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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198015236
Report Date: 07/08/2024
Date Signed: 07/08/2024 12:51:33 PM

Document Has Been Signed on 07/08/2024 12:51 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 INFANT CAREFACILITY NUMBER:
198015236
ADMINISTRATOR/
DIRECTOR:		SONDRA WISEFACILITY TYPE:
830
ADDRESS:3966 PENNSYLVANIA AVENUETELEPHONE:
(818) 249-6618
CITY:LA CRESCENTASTATE: CAZIP CODE:
91214
CAPACITY: 20TOTAL ENROLLED CHILDREN: 20CENSUS: 9DATE:
07/08/2024
TYPE OF VISIT:POCUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
11:07 AM
MET WITH:Marita Monfared TIME VISIT/
INSPECTION COMPLETED:
12:15 PM
NARRATIVE
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On 07/08/2024 , at 11:00 am , 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 rang the bell and called the facility . Phone number provided on the record was going straight to the voicemail and door bell was not working . At 11:10 am , LPA was able to enter to the the facility and met with Marita Monfared, Assistant Director , who guided analyst on a tour of the facility.
During the visit LPA obtained Assistant Director phone number to add to the facility record . Per Facility Representative she will check on the issue with the phone and the door bell .
During this inspection 13 children were present with 5 staff members . During the visit LPA reviewed . missing immunization records for the staff and reviewed 15 minutes checks for the infants.

During the visit, LPA cleared deficiency cited on 06/03/2024 and provided a copy of the Licensing Report to Facility Representative 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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