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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197417432
Report Date: 05/12/2025
Date Signed: 05/12/2025 03:43:25 PM

Document Has Been Signed on 05/12/2025 03:43 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
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME:MONTESSORI OF CALABASAS- INFANTFACILITY NUMBER:
197417432
ADMINISTRATOR/
DIRECTOR:		DONNA ESGROFACILITY TYPE:
830
ADDRESS:3840 OLD TOPANGA CYN.ROADTELEPHONE:
(818) 222-0240
CITY:CALABASASSTATE: CAZIP CODE:
91302
CAPACITY: 12TOTAL ENROLLED CHILDREN: 8CENSUS: 8DATE:
05/12/2025
TYPE OF VISIT:Required - 3 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
02:05 PM
MET WITH:Luana Madrigal, Regional DirectorTIME VISIT/
INSPECTION COMPLETED:
04:00 PM
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Licensing Program Analyst (LPA) Tatiana Bickham conducted an unannounced 3 year required inspection on 05/122025. LPA arrived at the facility at 2:05 PM. LPA met with Regional Director Luana Madrigal who guided LPA on tour of the facility. This is a infant center licensed for 12 infants. Facility consists of 2 classrooms. Hours of operation are Monday through Friday from 7:30 am – 5:30 pm. Facility has a preschool licensee 197417431.

All areas identified on the Facility Sketch were inspected. The following staff were present during this visit: Room #1: 2 staff with 2 infants and Room #2: 1 staff with 6 sleeping infants.

Teacher/child ratios were observed to be in accordance with Title 22 regulations. The Licensee is within the conditions, limitations, and capacity specified on the license. Staff names were recorded. All children were observed to be always under visual supervision of a teacher.

The facility has sufficient age-appropriate furniture, and equipment including cribs, cots or mats, changing tables and feeding chairs. There is indoor and outdoor activity space for infants that is physically separate from other children in care.

Each crib or mat is occupied by only one infant at time and cribs are kept free from all loose articles including blankets and pillows and there are no objects hanging above or attached to the crib. Infants are not swaddled while in care. Staff physically checks on sleeping infants every fifteen minutes and documents

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NAME OF LICENSING PROGRAM MANAGER: Raul Navarro
NAME OF LICENSING PROGRAM ANALYST: Tatiana Bickham
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 05/12/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/12/2025
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
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: MONTESSORI OF CALABASAS- INFANT
FACILITY NUMBER: 197417432
VISIT DATE: 05/12/2025
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any signs of distress which includes but is not limited to flushed skin color, increase in body temperature, restlessness and labored breathing. Documentation for infants up to 12 months includes sleeping position if it is other than on their back. Individual Infant Sleeping Plan is completed and in file for each infant up to 12 months of age. Infants up to 12 months of age are placed on their backs for sleeping. Staff-infant ratio requirements are being met while infants are sleeping.

All toilets and hand washing facilities are in safe and sanitary operating condition. Floors in the facility are clean and safe. Disinfectants, cleaning solutions, medication and other items that are dangerous to children, were inaccessible to infants. Per Regional Director, filtered drinking water is available indoors for infants, infants use their own sippy cups brought from home. Carbon monoxide detector was operable.



Infant families provide all food/ bottles for infants. Solid waste storage containers have tight-fitting covers and are in good repair. Drinking water is available both indoors and outdoors. The facility is free of flies, insects and rodents. There is a working carbon monoxide detector.

All floors were observed to be clean and safe. All materials accessible to infants were observed to be toxic-free. Per Regional Director, there are no firearms stored on the premises. LPA did not observe any pools or bodies of water.



Outdoor playground equipment is in a safe condition, free of sharp, loose or pointed parts. The surface of the outdoor activity space is maintained in a safe condition and is free of hazards. All areas around or under climbing equipment, slides, and similar equipment are cushioned with material that absorbs a fall. There is adequate shade in the play yard. Per Licensee, potable water is available outdoors for drinking. LPA advised that no infants shall be left without the supervision of a teacher at any time.

LPA reviewed staff records. There is at least one person trained in CPR and Pediatric First Aid present during this inspection. The review of Staff records was documented on the LIC 859. Staff present had proof of the AB 1207 Mandated Reporter Training certificate on file. Staff present also had proof against TB, measles, pertussis, and influenza.

Infant Records were reviewed. Inspection of required forms was made and documented on the LIC 857.
Infant roster was reviewed and is current. Sign-In and Sign-Out sheets were reviewed. Infant’s present were Page 2.
NAME OF LICENSING PROGRAM MANAGER: Raul Navarro
NAME OF LICENSING PROGRAM ANALYST: Tatiana Bickham
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 05/12/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/12/2025
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
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: MONTESSORI OF CALABASAS- INFANT
FACILITY NUMBER: 197417432
VISIT DATE: 05/12/2025
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signed in.

Regional Director was reminded that all adults 18 and over, including employees and volunteers, 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 up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. When any IMS is provided, an updated 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)/ (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

At this time, the facility is in compliance with California Title 22 Regulations. Therefore, there are no citations being issued today. Exit interview conducted and report was reviewed with Regional Director, Luana Madrigal. A notice of site visit was given and must remain posted for 30 days.

To improve the quality and value of the new inspection process, a survey will be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or tools, please send them by email to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/tion-process.

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NAME OF LICENSING PROGRAM MANAGER: Raul Navarro
NAME OF LICENSING PROGRAM ANALYST: Tatiana Bickham
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 05/12/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/12/2025
LIC809 (FAS) - (06/04)
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