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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 334844868
Report Date: 07/28/2022
Date Signed: 07/28/2022 03:09:57 PM

Document Has Been Signed on 07/28/2022 03:09 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
CCLD Regional Office, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501
FACILITY NAME:MONTESSORI SCHOOL OF CORONAFACILITY NUMBER:
334844868
ADMINISTRATOR:VARMA, MAHIMAFACILITY TYPE:
850
ADDRESS:260 W. ONTARIO AVENUETELEPHONE:
(951) 371-6731
CITY:CORONASTATE: CAZIP CODE:
92882
CAPACITY: 120TOTAL ENROLLED CHILDREN: 120CENSUS: 29DATE:
07/28/2022
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
02:08 PM
MET WITH:Deja Hoxy, Lead TeacherTIME COMPLETED:
03:15 PM
NARRATIVE
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Licensing Program Analysts(LPAs) Elyse Jones and Blanca Ruiz arrived at the facility to conduct a Case Management inspection for the purpose of addressing separate matters that were discovered during a previous inspection at the facility. During the interviews it was disclosed that the facility was operating beyond the conditions and limitations specified on the license. LPAs conducted a tour of the facility and census were taken.

See LIC 809-D for deficiency cited

An exit interview was conducted.

Notice of Site Visit was left with the Director and must be posted for 30 days.

A copy of the report was left at the facility and must be made available to the public for three years upon request. .

SUPERVISORS NAME: Aaron Ross
LICENSING EVALUATOR NAME: Elyse Jones
LICENSING EVALUATOR SIGNATURE: DATE: 07/28/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/28/2022
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 2
Document Has Been Signed on 07/28/2022 03:09 PM - It Cannot Be Edited


Created By: Elyse Jones On 07/28/2022 at 02:29 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
, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501

FACILITY NAME: MONTESSORI SCHOOL OF CORONA
FACILITY NUMBER: 334844868

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/28/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
08/04/2022
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: Based on the interviews ,the Licensee did not meet Limitations of Capacity regulation which poses an potential Health,
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Licensee's repersentative agrees to submit a written statement on behalf of the Licensee, stating they understand the conditions and limitations of the license and they agree to operate in substantial compliance.
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Safety & Personal Rights risk to the children in care. Licensee stated the facility was providing care & supervision in their lobby for a child who was not enrolled and was under two. The child is no longer enrolled and no incidents occurred during the time that care was provided at the facility in April.
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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:Aaron Ross
LICENSING EVALUATOR NAME:Elyse Jones
LICENSING EVALUATOR SIGNATURE:
DATE: 07/28/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/28/2022


LIC809 (FAS) - (06/04)
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