304371645-10-30-2023-06-CC-MQUO-CX4U7Q-20231030152020

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 304371645
Report Date: 10/30/2023
Date Signed: 10/30/2023 03:20:43 PM

Document Has Been Signed on 10/30/2023 03:20 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 OF ANAHEIM		FACILITY NUMBER:	304371645
ADMINISTRATOR:	UNKNOWN		FACILITY TYPE:	850
ADDRESS:	1401 SO. ANAHEIM BLVD. STE.105		TELEPHONE:	(714) 588-0237
CITY:	ANAHEIM	STATE: CA	ZIP CODE:	92805
CAPACITY: 89	TOTAL ENROLLED CHILDREN: 89	CENSUS: 0	DATE:	10/30/2023
TYPE OF VISIT:	Case Management - Other	UNANNOUNCED	TIME BEGAN:	02:10 PM
MET WITH:	Noelle Sevilla and Victoria Garcia		TIME COMPLETED:	03:30 PM

NARRATIVE

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LPA Quinto conducted a Case Management inspection on today’s date. LPA met with Noelle Sevilla and Victoria Garcia. There were no children present during the visit.

The purpose of today's Case Management inspection is to deliver and obtain signatures on the amended LIC 809, Facility Evaluation Report to update the indoor total measurements from 5900.44 to 3103.75.

This report and the amended report were discussed, and both reports were signed, and a copy was left with Noelle Sevilla.

Exit Interview was conducted.

SUPERVISORS NAME: Monica Cuddy
LICENSING EVALUATOR NAME: Mila Quinto
LICENSING EVALUATOR SIGNATURE:	DATE: 10/30/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/30/2023

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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