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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 304371605
Report Date: 07/24/2024
Date Signed: 08/07/2024 09:49:40 AM

Document Has Been Signed on 08/07/2024 09:49 AM - 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:
304371605
ADMINISTRATOR/
DIRECTOR:		KEMPS, DISHNIFACILITY TYPE:
830
ADDRESS:17550 YORBA LINDA BLVD.TELEPHONE:
(714) 528-0831
CITY:YORBA LINDASTATE: CAZIP CODE:
92886
CAPACITY: 12TOTAL ENROLLED CHILDREN: 12CENSUS: 11DATE:
07/24/2024
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
11:50 AM
MET WITH:Bin Bin ZhaoTIME VISIT/
INSPECTION COMPLETED:
12:05 PM
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***This is an amended version of report dated 7/24/24

On 7/24/24 at 11:50am, LPA met with Office Admin Zhao. Census taken 11 infants and 3 staff. Due to unforeseen circumstances, the LPA had to continue the visit at another time.



Report signed by teacher Damarys Chihuaque
SUPERVISORS NAME: Martha Malane
LICENSING EVALUATOR NAME: Anna Francesca Chan
LICENSING EVALUATOR SIGNATURE: DATE: 07/24/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/24/2024
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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