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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 364845734
Report Date: 09/21/2023
Date Signed: 09/21/2023 09:04:40 AM

Document Has Been Signed on 09/21/2023 09:04 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:CHILDREN'S MONTESSORI SCHOOLFACILITY NUMBER:
364845734
ADMINISTRATOR:LAURA PEREZFACILITY TYPE:
850
ADDRESS:328 WEST PHILLIPS STREETTELEPHONE:
(909) 988-7145
CITY:ONTARIOSTATE: CAZIP CODE:
91762
CAPACITY: 34TOTAL ENROLLED CHILDREN: 34CENSUS: 4DATE:
09/21/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
08:50 AM
MET WITH:New Facility Director, Misha DavidTIME COMPLETED:
09:25 AM
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On 09/21/23 at 8:50 a.m. an unannounced case management inspection was conducted by Licensing Program Analysts (LPAs) Blanca Ruiz and Elyse Jones. LPAs met with New Facility Director, Misha David. The center was toured and a census was taken. The purpose of the inspection was to deliver amended page(s) LIC 809 (Page 1 of 4) information from the report has been changed and one deficiency cited was removed from LIC 809D (Page 3 of 4) pertaining to the report provided on 09/18/23. During today’s inspection, the LPA delivered the amended page(s) and retrieved the original page(s).

No deficiencies were cited during inspection.

An exit interview conducted and report was review with New Facility Director, Misha David. A copy of this report was provided to the director on this date and must be made available to the public upon request for the next 3 years.

A notice of site visit was given and must remain posted immediately adjacent to, the interior side of the main door for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

SUPERVISORS NAME: Aaron Ross
LICENSING EVALUATOR NAME: Blanca Ruiz-Silva
LICENSING EVALUATOR SIGNATURE: DATE: 09/21/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/21/2023
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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