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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 304370922
Report Date: 02/05/2025
Date Signed: 02/05/2025 01:25:02 PM

Document Has Been Signed on 02/05/2025 01:25 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
ORANGE COUNTY CC RO, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
FACILITY NAME:MONTESSORI LEARNING CENTERFACILITY NUMBER:
304370922
ADMINISTRATOR/
DIRECTOR:		DAVIS, JEANNETTEFACILITY TYPE:
830
ADDRESS:331 NORTH HARBOR BLVD.TELEPHONE:
(714) 999-6618
CITY:ANAHEIMSTATE: CAZIP CODE:
92805
CAPACITY: 10TOTAL ENROLLED CHILDREN: 10CENSUS: 8DATE:
02/05/2025
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
11:00 AM
MET WITH:Director, Jeannette DavisTIME VISIT/
INSPECTION COMPLETED:
01:20 PM
NARRATIVE
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On 2/5/2025, Licensing Program Analyst (LPA) Sun conducted a Case Management – Deficiencies due to deficiencies observed during a visit. LPA informed Director,Jeannette Davis of the purpose of the Case Management.

Upon arrival at 08:30 AM, LPA met with Director, Jeannette Davis and toured the facility. LPA observed 4 children with 2 staff in the Infant Room. By 9:30 AM 4 additional infants and a third staff arrived at infant classroom. LPA observed that 8 of 8 infants were missing Infant Sleep Log documentation for 2/4/25. LPA and director reviewed Infant Sleep Logs for the months of January and February, LPA confirmed Infant Logs were not completed by staff for February 2025.

A review of the Facility Personnel Report Summary shows all facility staff or individuals who require caregiver background checks have received a criminal record clearance and a child abuse index clearance or an exemption clearance.

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SUPERVISORS NAME: Thuy Ho
LICENSING EVALUATOR NAME: Cynthia Sun
LICENSING EVALUATOR SIGNATURE: DATE: 02/05/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/05/2025
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE COUNTY CC RO, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
FACILITY NAME: MONTESSORI LEARNING CENTER
FACILITY NUMBER: 304370922
VISIT DATE: 02/05/2025
NARRATIVE
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The facility was not in compliance. Director, Jeannette Davis was informed that this licensing report dated 2/5/2025 documents one “Type B citation. The following deficiency was observed and cited today per CA Code of Regulations, Title 22, Division 12 Section 101429(a)(2)(C) Responsibility for Providing Care and Supervision for Infants (See LIC 809D).

Exit interview conducted and report was reviewed with the licensee. Appeal Rights were discussed. The facility representative was provided a copy of their appeal rights (LIC 9058) and their signature on this form acknowledges receipt of these rights. All appeals must be in writing and received by the Regional Office within 15 business days. A notice of site visit was provided and must remain posted for 30 days.

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SUPERVISORS NAME: Thuy Ho
LICENSING EVALUATOR NAME: Cynthia Sun
LICENSING EVALUATOR SIGNATURE:

DATE: 02/05/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/05/2025
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 02/05/2025 01:25 PM - It Cannot Be Edited


Created By: Cynthia Sun On 02/05/2025 at 12:58 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
, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME: MONTESSORI LEARNING CENTER
FACILITY NUMBER: 304370922

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/05/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
02/28/2025
Section Cited
CCR
101429(a)(2)(C)

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(C) Documentation shall be maintained in the infant’s file and be available to the Department for review. Documentation shall include the following:

This requirement is not met as evidenced by:
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Director stated she will meet with staff and review completing Infant Sleep Logs. Director stated she will email LPA a proof of staff meeting and Infant Sleep Logs from 2/5/25-2/28/25. Director stated she will email LPA by due date.
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Based on interview and record review, the licensee did not comply with the section cited 8 out of 8 infants did not have 15-minute sleep log, which poses a potential health, safety or personal rights risk to persons 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:Thuy Ho
LICENSING EVALUATOR NAME:Cynthia Sun
LICENSING EVALUATOR SIGNATURE:
DATE: 02/05/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/05/2025


LIC809 (FAS) - (06/04)
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