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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 334844886
Report Date: 10/10/2025
Date Signed: 10/10/2025 01:12:33 PM

Document Has Been Signed on 10/10/2025 01:12 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
RIVERSIDE SE CC RO, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501
FACILITY NAME:PEPPERTREE MONTESSORI-TEMECULAFACILITY NUMBER:
334844886
ADMINISTRATOR/
DIRECTOR:		MINER,MICHELLEFACILITY TYPE:
830
ADDRESS:29373 RANCHO CALIFORNIA RD.TELEPHONE:
(949) 246-0852
CITY:TEMECULASTATE: CAZIP CODE:
92591
CAPACITY: 26TOTAL ENROLLED CHILDREN: 10CENSUS: 3DATE:
10/10/2025
TYPE OF VISIT:Annual/RequiredUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
07:50 AM
MET WITH:Caroline Avezedo, DirectorTIME VISIT/
INSPECTION COMPLETED:
10:50 AM
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Licensing Program Analyst (LPA) William Chancellor conducted an unannounced annual inspection on October 10, 2025, at 7:50 AM. LPA met with Director Caroline Azevedo, who provided a tour of the center. This is a combination childcare center, where the preschool component was additionally inspected on today’s date. A tour of both the indoor and outdoor areas of the facility was conducted, and the following observations were noted. LPA observed the toddler room to be operating, with three daycare children present and two staff. The previous infant room is now being utilized for a private school affidavit program. LPA will return at a future date, to conduct a case management inspection to update the capacity of each component.

The required postings, including the facility license, Emergency Disaster Plan (LIC610), Parent’s Rights Poster (PUB393), Personal Rights (LIC613A), were observed to be up to date and appropriately displayed. The facility is operating within the capacity limits as stated on its license.

Classrooms contained age and size-appropriate furniture and equipment, free of hazards. Director Caroline Azevedo confirmed that no weapons are present on the premises, and there are no accessible bodies of water. Director confirmed and is aware that any wading pools or similar items must be emptied immediately after use and stored upright. Drinking water is accessible both indoors and outdoors, through filtered water, where children have access to individual drinking cups. LPA verified that lead testing was completed on December 21, 2022. The next testing is due within five years from the initial test date. Per PIN 21-21.1-CCP directives, and the director was referred to the Department’s website for additional lead toxicity prevention and water testing information.

Medications are stored in an area that is inaccessible to children, with the specific location noted. Hazardous items, including disinfectants, cleaning solutions, and other dangerous substances, are stored out of children’s reach, while poisons and toxins are securely locked away. The floors were observed to be clean, safe, and well maintained. Proper hand washing procedures were observed before and after diapering and feeding.

NAME OF LICENSING PROGRAM MANAGER: Pauline Beschorner
NAME OF LICENSING PROGRAM ANALYST: William M Chancellor Jr.
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 10/10/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/10/2025
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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California Health & Human Services Agency
California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:
  • Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.
  • Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)
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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
RIVERSIDE SE CC RO, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501
FACILITY NAME: PEPPERTREE MONTESSORI-TEMECULA
FACILITY NUMBER: 334844886
VISIT DATE: 10/10/2025
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The bathrooms were found to be clean, safe, and in proper working condition. At least one potty chair is available for every five potty-training infants. Outdoor play areas are equipped with age and size-appropriate equipment in good condition. Families bring their own individual snacks and lunches. Waste containers have tight-fitting covers and are in good repair.

The sign-in/sign-out records were reviewed and found to be compliant with regulations. Disaster drills are conducted at least every six months, with the most recent drill occurring on July 23, 2025. A review of children’s and staff records confirmed that all required documents are complete. Staff qualifications meet licensing requirements, and at least one staff member has a valid Pediatric CPR/First Aid certification and was present, with certification expiration dates documented. The director has completed Health and Safety Training. Background clearances for all required staff members have been verified, ensuring compliance with criminal records and child abuse index clearance requirements.

