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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198015235
Report Date: 07/08/2024
Date Signed: 07/08/2024 12:50:54 PM

Document Has Been Signed on 07/08/2024 12:50 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
MONTEREY PARK CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME:PENNSYLVANIA AVENUE MONTESSORI PRESCHOOLFACILITY NUMBER:
198015235
ADMINISTRATOR/
DIRECTOR:		SONDRA WISEFACILITY TYPE:
850
ADDRESS:3966 PENNSYLVANIA AVENUETELEPHONE:
(818) 231-5605
CITY:LA CRESCENTASTATE: CAZIP CODE:
91214
CAPACITY: 56TOTAL ENROLLED CHILDREN: 56CENSUS: 22DATE:
07/08/2024
TYPE OF VISIT:POCUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:15 PM
MET WITH:Marita Monfared TIME VISIT/
INSPECTION COMPLETED:
01:00 PM
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On 07/08/2024, at 12:00 PM , Licensing Program Analyst(LPA) Shushanik Safaryan conducted an unannounced POC (Plan of Correction) inspection to the above facility to ensure Type B deficiency cited on 06/03/2024 has been cleared.

Upon arrival LPA met with Marita Monfared , Assistant Director ,who guided analyst on a tour of the facility. During this inspection 22 children were present with 4 staff members . During the visit LPA reviewed missing immunization records and health screening reports for the staff members .

During the visit, LPA cleared deficiency cited on 06/03/2024 and provided a copy of the Licensing Report to Facility Representative , Marita Monfared and issued POC clearance letter.

The Notice of Site Visit (LIC 9213) was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

End of the report .
SUPERVISORS NAME: Brandi VanOosten
LICENSING EVALUATOR NAME: Shushanik Safaryan
LICENSING EVALUATOR SIGNATURE: DATE: 07/08/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/08/2024
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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