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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 364841885
Report Date: 02/16/2023
Date Signed: 02/16/2023 12:23:50 PM

Document Has Been Signed on 02/16/2023 12:23 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:ST. MARY'S MONTESSORI SCHOOLFACILITY NUMBER:
364841885
ADMINISTRATOR:MARTINEZ DESERIEFACILITY TYPE:
850
ADDRESS:6880 N VICTORIA WINDROWS LOOPTELEPHONE:
(909) 200-2727
CITY:RANCHO CUCAMONGASTATE: CAZIP CODE:
91739
CAPACITY: 209TOTAL ENROLLED CHILDREN: 209CENSUS: 176DATE:
02/16/2023
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Deserie Martinez/DirectorTIME COMPLETED:
01:00 PM
NARRATIVE
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On 2/16/23 at 10:00 am, Licensing Program Analyst (LPA) Patricia Berry conducted a case management-deficiencies inspection. LPA met with Deserie Martinez/director and was granted access into the facility. LPA toured facility and took a census.

On 2/9/23 it was self-reported by the director that on 2/8/23 a child was found by a parent walking by herself on school-grounds. Director stated during dismissal it was assumed by staff the child was walking toward her parent; however, it was discovered three minutes later the child was walking alone. Director and Admin manager developed a plan for dismissal/transition to ensure moving forward the children will be safe.The director and admin manager have added more staff to ensure adequate supervision and have also implemented wearing orange vests to distinguish the dismissal staff and added walkie talkies.

According to regulation 101229 Responsibility for Providing Care and Supervision (1) No child(ren) shall be left without the supervision of a teacher at any time, ...Supervision shall include visual observation.

See 809D for deficiency.

Civil penalty LIC421IM issued today for $1,000.00 (repeat violation)

Exit interview conducted with director, report, appeal rights, acknowledgment of receipt and Notice of Site Visit provided to the director.
Notice of Site Visit must be posted for 30 days.

This report must be made available to the public for three years.
SUPERVISORS NAME: Gilbert Sena
LICENSING EVALUATOR NAME: Patricia Berry
LICENSING EVALUATOR SIGNATURE: DATE: 02/16/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/16/2023
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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Document Has Been Signed on 02/16/2023 12:23 PM - It Cannot Be Edited


Created By: Patricia Berry On 02/16/2023 at 11:16 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
, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501

FACILITY NAME: ST. MARY'S MONTESSORI SCHOOL
FACILITY NUMBER: 364841885

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/16/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
02/16/2023
Section Cited
CCR
101229(a)(1)

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Responsibility for Providing Care and Supervision (a) The licensee shall provide care and supervision...(1) No child shall be left without ... supervision... ...shall include visual observation.
This requirement was not met as evidenced by



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Director stated on 2/8/23 she immediately had an emergency meeting all lead teachers. On 2/9 director informed the parent of the child and implemented a new routine and had a mock training for dismissal.
Director stated she will conduct
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Based on incident self-reported by director a child was left, alone on school-grounds 2/8/23.
This is an immediate risk to the health and safety of children in care. Civil penalty LIC421IM issued today for $1,000.00 (repeat violation)
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supervision training with all staff from an outside vendor and send list of participants and topics to CCL by 2/25/23.

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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:Gilbert Sena
LICENSING EVALUATOR NAME:Patricia Berry
LICENSING EVALUATOR SIGNATURE:
DATE: 02/16/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/16/2023


LIC809 (FAS) - (06/04)
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