300614024-2-21-2025-06-CC-CSUN-DE4VL8-20250221153131

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 300614024
Report Date: 02/21/2025
Date Signed: 02/21/2025 03:31:36 PM

Document Has Been Signed on 02/21/2025 03:31 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:	MONTESSORI EDUCATION CENTER		FACILITY NUMBER:	300614024
ADMINISTRATOR/ DIRECTOR:	HALE, KATHLEEN		FACILITY TYPE:	850
ADDRESS:	1658 BROADWAY		TELEPHONE:	(714) 991-7400
CITY:	ANAHEIM	STATE: CA	ZIP CODE:	92802
CAPACITY: 61	TOTAL ENROLLED CHILDREN: 61	CENSUS: 19	DATE:	02/21/2025
TYPE OF VISIT:	Case Management - Incident	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	10:30 AM
MET WITH:	Director, Kathleen Hale		TIME VISIT/ INSPECTION COMPLETED:	03:30 PM

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Licensing Program Analysts (LPA) Cynthia Sun conducted an unannounced case management inspection in response to a self-report Unusual Incident dated 2/14/25. LPA met with Director, Kathleen Hale. Census was taken as follows: 4 staff supervising 19 preschool children. All children were supervised while playing in preschool playground and eating lunch.

A review of staff criminal clearance records on this date indicates that all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions.

On 2/14/25 Regional Office received a self-reported Unusual Incident Report (UIR) stating that on 2/13/25, Staff #1 (S1) was eating cashews in classroom and Child #1(C1) wanted cashews. S1 gave cashews to C1 who has allergies to nuts. S1 noticed that C1’s eyes were getting red and then S1 realized C1 was allergic to nuts. S1 called Parent #1 (P1) said to give C1 the EpiPen and that someone will be coming to pick up C1. When Adult #1 (A1) got to the facility, A1 gave C1 the Epi-pen and took C1 home. P1 chose not to take C1 to the doctor P1 stayed home to watch C1. S1 knew C1 had allergies but forgot. C1 returned to facility on 2/18/25.

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SUPERVISORS NAME: Thuy Ho
LICENSING EVALUATOR NAME: Cynthia Sun
LICENSING EVALUATOR SIGNATURE:	DATE: 02/21/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/21/2025

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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE COUNTY CC RO, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME: MONTESSORI EDUCATION CENTER	FACILITY NUMBER: 300614024
	VISIT DATE: 02/21/2025

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During today's inspection, LPA inspected facility, interviewed staff, obtained facility children roster, C1’s Parent/Guardian and Authorization Health Care Provider Request for Medication, LIC 701 Physicians’ Report-Child Care Center, LIC627 Consent for Emergency Medical Treatment, LIC9221 Parent Consent for Administration of Medications and Medication Chart, LIC503 Pre-Admission Health History-Parent’s Report, Montessori Education Center Incidental Medical Services Plan of Operation, and LIC 700 Identification and Emergency Information Child Care Centers-Family Child Care Homes.

Due to insufficient information available at this time, the reported incident needs further investigation.

An Inspection and exit interview was completed with Director, Kathleen Hale. The report was reviewed and discussed. Appeal Rights were discussed.

The facility representative was informed that the “Notice of Site Visit” must be posted for 30 consecutive days. The “Notice of Site Visit” must be posted on or adjacent to the door. Failure to post will result in Civil Penalties of $100.00.

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SUPERVISORS NAME: Thuy Ho
LICENSING EVALUATOR NAME: Cynthia Sun
LICENSING EVALUATOR SIGNATURE:	DATE: 02/21/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/21/2025

LIC809 (FAS) - (06/04)

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