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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197419681
Report Date: 09/12/2024
Date Signed: 09/12/2024 03:53:54 PM

Document Has Been Signed on 09/12/2024 03:53 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
CCLD Regional Office, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME:PALOS VERDES MONTESSORI ACADEMYFACILITY NUMBER:
197419681
ADMINISTRATOR/
DIRECTOR:		MARISSA MABINIFACILITY TYPE:
850
ADDRESS:28451 INDIAN PEAK ROADTELEPHONE:
(310) 541-2405
CITY:RANCHOS PALOS VERDESSTATE: CAZIP CODE:
90274
CAPACITY: 98TOTAL ENROLLED CHILDREN: 54CENSUS: 49DATE:
09/12/2024
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:45 PM
MET WITH:Marissa Mabini, LicenseeTIME VISIT/
INSPECTION COMPLETED:
04:15 PM
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On 09/12/2024, Licensing Program Analyst Adrian Risher conducted a case management inspection. The purpose of the visit was to interview potential witnesses regarding a previous complaint investigation. LPA met with Nimi Weerasinghe, Administrator initially. Director Marissa Mabini was assisting in a classroom upon LPA's arrival. LPA observed 49 children in care with 6 staff.

LPA conducted interviews with staff and children in care to gather additional information regarding a previous complaint investigation. LPA requested a copy of the current and previous rosters.

LPA did not observe any deficiencies during today's visit.

Exit interview was conducted and a copy of the report was provided. Appeal rights were reviewed and provided.
SUPERVISORS NAME: Maureen Neal
LICENSING EVALUATOR NAME: Adrian Risher
LICENSING EVALUATOR SIGNATURE: DATE: 09/12/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/12/2024
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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