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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 304371604
Report Date: 03/29/2024
Date Signed: 03/29/2024 04:12:37 PM

Document Has Been Signed on 03/29/2024 04:12 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
ORANGE COUNTY CC RO, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
FACILITY NAME:CHILDREN'S MONTESSORI CENTER OF YORBA LINDAFACILITY NUMBER:
304371604
ADMINISTRATOR:KEMPS, DISHNIFACILITY TYPE:
850
ADDRESS:17550 YORBA LINDA BLVD.TELEPHONE:
(714) 528-0831
CITY:YORBA LINDASTATE: CAZIP CODE:
92886
CAPACITY: 62TOTAL ENROLLED CHILDREN: 62CENSUS: 15DATE:
03/29/2024
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
12:01 PM
MET WITH:Licensee Huijun GeTIME COMPLETED:
02:00 PM
NARRATIVE
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On 03/29/2024, Licensing Program Analyst (LPA) Romy Castanon conducted a Case Management due to deficiencies observed during today's visit. LPA Castanon met with Facility Representative Binbin “Vicky” Zhao and Licensee Huijun Ge. Observed at the time of the visit was a total of 15 children and 2 staff members.

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, except for Hui “Vanessa” Li (start date: 03/21/2024). LPA informed Licensee staff above was not listed as associated to the facility on report summary. Licensee could not provide LPA with staff personnel file so there is no documentation of Staff Vanessa completing a background check. After reviewing two Licensing Department systems including Guardian, a fingerprint clearance does not exist for Staff Vanessa. FR Vicky stated Staff Vanessa was a volunteer. LPA reminded FR Vicky that fingerprint clearance is still needed. A civil penalty is being assessed today.

LPA also informed FR that Interim Director Amynah Moloo was not listed as associated to the facility in the report summary. FR stated they faxed their director’s packet to the Licensing Office on 03/25/2024 and were able to provide a copy of their fax receipt. LPA was able to determine that Staff Amynah holds an eligible fingerprint clearance but was not transferred to the new facility when they started. LPA provided the facility with a website link to Guardian.

Based on LPA’s interview conducted with Licensee, and record review, the facility is being cited in accordance with California Code of Regulations, Title 22, Division 12, Section 101170(e)(1) Criminal Background Clearance for one (1) staff not cleared to work at the facility and 101170(e)(2) Criminal Record Clearance for one (one) staff member that has a fingerprint clearance but was not associated with the facility.
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SUPERVISORS NAME: Patricia Magana
LICENSING EVALUATOR NAME: Romelia M Castanon
LICENSING EVALUATOR SIGNATURE: DATE: 03/29/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/29/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.

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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: CHILDREN'S MONTESSORI CENTER OF YORBA LINDA
FACILITY NUMBER: 304371604
VISIT DATE: 03/29/2024
NARRATIVE
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Appeal Rights were discussed. Licensee was provided a copy of their appeal rights (LIC 9058) and their signature on this form acknowledges receipt of these rights. All appeals must be in writing and received by the Regional Office within 15 business days. A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with Licensee Huijun Ge.

Upon receipt, licensee shall post and provide copies of this licensing report to parents/guardians of children in care at the facility and to parents/guardians of children newly enrolled at the facility during the next 12 months. Licensee shall have LIC9224 (Acknowledgement of Receipt) signed and kept in each child's file.

End of Report

SUPERVISORS NAME: Patricia Magana
LICENSING EVALUATOR NAME: Romelia M Castanon
LICENSING EVALUATOR SIGNATURE:

DATE: 03/29/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/29/2024
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 03/29/2024 04:12 PM - It Cannot Be Edited


Created By: Romelia M Castanon On 03/29/2024 at 03:11 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
, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME: CHILDREN'S MONTESSORI CENTER OF YORBA LINDA

FACILITY NUMBER: 304371604

DEFICIENCY INFORMATION FOR THIS PAGE:

VISIT DATE: 03/29/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
04/01/2024
Section Cited
CCR
101170(e)(1)

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101170(e)(1) Criminal Record Clearance. Prior to working or volunteering in a licensed child care facility, all individuals subject to a criminal record review shall obtain a clearance or criminal record exemption. This requirement is not met as evidenced by:
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Licensee will regester with Guardian and review user guides on website. Staff Vanessa is unable to return on campus until a valid and eligible clearance is received. Licensee will send copy of clearance and association to LPA by POC date.
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Based on LPA’s observation, record review and interview with Licensee, Staff Hui “Vanessa” Li was caring for children in the infant classroom since 03/25/2024 and does not have a fingertprint clearance on file. This poses an immediate risk to the health, safety or personal rights risk to the persons in care.
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Type A
04/01/2024
Section Cited
CCR101170(e)(2)

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101170(e)(2)All individuals subject to a criminal record review pursuant to Health and Safety Code Section 1596.871 shall prior to working, residing or volunteering in a licensed facility: (2) Request a transfer of a criminal record clearance as specified in Section 101170(f) This requirement is not met as evidenced by:
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Licensee will register for Guardian access and review user guides. Licensee will ensure staff have eligible clearance and are associated to the facility before allowing them to be on campus. LPA was able to associate staff Amynah during visit. Licensee will send copy of facility roster to LPA by POC date.
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Based on LPA's observations, record review and interciew with Licensee, Staff Amynah Moloo was caring for children without a proper background clearance transfer for this facility. This poses an immediate risk to the health, safety or personal rights to persons 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:Patricia Magana
LICENSING EVALUATOR NAME:Romelia M Castanon
LICENSING EVALUATOR SIGNATURE:
DATE: 03/29/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/29/2024


LIC809 (FAS) - (06/04)
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