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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 360910803
Report Date: 03/14/2023
Date Signed: 03/14/2023 06:06:22 PM

Document Has Been Signed on 03/14/2023 06:06 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
INLAND EMPIRE CHILD, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501
FACILITY NAME:MONTESSORI IN REDLANDS, INCFACILITY NUMBER:
360910803
ADMINISTRATOR:KIM MONTAGUEFACILITY TYPE:
850
ADDRESS:1890 ORANGE AVENUETELEPHONE:
(909) 793-6989
CITY:REDLANDSSTATE: CAZIP CODE:
92373
CAPACITY: 175TOTAL ENROLLED CHILDREN: 158CENSUS: 142DATE:
03/14/2023
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
12:32 PM
MET WITH:Head of School Jenny DavidsonTIME COMPLETED:
03:30 PM
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On 03/14/2023 a case management visit is being conducted by Licensing Program Analyst (LPA) Susan Brewer, in response to the receipt of a self-reported unusual incident report (UIR) from the facility. The LPA was greeted by Head of School Jenny Davidson and granted entry to tour the facility inside and out. The UIR was received by the licensing agency on 03/07/2023. It indicates that a daycare child, tripped fell and injured their upper right hip area when playing outdoors.

LPA S.Brewer, reviewed facility records and conducted interviews. Further information will be needed. Upon completion of the review, the outcome and/or recommendations will be provided to the licensee.

No citations issued.

No civil penalties issued.

An exit interview was conducted and a copy of this report was provided to Head of School Jenny Davidson.
SUPERVISORS NAME: Kimberly Williams
LICENSING EVALUATOR NAME: Susan Brewer
LICENSING EVALUATOR SIGNATURE: DATE: 03/14/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/14/2023
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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