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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376105221
Report Date: 09/15/2025
Date Signed: 09/18/2025 09:50:37 AM

Document Has Been Signed on 09/18/2025 09:50 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
SAN DIEGO N. CC RO, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108
FACILITY NAME:CENTRAL MONTESSORI SCHOOLFACILITY NUMBER:
376105221
ADMINISTRATOR/
DIRECTOR:		BANAFSHEH MORTAZAVIFACILITY TYPE:
860
ADDRESS:288 A-B NORTH EL CAMINO REALTELEPHONE:
(760) 479-9889
CITY:ENCINITASSTATE: CAZIP CODE:
92024
CAPACITY: 80TOTAL ENROLLED CHILDREN: 80CENSUS: 0DATE:
09/15/2025
TYPE OF VISIT:PrelicensingANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:15 AM
MET WITH:Banafsheh MortazaviTIME VISIT/
INSPECTION COMPLETED:
11:45 AM
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On 09/15/25 at 9:15am, Licensing Program Analysts (LPA), Samantha Clenista and Selina Siao conducted an announced Pre-Licensing inspection for a new license. Upon arrival, LPAs met with Applicant/Facility Representative, Banafsheh Mortazavi. The Applicant is requesting to be licensed for 22 toddlers (18-36 months) in Room 7 and 58 preschoolers (2-5 years old) in Rooms 8 and 9. Hours of operation will be Monday thru Friday, 7am-6pm. This facility shares the same entrance, director and outdoor playground with Applicant’s already licensed facility #376700910 located at 286 North El Camino Real Encinitas, CA 92024.

All indoor and outdoor activity space utilized for the children was inspected today. LPAs informed Applicant that staff are required to maintain direct visual supervision of the children at all times during indoor and outdoor activities to ensure their overall health and safety. When medications are on site, Applicant stated that they will be in a blue bag behind every classroom door. A fully equipped first aid kit is located in the kitchen. There is an operational carbon monoxide detector on site located in each classroom and kitchen. All required licensing documents were observed posted in the main entry hallway located at the main office located at 286 North El Camino Real Encinitas, CA 92024. Children will be signed in and out via Procare App.

LPAs continued to tour the facility and measured all indoor and outdoor activity space. Total indoor activity space for the toddlers measured at 835.36 sq. ft., sufficient to accommodate the requested overall capacity of 22 toddlers. Total indoor activity space for preschool children measured at 1981.06 sq. ft., which is only sufficient to accommodate 56 children, instead of the requested 58. LPAs observed all indoor activity space to be complete with safe, age-appropriate furniture and equipment, including tables, chairs, cubbies, napping cots/mats, bookshelves, and other activity supplies for the children.
NAME OF LICENSING PROGRAM MANAGER: Monica Cuddy
NAME OF LICENSING PROGRAM ANALYST: Samantha Clenista
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 09/15/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/15/2025
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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California Health & Human Services Agency
California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:
  • Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.
  • Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)
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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		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: CENTRAL MONTESSORI SCHOOL
FACILITY NUMBER: 376105221
VISIT DATE: 09/15/2025
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 Drinking water is available in the classrooms via refillable filtered water jug. LPAs observed all hazardous items to be inaccessible to children. There are no bodies of water or weapons on the property. Fire clearance was granted on 09/02/25.

Changing table located in the toddler room (Room 7) has at least 1” padding covered with moisture-resistant, washable material. Sides of the changing table are at least 3” high and the changing table is within arm’s reach of a sink. Diapering sink is not used for meal preparation or dishwashing. Sleep logs and Needs and Services Plans for children who are less than 24 months will be kept in a folder within the classroom, and Applicant was reminded that the Needs and Services Plan must be updated quarterly.

LPAs observed a total of 2 sinks and 2 toilets available for toddler use, and 4 sinks and 4 toilets available for preschool use. These are sufficient to accommodate the requested overall capacity for each program. There are two staff restrooms, equipped with a total of 2 sinks and 2 toilets. The isolation area for children who are ill will be an area located within the staff lounge and one staff restroom (which is labeled) that will be used for the isolation bathroom. The Applicant is reminded that any changes to the facility must be reported to and approved by Community Care Licensing.



