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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 300610669
Report Date: 06/17/2024
Date Signed: 06/17/2024 02:45:35 PM

Document Has Been Signed on 06/17/2024 02:45 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
ORANGE COUNTY CC RO, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
FACILITY NAME:IVYCREST MONTESSORI PRIVATE SCHOOLFACILITY NUMBER:
300610669
ADMINISTRATOR/
DIRECTOR:
AIDA KINGFACILITY TYPE:
850
ADDRESS:2025 E. CHAPMAN AVENUETELEPHONE:
(714) 879-6091
CITY:FULLERTONSTATE: CAZIP CODE:
92831
CAPACITY: 214TOTAL ENROLLED CHILDREN: 214CENSUS: DATE:
06/17/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:25 PM
MET WITH:Director, Aida KingTIME VISIT/
INSPECTION COMPLETED:
03:00 PM
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On 6/17/24 at 1:25 p.m., Licensing Program Analyst (LPA), Christine Jung conducted an unannounced case management inspection to follow up on an incident that was self-reported to the Department on 5/15/24. Upon arrival, LPA met with Director, Aida King. LPA disclosed the purpose of the inspection and was led on a tour of the facility. There were 159 children and 14 staff members present. Hours of operation are Monday through Friday 7:00 a.m. to 6:00 p.m.

A review of the Facility Personnel Report Summary on this date indicates all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions.

An unusual incident report (UIR) was submitted to the Department on 5/15/24 reporting an injury to Child 1 (C1). The facility reported that on 5/15/24, C1 sustained an injury during nap time. C1 stuck their finger in the AC filter vent that is located close to the floor. Facility staff reported the incident to the Department in a timely manner. Based on the information obtained on this date, additional information is needed to conclude this incident.

A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with the Director Aida King.

SUPERVISORS NAME: Martha Malane
LICENSING EVALUATOR NAME: Soo Jin Jung
LICENSING EVALUATOR SIGNATURE: DATE: 06/17/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/17/2024
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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