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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 364846067
Report Date: 01/16/2025
Date Signed: 01/16/2025 11:37:59 AM

Document Has Been Signed on 01/16/2025 11:37 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
RIVERSIDE CC RO, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501
FACILITY NAME:GOODEARTH MONTESSORI SCHOOLFACILITY NUMBER:
364846067
ADMINISTRATOR/
DIRECTOR:		ESCOBEDO, ALICEFACILITY TYPE:
850
ADDRESS:2593-A CHINO HILLS PKWYTELEPHONE:
(909) 393-0998
CITY:CHINO HILLSSTATE: CAZIP CODE:
91709
CAPACITY: 156TOTAL ENROLLED CHILDREN: 156CENSUS: 85DATE:
01/16/2025
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:03 AM
MET WITH:Alice EscobedoTIME VISIT/
INSPECTION COMPLETED:
11:47 AM
NARRATIVE
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Licensing Program Analysts (LPAs) Elyse Jones and Chase Atherton arrived at the facility, met with Director Alice Escobedo, toured the facility, and took census. During the facility tour LPAs observed active construction taking place on the playground. Director stated they did not notify the Department prior to construction/alterations taking place. LPAs arrived to conduct a Case Management inspection for the purpose of addressing these separate matters that were discovered during a separate inspection.

Title 22 states, "Prior to construction or alterations, the licensee shall notify the Department of the proposed change(s)". Facility records were reviewed and pertinent parties were interviewed. Based on the information gathered, the facility did not notify the Department prior to construction/alterations.

See LIC809D for cited deficiencies of the California Code of Regulations, Title 22, Div. 12

A notice of site visit was given and must remain posted on, or immediately adjacent to, the interior side of the main door for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

An exit interview was conducted and a copy of this report and a copy of appeal rights was provided to facility staff, Alice Escobedo.
SUPERVISORS NAME: Ana Noble
LICENSING EVALUATOR NAME: Chase Atherton
LICENSING EVALUATOR SIGNATURE: DATE: 01/16/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/16/2025
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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Document Has Been Signed on 01/16/2025 11:37 AM - It Cannot Be Edited


Created By: Chase Atherton On 01/16/2025 at 10:25 AM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501

FACILITY NAME: GOODEARTH MONTESSORI SCHOOL
FACILITY NUMBER: 364846067

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/16/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
01/20/2025
Section Cited
CCR
101237(a)

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101237 Alterations to Existing Buildings or New Facilities (a) Prior to construction or alterations, the licensee shall notify the Department of the proposed change(s).
This requirement is not met as evidence by:
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Facility will submit a signed statement of understating of Calfornia Code of Regulations Section 101237 by the POC due date. Additionally the facility will submit an Unusual Incident Report (UIR) to the Department by the POC due date.
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Based on interview and records review, the Licensee did not meet the above regulation which posed/poses a potential health and safety risk to persons in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Ana Noble
LICENSING EVALUATOR NAME:Chase Atherton
LICENSING EVALUATOR SIGNATURE:
DATE: 01/16/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/16/2025


LIC809 (FAS) - (06/04)
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