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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198020276
Report Date: 10/26/2021
Date Signed: 10/26/2021 04:47:24 PM

Document Has Been Signed on 10/26/2021 04:47 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:LITTLE BUNNIES MONTESSORI SCHOOL LLCFACILITY NUMBER:
198020276
ADMINISTRATOR:SAKUNTALA ABEYASEKERAFACILITY TYPE:
850
ADDRESS:405 N. STONEMAN AVETELEPHONE:
(626) 456-3400
CITY:ALHAMBRASTATE: CAZIP CODE:
91801
CAPACITY: 26TOTAL ENROLLED CHILDREN: 26CENSUS: 15DATE:
10/26/2021
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
02:15 PM
MET WITH:Sakuntala Abeyasekera TIME COMPLETED:
03:00 PM
NARRATIVE
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Licensing Program Analyst (LPA) Seung Lee conducted an unannounced case management inspection. Upon arrival LPA Lee met with Director Sakuntala Abeyasekera.

The purpose of the inspection was to address an in incident that occurred at this facility on 10/20/2021. During an interview when asked why this incident was not initially reported to the department within 24 hours, the Director stated that she forgot to report the incident. When asked if she was aware that facilities are required to report any unusual incidents and injures to the department by phone within 24 hours, the Director stated she did know that but forgot to report it. This is a potential risk to children in care. Please see the attached 809D for the deficiency.

During the inspection the Director was advised to consider installing some sort of alarm system to the side exit of the facility. The Director stated that the facility is not allowed to install any additional locks or barriers for this exit because it would be considered a fire hazard.

Exit interview conducted with Director Sakuntala Abeyasekera. Appeal rights discussed and explained.

SUPERVISORS NAME: Guangorena Claudia
LICENSING EVALUATOR NAME: Seung Lee
LICENSING EVALUATOR SIGNATURE: DATE: 10/26/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/26/2021
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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Document Has Been Signed on 10/26/2021 04:47 PM - It Cannot Be Edited


Created By: Seung Lee On 10/26/2021 at 03:25 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: LITTLE BUNNIES MONTESSORI SCHOOL LLC
FACILITY NUMBER: 198020276

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/26/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
10/27/2021
Section Cited
CCR
101212(d)

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Upon the occurrence, during the operation of the child care center of any of the events specified in (d)(1) below, a report shall be made to the Department by telephone or fax within the Department's next working day and during its normal business hours. In addition, a written report containing the information specified .
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Director stated that the facility will make sure to report incidents within the required time period moving forward.
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in (d)(2) below shall be submitted to the Department within seven days following the occurrence of such event. This requirment was not met when the Director stated she forgot to report an incident that occurred at the facility on 10/20/2021 to the department within 24 hours. This is a pontential risk to children in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Guangorena Claudia
LICENSING EVALUATOR NAME:Seung Lee
LICENSING EVALUATOR SIGNATURE:
DATE: 10/26/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/26/2021


LIC809 (FAS) - (06/04)
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