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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198021483
Report Date: 12/22/2025
Date Signed: 12/22/2025 02:12:37 PM

Document Has Been Signed on 12/22/2025 02:12 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:EVERGREEN MONTESSORI ACADEMYFACILITY NUMBER:
198021483
ADMINISTRATOR/
DIRECTOR:		DR. KRISTINE VARDANYANFACILITY TYPE:
860
ADDRESS:2038 E FOOTHILL BLVDTELEPHONE:
(626) 460-0468
CITY:PASADENASTATE: CAZIP CODE:
91107
CAPACITY: 108TOTAL ENROLLED CHILDREN: 108CENSUS: 56DATE:
12/22/2025
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:45 AM
MET WITH:Kristine Vardanyan and Rosangelica GonzalezTIME VISIT/
INSPECTION COMPLETED:
03:15 PM
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On 12/22/2025 at 10:45 am, Licensing Program Analysts (LPA), Stephanie Li conducted an unannounced Case Management inspection for an capacity change. LPA met with applicant representatives Dr. Kristine Vardanyan and Rosangelica Gonzalez. This facility is currently licensed to serve 108 children under a single license serving 52 infants from ages 0-24 months in the Infant Room 1, 2, 3 and 4, 12 toddlers from ages 18-36 months in the toddler class in main building, and 40 preschoolers from ages 3 to 5 years in the Preschool main building.

This location is currently licensed to care for (108) children: (40) Preschoolers from ages 2 to 6 in classrooms pre-primary and primary, (12) Toddlers in the toddler classroom in main building, and 52 infants in Bungalow A (room 1 and 2) and B (room 3 and 4). The Applicant, AKO Corp., is requesting to be licensed for a total new capacity of 111 children by moving and combing their toddler option children from the main building to the currently licensed toddler room 4 for a total capacity of 59 infants and toddlers and requesting to be licensed for a total of 52 preschool children in the preschool main rooms.

This location will have three separate Buildings: Bungalow A, Bungalow B and the Preschool Building. Bungalow A will house the infant program in (2) classrooms: classroom 1 and 2. Bungalow B will house (2) classroom 3 and 4. Classrooms 1 and 2 will serve ages 0 to 12 months, Classrooms 3 will serve ages 12 to 24 months, Classroom 4 will serve ages 18 to 36 months . Preschool Building (main building) will serve ages 2 to 6 years in existing preschool classrooms in (3) classrooms: Pre-Primary 1, Pre-Primary 2, and Primary. Hours of operation will be Monday to Friday from 7:00 am to 6:00 pm.

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NAME OF LICENSING PROGRAM MANAGER: Christina Gabelman
NAME OF LICENSING PROGRAM ANALYST: Stephanie Li
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 12/22/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/22/2025
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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California Health & Human Services Agency
California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:
  • Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.
  • Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)
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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: EVERGREEN MONTESSORI ACADEMY
FACILITY NUMBER: 198021483
VISIT DATE: 12/22/2025
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The front of this facility is accessible from East Foothill Blvd. There is an additional entry which is accessible from Walnut Street. This is also where the facility parking lot is located. Per Director, the parents of toddlers will use this entrance to avoid commingling. Parents of Preschoolers will also have access to this entrance. The existing facility has an approved waiver on file allowing toddlers to cross through the designed preschool yard in order to reach the entrance of the toddler classroom.

All indoor and outdoor activity space utilized for the children was inspected today. LPA reminded Rosangelica Gonzalez that staff are required to maintain direct visual supervision of the children at all times during indoor and outdoor activities. When medications are on site they will be stored in classrooms in a lock box in the cabinets.

A fully equipped first aid kit is located throughout the facility. There is an operational carbon monoxide detector on site located throughout the facility. All required licensing documents were observed posted outside of the Infant classroom. Children will be signed in and out at classroom entrance using the ProCare app. Facility sketch with dimensions for the main preschool building were obtained during visit.

Total infant and toddler indoor activity space measured for 1,992.54 square footage, which can only accommodate 56 infant children at one time. The preschool indoor activity space measured for 1873.24 square footage, which can accommodate the licensed capacity of 52 children. Updated facility sketch along with printed building square footage for the main building was obtained during visit.

LPA observed all hazardous items to be inaccessible to children. There are no bodies of water or weapons on the property. Fire clearance was granted on 12/09/2025.