The director was reminded that all adults 18 and over, including employees and volunteers, must obtain a criminal record clearance or exemption before working in the facility. Non-compliance with this regulation may result in a civil penalty of $100 per day for up to five days, or up to 30 days for repeat violations.

LPA discussed safe sleep regulations and provided the director with resources available at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep. Additionally, LPA recommended checking the Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ to ensure infant devices are not subject to recalls and encouraged registration of all infant devices with the CPSC for recall notifications.

LPA reviewed medication storage, equipment and supply storage, and record-keeping procedures. Information regarding IMS policies, as outlined in PIN 22-02-CCP, was provided. Resources regarding ADA compliance were also shared, including the US Department of Justice ADA Information Line at (800) 514-0301 (voice) or (800) 514-0383 (TTY), and the publication "Commonly Asked Questions about Child Care Centers and the ADA" available at https://www.ada.gov/resources/child-care-centers/. A technical violation will be provided, regarding an expired as needed medication on site.

The director was informed about the MyChildCarePlan.org website, a consumer education resource that connects families to childcare providers and Resource and Referral Agencies (R&Rs) across California. Licensing forms and regulations for Child Care Centers are available on the Department’s website at www.ccld.ca.gov, where providers can also subscribe to receive important updates by email.

NAME OF LICENSING PROGRAM MANAGER: Pauline Beschorner
NAME OF LICENSING PROGRAM ANALYST: William M Chancellor Jr.
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 10/10/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/10/2025
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
RIVERSIDE SE CC RO, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501
FACILITY NAME: PEPPERTREE MONTESSORI-TEMECULA
FACILITY NUMBER: 334844886
VISIT DATE: 10/10/2025
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LPA reviewed reporting requirements with the director, emphasizing that any unusual incidents or injuries must be reported to the Department within 24 hours via telephone and within seven days in writing. The Duty Officer can be reached Monday through Friday from 8:00 AM to 5:00 PM at (951) 782-4200, or reports may be emailed to UnusualIncidentReportsDO10@dss.ca.gov.

To enhance the quality of inspections, a survey may be sent to the email address on file. LPA encouraged participation and provided the email inspectionprocess@dss.ca.gov for any questions regarding the inspection process. Additional information about the inspection methods and tools is available at www.cdss.ca.gov/inforesources/community-care-licensing/inspection-process.

On October 7, 2025, a search of the California Attorney General - Megan’s Law website was conducted, and no registered sex offenders were found at the facility address. Some offenders may not be subject to public disclosure under state law; however, the Department performs monthly cross-references of all CCLD facility addresses with the Megan’s Law database provided by the California Department of Justice.

The director was requested to update and submit the following documents within 30 days, if applicable:

· LIC 500 Personnel Report,


· LIC 610 Emergency & Disaster Plan,
· Parent Handbook/Program Curriculum/Admission Policies and Procedures/Fee Schedule (if updates have been made or if the file copy is older than two years),
· LIC 309 Administrative Organization (if updated within the past two years), and
· LIC 308 Designation of Administrative Responsibility (if updated within the past two years).

At this time, no deficiencies were cited. Please refer to advisory notes (LIC 9102) to review regulations that were observed to be either in question or a potential risk. Advisory Notes are provided with the intent to avoid issuing citations for violations that are technical in nature and do not present an immediate or potential health, safety or personal rights risk to those in care.

A Notice of Site Visit was provided and must remain posted for 30 days.

An exit interview was conducted with Director Caroline Azevedo, and a copy of this report was reviewed. Appeal rights were discussed and provided during the exit interview with Director Caroline Azevedo.

NAME OF LICENSING PROGRAM MANAGER: Pauline Beschorner
NAME OF LICENSING PROGRAM ANALYST: William M Chancellor Jr.
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 10/10/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/10/2025
LIC809 (FAS) - (06/04)
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