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

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 364845659
Report Date: 03/11/2022
Date Signed: 08/30/2022 09:43:50 AM

Document Has Been Signed on 08/30/2022 09:43 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
CCLD Regional Office, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501
FACILITY NAME:NADIA'S MONTESSORI CHILD CAREFACILITY NUMBER:
364845659
ADMINISTRATOR:SILAN, ANIE MONNETTE IRUGUFACILITY TYPE:
850
ADDRESS:5001 RIVERSIDE DR.TELEPHONE:
(909) 964-0442
CITY:CHINOSTATE: CAZIP CODE:
91710
CAPACITY: 67TOTAL ENROLLED CHILDREN: 67CENSUS: 36DATE:
03/11/2022
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
09:23 AM
MET WITH:Anie-Monnette Silan, DirectorTIME COMPLETED:
11:20 AM
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
***********************AMENDED REPORT****************************************
On 03/11/2022, Licensing Program Analysts (LPAs) Kay Phillips and Elyse Jones arrived at the facility above to conduct a Case Management Inspection for the purpose of addressing a matter that was discovered during an inspection at the facility. During the inspection LPAs conducted a tour of the facility and census were taken.

On 12/27/2021, Licensing Program Analysts (LPAs) Kay Phillips and Giselle Carbullido arrived at the facility above to conduct an investigation due to a complaint regarding the above facility. During the course of the investigation, staff reported sitting in the doorway between 2 classrooms supervising the children during nap time. The same staff noted to sending a child to the restroom alone while staff continued to supervise napping children. Staff was unable to provide visual line of sight to the child using the potty and if staff had walked away to assist the child using the potty, there would be no supervision to the napping children. The child using the potty was observed with wet clothing; however, it was unknown how it occurred. According to the regulation, supervision should always have a line of sight to all children in care without visual obstruction.

See LIC 809-D for deficiencies cited.

An exit interview was conducted with the facility director and appeal rights were provided.

Notice of Site Visit was left with the Director and must be posted for 30 days.

A copy of the report was left at the facility and must be made available to the public for three years upon request. A copy of a LIC 9224 was provided and discussed.
SUPERVISORS NAME: Aaron Ross
LICENSING EVALUATOR NAME: Karrene Turner
LICENSING EVALUATOR SIGNATURE: DATE: 03/11/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/11/2022
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 2
Document Has Been Signed on 08/30/2022 09:44 AM - It Cannot Be Edited

Document is an Amendment of Original Document on 08/24/2022 11:31 AM


Citations on this Visit Report are Under Appeal!


Created By: Karrene Turner On 03/11/2022 at 10:05 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
CCLD Regional Office, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501

FACILITY NAME: NADIA'S MONTESSORI CHILD CARE
FACILITY NUMBER: 364845659

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/11/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Under Appeal
Type A
03/12/2022
Section Cited
CCR
101229(a)(1)

1
2
3
4
5
6
7
Responsibility for Providing Care & Supervision
(a) The Licensee shall provide care & supervision as necessary to meet the children's needs. (1) No child(ren) shall be left without the supervision of a teacher at any time, except as specified in Sections 101216.2(e)(1) and 101230(c)(1). Supervision shall include visual observation.
1
2
3
4
5
6
7
Licensee agrees to submit a written statment ensuring the Department how care and supervision will be provided to all children in care during naptime by POC due date.

Licensee agrees to conduct an in-service training with staff regarding the responsibility to provide appropriate supervision.
8
9
10
11
12
13
14
This requirement was not met as evidenced by staff statements of sending a child to the restroom alone while staff continued to supervise napping children. In addition, staff observed the same child with wet clothing but was unable to determine how it occurred.
8
9
10
11
12
13
14
Copies of sign-in sheet and agenda to be submitted, as proof to the Riverside Child Care Regional Office by 03/18/2022.

******AMENDED REPORT**********

1
2
3
4
5
6
7
1
2
3
4
5
6
7
8
9
10
11
12
13
14
8
9
10
11
12
13
14
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:Aaron Ross
LICENSING EVALUATOR NAME:Karrene Turner
LICENSING EVALUATOR SIGNATURE:
DATE: 03/11/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/11/2022


LIC809 (FAS) - (06/04)
Page: 2 of 2