In the infant room feeding tables have broad based legs, plastic seats are in good repair and trays lock onto chairs. Changing tables have at least 1” padding covered with moisture resistant, washable material. Sides of the changing table are at least 3” high and the changing table is within arm’s reach of a sink. Diapering sink is not used for meal preparation or dishwashing. Cribs meet regulatory requirements. Crib area is separated from activity space via built in glass wall. This barrier was observed to reach from the floor to the ceiling, made of sound absorbing material and allows for supervision of napping children. Sleep logs will be maintained on the countertop near the crib area. Needs and Services Plans and Sleep Plans are kept in the infant binder within the classroom. Toddler option ages 18-36 months diaper changing table waiver is no longer required due to moving toddler option class from main building into toddler rm 4. Page 2 of 4

NAME OF LICENSING PROGRAM MANAGER: Christina Gabelman
NAME OF LICENSING PROGRAM ANALYST: Stephanie Li
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 12/22/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/22/2025
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: EVERGREEN MONTESSORI ACADEMY
FACILITY NUMBER: 198021483
VISIT DATE: 12/22/2025
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LPA observed the infant program to have a total of 4 sinks and 4 toilets available for children’s use. Classrooms 1, 2, 3 and 4 were observed to have changing tables located within arm’s reach of a sink.

Facility will be providing am/pm snacks and parents will have the option to purchase lunch for their child through a third-party vendor. Per Director, for children ages 0 to 12 months parents will provide formula, drinking water, and snacks for their children. LPA observed each infant classroom to contain a refrigerator, sink, bottle warmers, and prep countertop.

This facility currently has (3) existing play yards designated for preschoolers, toddlers, and infants. The yards were observed to be separated from one another. Infant yard 1, toddler option yard 2, and preschool yard 3. Fencing is made of vinyl which is at least four feet high. The total square footage for the infant and toddler outdoor activity space measured for 2887.86 square feet, which can only accommodate 38 infants at one time. A playground waiver is on file to share the playground at different times in the AM and PM due to limited square footage. An updated play schedule has been reviewed and obtained during visit and play schedules are remaining the same for the designated classrooms. LPA advised that play schedules must be posted next to waiver on board. Shade is provided via shade canopies. There are sufficient outdoor age-appropriate toys and play equipment available on the playground. There is a climbing structure in the preschool playground for children, which is properly anchored. There is adequate cushioning in fall zones. Drinking water is available via filter water jug. LPA did not observed any hazardous items on the playground to be accessible to children. Dr. Kristine Vardanyan and Rosangelica Gonzalez was reminded that any changes to the facility must be reported to and approved by Community Care Licensing.

For child care center licenses issued after July 1, 2022, the licensee shall test their water for lead within 180 days of licensure pursuant to Written Directives section 101700 (PIN 21-21.1- CCP) and must be retested every 5 years. Per Director, water lead testing was last done in June 2023.

Representative Dr. Kristine Vardanyan and Rosangelica Gonzalez was reminded that all adults 18 and over responsible for administration or direct supervision of staff, persons who provides care and supervision to children, and staff who have contact with children, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a Child Care Center. A civil penalty of $100.00 minimum/day for a maximum of 5-days or, if the penalty is for a repeat violation, for a maximum of 30-days per person will be assessed if this regulation is violated. Page 3 of 4

NAME OF LICENSING PROGRAM MANAGER: Christina Gabelman
NAME OF LICENSING PROGRAM ANALYST: Stephanie Li
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 12/22/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/22/2025
LIC809 (FAS) - (06/04)
Page: 4 of 5
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: EVERGREEN MONTESSORI ACADEMY
FACILITY NUMBER: 198021483
VISIT DATE: 12/22/2025
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This facility is currently providing Incidental Medical Services – IMS. For IMS information, see PIN 22-02-CCP. A Plan of Operation that includes IMS must be submitted to the Department. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice) or (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm

LPA discussed the safe sleep regulations with licensee representative and discussed the Child Care Licensing Safe Sleep webpage at: https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep, as an additional resource. LPA also informed [applicant, licensee, or facility representative] of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at: https://www.cpsc.gov/, and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

Applicant Representative was informed of the MyChildCarePlan.org site, a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

During this inspection, LPA S Li consulted with Director regarding updated play schedules to reflect classroom groups and posting play schedules next to playground waiver. Dr. Kristine Vardanyan and Rosangelica Gonzalez was informed that the playground waiver will remain in place as no components or play schedules will change.

No corrections are needed. Upon a final file review and approval, a license for 108 children (37 infants, 19 toddlers, and 52 preschoolers) will be granted.

Exit interview conducted and report was reviewed with the Applicant Representatives, Dr. Kristine Vardanyan and Rosangelica Gonzalez.

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NAME OF LICENSING PROGRAM MANAGER: Christina Gabelman
NAME OF LICENSING PROGRAM ANALYST: Stephanie Li
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 12/22/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/22/2025
LIC809 (FAS) - (06/04)
Page: 5 of 5