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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 360910803
Report Date: 04/13/2023
Date Signed: 04/13/2023 04:11:29 PM

Document Has Been Signed on 04/13/2023 04:11 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
INLAND EMPIRE CHILD, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501
FACILITY NAME:MONTESSORI IN REDLANDS, INCFACILITY NUMBER:
360910803
ADMINISTRATOR:KIM MONTAGUEFACILITY TYPE:
850
ADDRESS:1890 ORANGE AVENUETELEPHONE:
(909) 793-6989
CITY:REDLANDSSTATE: CAZIP CODE:
92373
CAPACITY: 175TOTAL ENROLLED CHILDREN: 158CENSUS: 140DATE:
04/13/2023
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
12:48 PM
MET WITH:Director Kim MontagueTIME COMPLETED:
04:20 PM
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On 04/13/2023 a case management visit is being conducted by Licensing Program Analyst (LPA) Susan Brewer, in response to the receipt of a self-reported unusual incident report (UIR) from the facility. The LPA was greeted by Director Kim Montague, and granted entry to tour the facility inside and out. The UIR was received by the licensing agency on 03/07/2023. It indicates that during the course of outdoor play, a daycare child injured their leg on 03/06/2023, resulting in a fracture to the right leg, just above the knee.

LPA S.Brewer, conducted an initial inspection on 03/14/2023, reviewed facility records, documents and interviews were conducted with pertinent parties. On today's inspection, LPA S. Brewer conducted additional interview with pertinent parties which revealed that staff were present to supervise the daycare child when the incident took place. The subject child by admission jumped from an outdoor bench, located just outside of their classroom after placing their outdoor play shoes on. The subject child recalled staff being present to supervise however, the staff present were unable to intervene to prevent the child from falling and/or slipping in a puddle of mud, when the child's feet touched the ground. It was determined that the incident was an accidental injury, during the normal course of play the subject child admittedly did not recall how they were positioned on the bench prior to fall. The facility followed their operational plan, by aiding the child and implementing First Aid, applying ice packs to the suspected injury. The licensee contacted parents and provided parents with a written report. Based on information gathered, the facility acted appropriately and no violations have been identified.

No citations were issued.

No Civil Penalties were issued.

An exit interview was conducted and a copy of this report was provided to Director Kim Montague.
SUPERVISORS NAME: Kimberly Williams
LICENSING EVALUATOR NAME: Susan Brewer
LICENSING EVALUATOR SIGNATURE: DATE: 04/13/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/13/2023
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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