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

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376701396
Report Date: 07/20/2022
Date Signed: 07/20/2022 10:30:44 AM


Document Has Been Signed on 07/20/2022 10:30 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, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108



FACILITY NAME:KINDERHOUSE MONTESSORI SCHOOLFACILITY NUMBER:
376701396
ADMINISTRATOR:ALEXANDRA POPFACILITY TYPE:
850
ADDRESS:6540 FLANDERS DRIVETELEPHONE:
(858) 550-0097
CITY:SAN DIEGOSTATE: CAZIP CODE:
92121
CAPACITY:120CENSUS: 61DATE:
07/20/2022
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Alexandra PopTIME COMPLETED:
10:40 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
On 7/20/22 at approximately 9:30 AM, Licensing Program Analyst (LPA) Annette Sutherland conducted an unannounced case management inspection.  LPA was met at the entry point by Director Alexandra Pop.  LPA introduced herself, displayed her department identification and explained the purpose of the visit. The purpose of this visit was to follow up on a unusual incident report dated 6/28/22. Where a child's personal rights were violated. Director provided a tour of the facility. LPA observed the preschool classrooms within ratio & capacity . Staff present had criminal record clearances and were associated.

Director Alexandra Pop stated that the Staff member involved has been terminated effective 6/28/22.

See 809D for Deficiency Cited

LPA Annette Sutherland informed Alexandra Pop that this report dated 7/20/22 document(s) 1 Type A citation(s) which shall be posted for 30 consecutive days as there is immediate risk(s) to the health, safety, or personal rights of children in care.
 
Also, LPA Annette Sutherland  informed the Director Alexandra Pop to provide a copy of this licensing report dated 7/20/22 that documents any Type A citation(s) to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification.

Exit interview conducted and report was reviewed with Alexandra Pop. A notice of site visit was given and must remain posted for 30 days.
SUPERVISOR'S NAME: Monica CuddyTELEPHONE: (619) 767-2249
LICENSING EVALUATOR NAME: Annette SutherlandTELEPHONE: (619) 629-8751
LICENSING EVALUATOR SIGNATURE:
DATE: 07/18/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/18/2022
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 07/20/2022 10:30 AM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108


FACILITY NAME: KINDERHOUSE MONTESSORI SCHOOL
FACILITY NUMBER: 376701396

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/20/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
07/21/2022
Section Cited

1
2
3
4
5
6
7
Personal Rights- The licensee shall ensure that each child is accorded the following personal rights: (3) To be free from corporal or unusual punishment… This requirement was not met as evidenced by:
8
9
10
11
12
13
14
Based on interview and record review, Staff # 1 violated rights on 6/28/22 when Staff #1 pinched Child #1, which poses an immediate Health, Safety, and Personal Rights risk to children in care.
8
9
10
11
12
13
14
documents with the Director and understand them. Director will submit these staff statements to LPA Sutherland via email Annette.sutherland@dss.ca.gov by 7/28/22.

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: Monica CuddyTELEPHONE: (619) 767-2249
LICENSING EVALUATOR NAME: Annette SutherlandTELEPHONE: (619) 629-8751
LICENSING EVALUATOR SIGNATURE:
DATE: 07/19/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/19/2022
LIC809 (FAS) - (06/04)
Page: 2 of 2