Facility will provide AM and PM snacks. The kitchen area currently includes one sink, a microwave, refrigerator and storage cabinets for snacks. The kitchen area and food storage areas were observed to be free of rodents and/or vermin. Food was observed to be properly stored separate from cleaning materials. There were no hazardous items located in kitchen during inspection.

The facility does not have its own designated outdoor playground. The applicant requested that they share the playground that is currently under their licensed facility #376700910, since they share the same entrance, ownership, and the buildings are next to one another. There are two fenced in playgrounds at the current facility, one for toddlers and one for preschool. Fencing (via rot iron and chain link) is at least four feet high. The total square footage for the outdoor activity space for the preschool is 6,821 sq. ft., which is sufficient to accommodate the requested capacity. The total square footage for all the outdoor activity space for the toddlers is 4,221 sq. ft., which is sufficient to accommodate the requested capacity.
NAME OF LICENSING PROGRAM MANAGER: Monica Cuddy
NAME OF LICENSING PROGRAM ANALYST: Samantha Clenista
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 09/15/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/15/2025
LIC809 (FAS) - (06/04)
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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		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: CENTRAL MONTESSORI SCHOOL
FACILITY NUMBER: 376105221
VISIT DATE: 09/15/2025
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A playground waiver to share the current licensed facility’s playground at different times in the AM and PM due to this facility not having their own designated playground shall be submitted and approved prior to licensure. Shade is provided via trees, patio covers and pergolas. There are sufficient outdoor age-appropriate toys and play equipment available on the playgrounds. There are climbing structures located on both the toddler and preschool playgrounds which appeared to be age appropriate for both ages. There is adequate cushioning in fall zones of climbers provided by sand. LPAs observed all hazardous items on the playgrounds to be inaccessible to children.

For child care center licenses issued after July 1, 2022, the licensee shall test their water for lead within 180 days of licensure pursuant to Written Directives section 101700 (PIN 21-21.1- CCP).

Applicant was reminded that all adults 18 and over responsible for administration or direct supervision of staff, persons who provides care and supervision to children, and staff who have contact with children, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a Child Care Center. A civil penalty of $100.00 minimum/day for a maximum of 5-days or, if the penalty is for a repeat violation, for a maximum of 30-days per person will be assessed if this regulation is violated.

This facility plans to provide Incidental Medical Services – IMS. For IMS information, see PIN 22-02-CCP. A Plan of Operation that includes IMS must be submitted to the Department. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice) or (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm

LPA reviewed with Applicant the LIC 311A, Records to Be Maintained at The Facility, for child’s records, personnel records, administrative records, and documents to be posted.

Applicant was informed of the MyChildCarePlan.org site, a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.
NAME OF LICENSING PROGRAM MANAGER: Monica Cuddy
NAME OF LICENSING PROGRAM ANALYST: Samantha Clenista
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 09/15/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/15/2025
LIC809 (FAS) - (06/04)
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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		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: CENTRAL MONTESSORI SCHOOL
FACILITY NUMBER: 376105221
VISIT DATE: 09/15/2025
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Exit interview conducted and report was reviewed with Applicant/Director, Banafsheh Mortazavi.

Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other important information communication platforms. To receive important licensed related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-care-licensing/subscribe and select the Child Care option to receive email communication.

The following corrections are needed prior to the issuance of the license:
· Submit a waiver to have the same person, Banafsheh Mortazavi, to be the director at this location and the facility next to it, which Licensee also operates in (286 North El Camino Real Encinitas, CA 92024).
· Submit a waiver request to share the playground that is located between 286 and 288 North El Camino Real Suite A-B).

Applicant/Licensee Representative, Banafsheh Mortazavi, understands that all proof of corrections must be provided to the Department within 30 days, or the application may be denied.
NAME OF LICENSING PROGRAM MANAGER: Monica Cuddy
NAME OF LICENSING PROGRAM ANALYST: Samantha Clenista
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 09/15/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/15/2025
LIC809 (FAS) - (06/04)
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