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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 334845456
Report Date: 06/28/2024
Date Signed: 06/28/2024 03:58:24 PM

Document Has Been Signed on 06/28/2024 03:58 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
RIVERSIDE SE CC RO, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501
FACILITY NAME:GROWING TREE MONTESSORI PRESCHOOLFACILITY NUMBER:
334845456
ADMINISTRATOR/
DIRECTOR:		DENG, QIFACILITY TYPE:
850
ADDRESS:31935 VIA RIO TEMECULA ROADTELEPHONE:
(951) 900-8999
CITY:TEMECULASTATE: CAZIP CODE:
92592
CAPACITY: 106TOTAL ENROLLED CHILDREN: 106CENSUS: 44DATE:
06/28/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
03:16 PM
MET WITH:Julia Fletes, DirectorTIME VISIT/
INSPECTION COMPLETED:
04:15 PM
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On date and time listed, Licensing Program Analyst (LPA) William Chancellor arrived unannounced to the facility to conduct a case management visit due to an unusual incident report received on June 12, 2024. The incident involved a child letting go of the seesaw handle, falling, hitting their head and requiring medical attention. LPA conducted a tour of the facility, requested medical discharge paper work and interviewed two staff involved in the incident. Appropriate ratio's and supervision were observed.

Interviews revealed that staff were in ratio at the time of the incident and S1 observed C1 fall from the seesaw, hitting their head. LPA has determined that the facility staff took the necessary steps to immediately contact the emergency contacts, allowing C1 to receive medical attention in a timely manner. C1 returned the next day and is still enrolled with the CCC.

An exit interview was conducted, a copy of this report, LIC 811 (Confidential Names List) and appeal rights were reviewed with and provided to Director Julia Fletes. A notice of site visit was also provided and must remain posted for 30 days.

SUPERVISORS NAME: Pauline Beschorner
LICENSING EVALUATOR NAME: William M Chancellor Jr.
LICENSING EVALUATOR SIGNATURE: DATE: 06/28/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/28/2024
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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