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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 360910803
Report Date: 03/08/2024
Date Signed: 03/08/2024 01:29:30 PM

Document Has Been Signed on 03/08/2024 01:29 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: 175CENSUS: 133DATE:
03/08/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
12:00 PM
MET WITH:Kim Montague, DirectorTIME COMPLETED:
01:45 PM
NARRATIVE
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Licensing Program Analyst (LPA) Raymond Moorehead conducted a case management inspection with Kim Montague, Director. A case management inspection is being conducted in response to the receipt of an Unusual Incident Report (UIR) from the facility. The UIR was received by the licensing agency on 02/23/2024 as the incident was self-reported.

The UIR documented an incident where a child reportedly fell and bumped their head on a table due to accidentally being bumped into by a friend. The fall resulted in the child needing medical attention. The facility tended to the child with care immediately, and the child was safely picked up by a parent/authorized representative. The child has since then returned to the facility and activity is normal.

During today's visit, LPA investigated the incident, Director and Staff were interviewed, documentation was obtained, a tour/census was taken, and the following was disclosed. It was reported that the subject child was playing in a group, then as the subject child was walking fast, another child bumped into them in which caused the subject child to hit the table that was nearby. The facility provided ice and gauze for the child and the child was picked up.

LPA observed the area in which the subject child fell and bumped their head on the table. No safety hazards were observed at this time. It was determined by LPA and Director/Staff Member that there were no safety hazards present and the two children had a accident where one bumped into the other.


Based on the information obtained, there appeared to be no violations of Title 22 Regulations pertaining to the reported incident at this time. LPA conducted an exit interview with Kim Montague, Director and provided a copy of this report. A Notice of Site Visit was issued and must remain posted for the next 30 days.
SUPERVISORS NAME: Aaron Ross
LICENSING EVALUATOR NAME: Raymond Moorehead
LICENSING EVALUATOR SIGNATURE: DATE: 03/08/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/08/2024
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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