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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 372001190
Report Date: 04/08/2024
Date Signed: 04/08/2024 10:47:38 AM

Document Has Been Signed on 04/08/2024 10:47 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
SAN DIEGO N. CC RO, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108
FACILITY NAME:MONTESSORI CENTER, THEFACILITY NUMBER:
372001190
ADMINISTRATOR/
DIRECTOR:		EDELAINE TORDECILLASFACILITY TYPE:
850
ADDRESS:740 PINE AVENUETELEPHONE:
(442) 333-9359
CITY:CARLSBADSTATE: CAZIP CODE:
92008
CAPACITY: 71TOTAL ENROLLED CHILDREN: 71CENSUS: 33DATE:
04/08/2024
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:25 AM
MET WITH:Pam CrismanTIME VISIT/
INSPECTION COMPLETED:
09:30 AM
NARRATIVE
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On 4/8/2024 @ 8:25AM, Licensing Program Analyst (LPA) Nancy Diaz conducted an unannounced case management inspection. LPA toured the facility with Marcela Sison, Administrative Staff. Mrs. Crisman arrived at the facility at 8:45AM.

The following census were observed at 9:30AM:
Room #1 with 17 preschool children and staff Janet dela Cruz & Leila Tobias.
Room #2 with 11 preschool children and staff Evangeline Puno and Prem Murugesan.
Room #3 with 5 Toddlers and staff Alicia Solano & Daniella Heitzman.

Type B deficiency was observed today. Type B deficiency if not corrected may pose a potential risk to the health, safety or personal rights of children in care.

LPA reviewed the report with Pam Crisman and provided a copy. Appeal rights and Notice of Site visit were also given. Notice of site visit must be posted for 30 days.
SUPERVISORS NAME: Joelle Redding
LICENSING EVALUATOR NAME: Nancy Diaz
LICENSING EVALUATOR SIGNATURE: DATE: 04/08/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/08/2024
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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Document Has Been Signed on 04/08/2024 10:47 AM - It Cannot Be Edited


Created By: Nancy Diaz On 04/08/2024 at 09:27 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
, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108

FACILITY NAME: MONTESSORI CENTER, THE
FACILITY NUMBER: 372001190

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/08/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
04/15/2024
Section Cited
CCR
101212(b)

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REPORTING REQUIREMENTS
he name of the child care center director, and any fully qualified teacher(s) designated to act in the child care center director's absence, shall be reported to the Department within 10 days of a change of child care center director or designee(s).
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Mrs. Crisman shall submit the required forms (LIC 308 and attachments) to the department designating person in charge.
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THIS REQUIREMENT WAS NOT MET AS EVIDENCED BY:
Ms. Crisman failed to notify the department when she designated the new designated site director in 2023.
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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:Joelle Redding
LICENSING EVALUATOR NAME:Nancy Diaz
LICENSING EVALUATOR SIGNATURE:
DATE: 04/08/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/08/2024


LIC809 (FAS) - (06/04)
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