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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 304371604
Report Date: 08/13/2024
Date Signed: 08/13/2024 11:29:58 AM

Document Has Been Signed on 08/13/2024 11:29 AM - 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:CHILDREN'S MONTESSORI CENTER OF YORBA LINDAFACILITY NUMBER:
304371604
ADMINISTRATOR/
DIRECTOR:		KEMPS, DISHNIFACILITY TYPE:
850
ADDRESS:17550 YORBA LINDA BLVD.TELEPHONE:
(714) 528-0831
CITY:YORBA LINDASTATE: CAZIP CODE:
92886
CAPACITY: 62TOTAL ENROLLED CHILDREN: 62CENSUS: 2DATE:
08/13/2024
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:00 AM
MET WITH:Office Admin Binbin ZhaoTIME VISIT/
INSPECTION COMPLETED:
11:45 AM
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On 08/13/24, at 10:01am a case management deficiency inspection was conducted today by Licensing Program Analyst (LPA) Anna Chan and Licensing Program Manager (LPM) Martha Malane, who met with Office Admin Binbin Zhao . Upon arrival there were 1 staff present and 2 preschool children in care.

During a facility inspection and interview with staff, staff 1 (S1) stated, in the morning when S1 arrives at around 7:15am, there are days where there are 2 infants and 2 preschoolers in the one classroom and S1 would take the infants to the infant class. Staff 2 S2 stated on 8/7/24 and 8/8/24, preschool and infant was together in 1 classroom.until another staff gets in. Staff 3 (S3) stated there are days that when S3 gets in the facility, there are preschool and infants together in a classroom and S3 would take her preschool class to preschool classroom.

A review of criminal record clearances indicates that all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions.

Based on interviews conducted, it is discovered that the facility is comngling. it was determined that the facility violated California Code of Regulations, Title 22, Division 12, 101161(a) Limitations on Capacity. This is a repeat violation cited on 6/21/24. Civil penalties assessed.



LPA Chan informed Office Admin Binbin Zhao , that this report dated 08/13/2024 documents 1 Type A citation which shall be posted for 30 consecutive days as there is immediate risk to the health, safety, or personal rights of children in care. Also, LPA informed Office Admin Binbin Zhao to provide a copy of this licensing report dated 08/13/2024 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.
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SUPERVISORS NAME: Martha Malane
LICENSING EVALUATOR NAME: Anna Francesca Chan
LICENSING EVALUATOR SIGNATURE: DATE: 08/13/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/13/2024
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: CHILDREN'S MONTESSORI CENTER OF YORBA LINDA
FACILITY NUMBER: 304371604
VISIT DATE: 08/13/2024
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An exit interview was conducted, and the report and deficiency was reviewed with Office Admin Bin Bin Zhao.Notice of Site Visit was posted during the visit. The Office Admin Bin Bin Zhao was informed that the notice of the site visit must be posted for 30 consecutive days. Failure to post will result in civil penalties of $100.

Appeal Rights were explained. The Office Admin Bin Bin Zhao was provided a copy of 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. First level appeals should be sent to the regional manager to the address listed above.
SUPERVISORS NAME: Martha Malane
LICENSING EVALUATOR NAME: Anna Francesca Chan
LICENSING EVALUATOR SIGNATURE:

DATE: 08/13/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/13/2024
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 08/13/2024 11:29 AM - It Cannot Be Edited


Created By: Anna Francesca Chan On 08/13/2024 at 10:04 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
, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME: CHILDREN'S MONTESSORI CENTER OF YORBA LINDA
FACILITY NUMBER: 304371604

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/13/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
08/14/2024
Section Cited
CCR
101161(a)

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101161 Limitations on Capacity
(a) A licensee shall not operate a child care center beyond the conditions and limitations specified on the license, including the capacity limitation.
This requirement was not met as evidence by:
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Office Admin Zhao stated they will have a plan to prevent comingling from happening. Admin will train staff and review staff schedules and review parent contract and will submit to LPA by due date 8/14/24
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Based on staff interview, 3 staff stated, there are days in the morning that infants and preschooler are together in one classroom until another staff comes in.

This is an immediate risk to health and safety of the 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:Martha Malane
LICENSING EVALUATOR NAME:Anna Francesca Chan
LICENSING EVALUATOR SIGNATURE:
DATE: 08/13/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/13/2024


LIC809 (FAS) - (06/04)
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