fire clearance was granted on 4/30/2025.

Highchairs and feeding tables have broad-based legs, plastic seats are in good repair and trays lock onto chairs. Highchairs are made of washable, moisture-resistant material. Changing tables have at least 1” padding covered with moisture-resistant, washable material. Sides of the changing table are at least 3” high and the changing table is within arm’s reach of a sink. Diapering sink is not used for meal preparation or dishwashing. Cribs meet regulatory requirements. LPA observed 12 cribs within Room #1. Crib area was observed to be separated from activity space via transparent soundproof wall partition. The wall partition measured to the height of 3.458 however according to Title 22 regulation 101438.3 (b)(2) which states moveable walls or partitions shall be at least four feet high. LPA discussed with Mrs. De Zoysa options available to meet the crib/napping area requirements. Per Mrs. De Zoysa, she will increase the height of the existing wall divider. Sleep logs will be kept in Infant Room #1. Needs and Services Plans and Sleep Plans are kept in Director’s office.

There is at least one potty chair or toilet for every five infants. LPA observed a total of 4 sinks, 2 toilets, and 2 changing tables available for infant children’s use. These are sufficient to accommodate the requested capacity of infant children. LPA observed a total of 3 sinks and 2 toilets available for preschool children’s use. These are sufficient to accommodate the requested capacity of preschool children. There is a separate staff restroom equipped with a toilet and a sink. The isolation area for children who are ill will be the staff break room.

NAME OF LICENSING PROGRAM MANAGER: Monica Cuddy
NAME OF LICENSING PROGRAM ANALYST: Crystal Green
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 05/13/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/13/2025

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
MONTEREY PARK CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: OAKS MONTESSORI PRESCHOOL, THE	FACILITY NUMBER: 198021692
	VISIT DATE: 05/13/2025

NARRATIVE

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Parents will provide snack and lunch for their child. There is a kitchen prep area on site that contains a refrigerator, prep countertop, and microwave. Per the applicant representative, the facility will have snacks on hand in case of an emergency.

The facility currently has two fully fenced playground area. Fencing was made of wrought iron and wood, which is at least four feet high. The total square footage for infant outdoor activity space is 1,203.77 square footage, which can only accommodate 16 infants at one time, insufficient for the number of children being requested. A playground waiver to share the playground at different times in the AM and PM due to limited square footage shall be submitted and approved prior to licensure. The total square footage for preschool outdoor activity space is 4709.34 square footage, which is sufficient to accommodate the requested preschool capacity.
Shade is provided via fixed shade structures. There are sufficient outdoor age-appropriate toys and play equipment available on the playground. There is a climbing structure on the preschool playground for children ages 2 to 6 years old which is properly anchored.
LPA observed areas located within both the Infant and Preschool play yard to have insufficient cushioning materials around and under the swings and climbing play equipment. Drinking water is available via filter water jug and personal water bottles. LPA observed all hazardous items on the playground to be inaccessible to children. Applicant Representative was reminded that any changes to the facility must be reported to and approved by Community Care Licensing.
For child care center licenses issued after July 1, 2022, the licensee shall test their water for lead within 180 days of licensure pursuant to Written Directives section 101700 (PIN 21-21.1- CCP).

LPA discussed the safe sleep regulations with applicant representative 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 also informed [applicant, licensee, or facility representative] 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.

NAME OF LICENSING PROGRAM MANAGER: Monica Cuddy
NAME OF LICENSING PROGRAM ANALYST: Crystal Green
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 05/13/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/13/2025

LIC809 (FAS) - (06/04)

Page: 4 of 5

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: OAKS MONTESSORI PRESCHOOL, THE	FACILITY NUMBER: 198021692
	VISIT DATE: 05/13/2025

NARRATIVE

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Applicant representative was reminded that all adults 18 and over responsible for administration or direct supervision of staff, persons who provides care and supervision to children, and staff who have contact with children, 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.

Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02-CCP. 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) or (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
Applicant was informed of the MyChildCarePlan.org site, 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.

The following corrections are needed prior to the issuance of the license:

Applicant will need to submit proof of the wall partition height increased to at least the minimum requirement of four feet high around the designated nap area in Infant room #1.
Applicant will need to obtain and submit proof of the additional cushioning material placed under and around the swings and climbing structures located within both the Infant and Preschool yards.
Applicant will need to submit proof of obtaining additional shade around the sitting area located within the Preschool yard.

Once all corrections are received and reviewed a license will be issued for 44 children: (24) Infants from ages 0 to 24 months in the Infant Room 1 and 2 and (20) Preschoolers from ages 2 to 5 years old in the Preschool Room 1.

Exit interview conducted and report was reviewed with the Applicant Representative, Dumindra De Zoysa.

NAME OF LICENSING PROGRAM MANAGER: Monica Cuddy
NAME OF LICENSING PROGRAM ANALYST: Crystal Green
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 05/13/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/13/2025

LIC809 (FAS) - (06/04)

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