<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 364841885
Report Date: 09/26/2024
Date Signed: 09/26/2024 11:50:24 AM

Document Has Been Signed on 09/26/2024 11:50 AM - 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 CC RO, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501
FACILITY NAME:ST. MARY'S MONTESSORI SCHOOLFACILITY NUMBER:
364841885
ADMINISTRATOR/
DIRECTOR:		DESERIE MARTINEZFACILITY TYPE:
850
ADDRESS:6880 N VICTORIA WINDROWS LOOPTELEPHONE:
(909) 200-2727
CITY:RANCHO CUCAMONGASTATE: CAZIP CODE:
91739
CAPACITY: 209TOTAL ENROLLED CHILDREN: 209CENSUS: 163DATE:
09/26/2024
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:20 AM
MET WITH:Deserie Martinez/directorTIME VISIT/
INSPECTION COMPLETED:
12:15 PM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
On 9/26/24 at 10:20 am, Licensing Program Analyst (LPA) Patricia Berry conducted a Case Management (CM) visit to conclude an investigation of an Unusual Incident Report (UIR), which was received on 09/10/24. The UIR stated a child was inappropriately handled by two staff members. On 09/11/24, LPA conducted a CM, where LPA conducted interviews, reviewed video footage, and obtained photos. During today’s visit, LPA met with Deserie Martinez, toured the facility, and took census.

During the investigation of the UIR, LPA viewed video footage. LPA observed two teachers handling a crying child in an inappropriate manner. In the video, staff were observed grabbing the child’s arms inappropriately, roughly removing the child from the classroom doorway, and holding the child under the child’s arms.

Staff did not admit to handling the child inappropriately; however,staff stated they know they could have handled the situation differently.

LPA received five photos of the child’s injuries. The photos show multiple red marks, abrasions, on the child’s neck, back, leg and side of their body.

The facility after becoming aware of the situation immediately notified the parents of the injured child, contacted Community Care Licensing by telephone and sent in the Unusual Incident report. The Facility contacted Law Enforcement and sent an email to each parent/authorized representative in the facility regarding the incident. Training was conducted with all lead teachers on personal rights, discussing proper touching and if frustrated what to do to help yourself and the children. Training's are conducted on a regular basis on personal rights. Training's have also been previously done 7/24 with Community Care Licensing.

See LIC809D for cited deficiencies of the California Code of Regulations, Title 22, Div. 12.

(Cont on 809C)
SUPERVISORS NAME: Gilbert Sena
LICENSING EVALUATOR NAME: Patricia Berry
LICENSING EVALUATOR SIGNATURE: DATE: 09/26/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/26/2024
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 3
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVERSIDE CC RO, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501
FACILITY NAME: ST. MARY'S MONTESSORI SCHOOL
FACILITY NUMBER: 364841885
VISIT DATE: 09/26/2024
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
LPA informed director, Deserie Martinez, Type A citations must be reported, by the next business day, or the next day children are in care, to all authorized representatives of children currently enrolled; and to all newly enrolled children for the next 12 months from the date of citation. The signed Acknowledgement of Receipt form, LIC 9224, must be placed in the child’s file for verification.

An exit interview was conducted with Deserie Martinez. During the exit interview, appeal rights were discussed/provided, Notice of Site form provided, and a copy of this report was provided.




Notice of Site visit must be posted for 30 days.
SUPERVISORS NAME: Gilbert Sena
LICENSING EVALUATOR NAME: Patricia Berry
LICENSING EVALUATOR SIGNATURE:

DATE: 09/26/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/26/2024
LIC809 (FAS) - (06/04)
Page: 2 of 3
Document Has Been Signed on 09/26/2024 11:50 AM - It Cannot Be Edited


Created By: Patricia Berry On 09/26/2024 at 10:44 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: 09/26/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
09/27/2024
Section Cited
CCR
101223(a)(3)

1
2
3
4
5
6
7
Personal Rights (a) The licensee shall ensure that each child is accorded the following personal rights: (3) To be free from corporal or unusual punishment, infliction of pain...

This requirement was not met as evidenced by
1
2
3
4
5
6
7
Director stated she will send a plan on what training will be done for the personal rights citation by 9/27/24.

Director stated she will send the trainings conducted to CCL with a list of participants by 10/1/24.
8
9
10
11
12
13
14
Based on interviews, video footage and photos of the incident there was a violation of personal rights.

This is an immediate risk to the Health and Safety and Personal Rights of children in care.
8
9
10
11
12
13
14

1
2
3
4
5
6
7
1
2
3
4
5
6
7

1
2
3
4
5
6
7
1
2
3
4
5
6
7
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: 09/26/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/26/2024


LIC809 (FAS) - (06/04)
Page: 3 of 3