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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 334845456
Report Date: 03/23/2023
Date Signed: 03/23/2023 05:06:49 PM

Document Has Been Signed on 03/23/2023 05:06 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
CCLD Regional Office, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501
FACILITY NAME:GROWING TREE MONTESSORI PRESCHOOLFACILITY NUMBER:
334845456
ADMINISTRATOR:DENG, QIFACILITY TYPE:
850
ADDRESS:31935 VIA RIO TEMECULA ROADTELEPHONE:
(951) 900-8999
CITY:TEMECULASTATE: CAZIP CODE:
92592
CAPACITY: 106TOTAL ENROLLED CHILDREN: 106CENSUS: DATE:
03/23/2023
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
01:40 PM
MET WITH:Julia FletesTIME COMPLETED:
03:15 PM
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On March 23, 2023 at 1:40 pm, Licensing Program Analysts (LPAs) Jessica Rubio and William Chancellor arrived unannounced to the facility to conduct a case management visit due to an unusual incident report received for an incident that occurred on 3/9/2023, involving child (C1) tripping on the playground and requiring medical attention. LPAs met with Director Julia Fletes and conducted a tour of the facility. During the visit, LPAs conducted interviews with C1 and one staff (S1) who was present on the playground when the incident occurred. Interviews revealed the staff were in ratio at the time of the incident and S1 observed C1 fall. Staff provided appropriate first aid and notified C1's parents of the incident. LPAs determined that the facility was not in violation of Title 22 Regulations.

An exit interview was conducted, a copy of this report, LIC 811 (Confidential Names List) and appeal rights were reviewed with and provided to Director Julia Fletes. A notice of site visit was also provided and must remain posted for 30 days.

SUPERVISORS NAME: Pauline Beschorner
LICENSING EVALUATOR NAME: Jessica M Rubio
LICENSING EVALUATOR SIGNATURE: DATE: 03/23/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/23/2023
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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