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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198016985
Report Date: 07/14/2023
Date Signed: 07/14/2023 05:04:01 PM

Document Has Been Signed on 07/14/2023 05:04 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, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME:INTERNATIONAL MONTESSORI SCHOOL OF CLAREMONTFACILITY NUMBER:
198016985
ADMINISTRATOR:MITCHELL, WENDYFACILITY TYPE:
850
ADDRESS:341 W. SAN JOSE AVENUETELEPHONE:
(909) 621-1313
CITY:CLAREMONTSTATE: CAZIP CODE:
91711
CAPACITY: 64TOTAL ENROLLED CHILDREN: 63CENSUS: 42DATE:
07/14/2023
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
04:00 PM
MET WITH:Wedny MitchellTIME COMPLETED:
05:00 PM
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On July 14, 2023, at 4:00 pm Licensing Program Analyst (LPA) Carolyn Tuba conducted a case management inspection due to an incident that occurred at the facility on 6/22/2022. LPA met with Director, Wendy Mitchell, and guided LPA on a tour to obtain the census of 42 children with 7 staff.


The incident was not reported to the Department within the required 24 hours of occurrence due to the parent not seeking medical attention until a later date of the occurrence, however Assistant Director reported as soon as she was notified by the child’s parent that they had taken their child to the doctors. The incident consisted with a child having an injury to her left wrist that required medical attention.

Based on the information obtained and interviews conducted with the staff who observed the incident, as well as attempting to interview the child who sustained the injury but did not qualify as they were nonverbal. LPA observed that the child was no longer wearing the brace that was reported. LPA observed that there were no tripping hazards found in the classroom and took photos. LPA found that the incident was an accident, and the child has recovered after injury of tripping and falling in the classroom.

No deficiencies were cited today regarding today’s inspection.



The Notice of Site Visit (LIC 9213) – must remain posted for 30 days during the hours of operation after each site inspection by a licensing representative. Failure to maintain posting as required will result in a civil penalty of $100.00.

An exit interview was conducted, and a copy of this report was provided to Director, Wendy Mitchell along with Appeal Rights.

SUPERVISORS NAME: Ana Chico
LICENSING EVALUATOR NAME: Carolyn Tuba
LICENSING EVALUATOR SIGNATURE: DATE: 07/14/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/14/2023
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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