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

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 503603196
Report Date: 01/29/2025
Date Signed: 01/29/2025 02:22:02 PM

Document Has Been Signed on 01/29/2025 02:22 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
FRESNO CC RO, 1310 E. SHAW AVE,
FRESNO, CA 93710
FACILITY NAME:MONTESSORI SCHOOL OF MODESTOFACILITY NUMBER:
503603196
ADMINISTRATOR/
DIRECTOR:		SEGURA, EVAFACILITY TYPE:
850
ADDRESS:3501 SAN CLEMENTE AVE.TELEPHONE:
(209) 567-1115
CITY:MODESTOSTATE: CAZIP CODE:
95356
CAPACITY: 140TOTAL ENROLLED CHILDREN: 140CENSUS: 41DATE:
01/29/2025
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:30 PM
MET WITH:EVA SEGURATIME VISIT/
INSPECTION COMPLETED:
02:45 PM
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 01/29/2025, Licensing Program Analyst (LPA) Stephanie Vega-Gonzalez conducted a Case Management. LPA met with Director Eva Segura and toured the facility, and a census was taken.

The purpose of the inspection was due to the Department receiving confirmation of the removal of Staff #1. LPA explained to Director that Staff #1 cannot work, reside, or be present at this facility unless a criminal record exemption is granted. Pursuant to state law, an exemption may be granted if the Caregiver Background Check Bureau (CBCB) is in receipt of substantial and convincing evidence that the individual is of present good character. Director indicated the individual named on the form has not been present or worked at the facility since 11/08/2024.



Based on the evidence obtained during today’s visit, the LPA has verified that Staff #1 is no longer present or employed at this facility since 11/08/2024. LPA obtained an updated copy of the LIC500 Personnel Report.

During the tour LPA observed that in Room 3 children were sleeping while Staff #2 was moping. LPA reviewed CCR 101216.3 Teacher-Child Ratio with Director. Director informed Staff #2 to open the windows to allow ventilation.

Per Title 22, Division 12, Chapter 1, of the California Code of Regulations, no deficiencies are cited.

This report shall be made available to the public upon request.

LIC 9213 Notice of Site Visit is provided and required to be posted for 30 days.

Appeal rights were printed and provided.

SUPERVISORS NAME: Cynthia Brannon
LICENSING EVALUATOR NAME: Stephanie Vega-Gonzalez
LICENSING EVALUATOR SIGNATURE: DATE: 01/29/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/29/2025
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 1