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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198020471
Report Date: 07/03/2024
Date Signed: 07/08/2024 11:09:28 AM

Document Has Been Signed on 07/08/2024 11:09 AM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
L.A. DAY CARE-EAST, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME:ACACIA MONTESSORI SCHOOL COVINA INC.FACILITY NUMBER:
198020471
ADMINISTRATOR/
DIRECTOR:		MILDRED BAUTISTAFACILITY TYPE:
850
ADDRESS:450 W ROWLAND STTELEPHONE:
(626) 966-9356
CITY:COVINASTATE: CAZIP CODE:
91723
CAPACITY: 60TOTAL ENROLLED CHILDREN: 39CENSUS: 30DATE:
07/03/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:40 PM
MET WITH:Director Mildred BautistaTIME VISIT/
INSPECTION COMPLETED:
03:45 PM
NARRATIVE
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Licensing Program Analyst (LPA) Mary Silva conducted an unannounced case management inspection. Upon arrival LPA met with director Mildred Bautista Reyna, to whom the reason for the visit was explained. LPA was led on a tour of the facility. The purpose of the inspection was to obtain additional information from the facility regarding an incident reported to the regional office. Census was taken. LPA observed 30 children and 5 staff.

The department received an incident report via email from this facility on 06/14/2024 for an incident that occurred at the facility on 06/13/2024 involving possible violation of a child personal rights while in care.

During the inspection LPA conducted (2) staff interviews regarding the allegation. LPA obtained documentation in the form of facility roster and parent contract.

Based on the information that was verified during the inspection and the information on the incident report, Licensing staff did not observe any type of deficiencies that warranted a citation at this time.

The notice of site inspection must remain posted for a period of 30 days during hours of operation. Failure to maintain posting will result in a civil penalty of $100.00 dollars.

Exit interview conducted with Director Mildred Bautista, report and appeal rights were given and explained.
SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Mary Silva
LICENSING EVALUATOR SIGNATURE: DATE: 07/03/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/03/2024
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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