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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198020849
Report Date: 02/19/2025
Date Signed: 02/19/2025 02:09:34 PM

Document Has Been Signed on 02/19/2025 02:09 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:EVERBROOK ACADEMY, LLCFACILITY NUMBER:
198020849
ADMINISTRATOR/
DIRECTOR:		FUENTEZ, TERESAFACILITY TYPE:
850
ADDRESS:520 W. BASELINE RD.TELEPHONE:
(909) 399-0081
CITY:CLAREMONTSTATE: CAZIP CODE:
91711
CAPACITY: 132TOTAL ENROLLED CHILDREN: 132CENSUS: 72DATE:
02/19/2025
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:00 PM
MET WITH:Nadine Torres & Teresa FuentezTIME VISIT/
INSPECTION COMPLETED:
02:20 PM
NARRATIVE
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On 02/19/2025, at 12:00 pm Licensing Program Analyst (LPA) Carolyn Tuba conducted a case management inspection due to an incident that was self-reported by the facility. The incident occurred on 12/19/2024 at approximately 10:50 am. in the Toddler 2 classroom which is licensed as the Toddler Component. Covid Risk assessment was conducted. LPA met with Assistant Director, Nadine Torres who provided a tour to gain the census of 72 children with 8 staff. Director, Teresa Fuentez was available shortly after to facilitate the visit.

The incident was reported to the Department within the required 24 hours of occurrence.

During this investigation, LPA conducted an interview with the Director, Staff #1 (S1), and Parent #1 (P1). Child #1 (C1) was not interviewed because they did not qualify due to age of the child.

According to the Director, S1 and P1 all confirmed that there was an incident where S1 had pulled on the back of the shirt of C1 to get them down off a child’s furniture (LPA took photo). P1 had observed this on a live footage as there are cameras in each classroom that parents can log in and observe their child during classroom time. C1 was not hurt during this incident. According to S1 they did not grab the child to hurt them but just to get them down from the furniture as they were hurrying to transition to outside play. S1 realized that it was not an appropriate way to bring C1 down off the furniture. According S1 they had items in their hand and P1 had confirmed that as well. The Director stated that her boss had viewed the recorded footage, but unfortunately the footage only can be viewed for the first 24 hours. Director’s boss did confirm that the video did show S1 pulling on C1’s shirt to get them down and that S1 was holding items in their hands. P1 feels that it was not none to hurt their child but felt there was a better way of handling the situation. P1 confirmed that their child did not get hurt. Director stated that S1 was spoken to after the incident and coached on appropriate ways.
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SUPERVISORS NAME: Katrina Chicote
LICENSING EVALUATOR NAME: Carolyn Tuba
LICENSING EVALUATOR SIGNATURE: DATE: 02/19/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/19/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 3
Document Has Been Signed on 02/19/2025 02:09 PM - It Cannot Be Edited


Created By: Carolyn Tuba On 02/19/2025 at 01:17 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: EVERBROOK ACADEMY, LLC
FACILITY NUMBER: 198020849

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/19/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
02/28/2025
Section Cited
CCR
101223.2

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Discipline (a) Any form of discipline or punishment that violates a child's personal rights as specified in Section 101223 shall not be permitted regardless of authorized representative consent or authorization. This requirement was not met as evidence by: interviews conducted of an incident
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The staff member will view a video on the CCLD website www.ccld.childcarevideos.org on Children’s Personal Rights in Child Care and the staff member will write up at least a 1 page document on what they learned from the video. Director will send to LPA once completed.
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occuring on 12/19/2024 of a child climbing on classroom furniture and staff member pulled child by the back of the shirt to get them down. This poses a potential risk to the health, safety, and personal rights of 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:Katrina Chicote
LICENSING EVALUATOR NAME:Carolyn Tuba
LICENSING EVALUATOR SIGNATURE:
DATE: 02/19/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/19/2025


LIC809 (FAS) - (06/04)
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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		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: EVERBROOK ACADEMY, LLC
FACILITY NUMBER: 198020849
VISIT DATE: 02/19/2025
NARRATIVE
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The following deficiency listed on the attached LIC 809 (deficiency page) are being cited in accordance with California Code of Regulations Title 22. Deficiency that are being cited need to be cleared to protect the children’s health & safety.

A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with Director, Teresa Fuentez.
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SUPERVISORS NAME: Katrina Chicote
LICENSING EVALUATOR NAME: Carolyn Tuba
LICENSING EVALUATOR SIGNATURE:

DATE: 02/19/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/19/2025
LIC809 (FAS) - (06/04)
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