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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376600356
Report Date: 07/30/2025
Date Signed: 07/30/2025 03:01:26 PM

Document Has Been Signed on 07/30/2025 03:01 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
SAN DIEGO CC RO, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108
FACILITY NAME:MONTESSORI ACHIEVEMENT CENTERFACILITY NUMBER:
376600356
ADMINISTRATOR/
DIRECTOR:		WHEELER, PATRICIAFACILITY TYPE:
850
ADDRESS:10435 CAMPO ROADTELEPHONE:
(619) 442-2552
CITY:SPRING VALLEYSTATE: CAZIP CODE:
91978
CAPACITY: 42TOTAL ENROLLED CHILDREN: 50CENSUS: 37DATE:
07/30/2025
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
02:31 PM
MET WITH:Patricia WheelerTIME VISIT/
INSPECTION COMPLETED:
03:15 PM
NARRATIVE
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On July 30, 2025 at 2:31 p.m., Licensing Program Analyst (LPA) Angela Nguyen conducted an unannounced case management inspection for the purpose of citing for deficiencies observed during another inspection at the facility. LPA met with Licensee, Patricia Wheeler and disclosed the purpose of the inspection. There were (37) children present, being supervised by (4) staff members and (1) minor helper.

LPA reviewed staff records and revealed Jocelyn Pacheco (S1) and Danna Olson (S2) did not have criminal record clearances. S3 and S4 have criminal record clearances however; are not associated to the school. Licensee confirms that S1 has been employed at the facility for 1 year (8/2024) and S2 since 6/24/2025.

A review of staff files reveal, 6 out of 7 staff files were incomplete without documentation of immunization, tuberculosis records, credentials, LIC 9108, LIC 9052 and LIC 501.

(2) Type B Deficiencies, Per California Code of Regulations, Title 22, Division 12, Chapter 1, deficiencies are being cited on the attached LIC 809D.

(1) Type A deficiency and a $1000 civil penalty is assessed during today's inspection, (See LIC809D and LIC 421IM).
NAME OF LICENSING PROGRAM MANAGER: Tulam Vu
NAME OF LICENSING PROGRAM ANALYST: Angela Nguyen
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 07/30/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/30/2025
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
SAN DIEGO CC RO, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108
FACILITY NAME: MONTESSORI ACHIEVEMENT CENTER
FACILITY NUMBER: 376600356
VISIT DATE: 07/30/2025
NARRATIVE
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Type A deficiency which shall be posted for 30 consecutive days as there is immediate risk to the health, safety, or personal rights of children in care. LPA informed the licensee to provide a copy of this licensing report dated 7/30/2025 that documents any Type A deficiency to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification.
 
A Notice of Site Visit (LIC 9213) was given to Licensee, Patricia Wheeler and must remain posted on, or immediately adjacent to, the interior side of the main door for 30 days. LPA observed LIC 9213 was posted. Appeal Rights (LIC 9058) was provided. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

An exit interview was conducted and the report was reviewed with Licensee, Patricia Wheeler.
NAME OF LICENSING PROGRAM MANAGER: Tulam Vu
NAME OF LICENSING PROGRAM ANALYST: Angela Nguyen
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 07/30/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/30/2025
LIC809 (FAS) - (06/04)
Page: 5 of 5
Document Has Been Signed on 07/30/2025 03:01 PM - It Cannot Be Edited


Created By: Angela Nguyen On 07/30/2025 at 01:33 PM
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
, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108

FACILITY NAME: MONTESSORI ACHIEVEMENT CENTER
FACILITY NUMBER: 376600356

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/30/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
07/31/2025
Section Cited
CCR
101170(e)(1)

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(e)All individuals subject to a criminal record review pursuant to Health and Safety Code Section 1596.871 shall prior to working, residing or volunteering in a licensed facility:(1)Obtain a California clearance or a criminal record exemption as required by the Department
This requirement was not met as evidence by:
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Licensee stated she will obtain criminal record clearances for S1 and S2 no later than 07/31/2025 and submit receipt of completion to the Department.
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Based on Licensee's admission and record review, the licensee did not comply with the section cited above by not ensuring all adults working at the child care center have obtained a criminal record clearance prior to initial presence in the facility which poses an immediate 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.
Tulam Vu
NAME OF LICENSING PROGRAM MANAGER:
Angela Nguyen
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 07/30/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/30/2025


LIC809 (FAS) - (06/04)
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Document Has Been Signed on 07/30/2025 03:01 PM - It Cannot Be Edited


Created By: Angela Nguyen On 07/30/2025 at 01:48 PM
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
, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108

FACILITY NAME: MONTESSORI ACHIEVEMENT CENTER
FACILITY NUMBER: 376600356

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/30/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
08/29/2025
Section Cited
CCR
101217(a)(10)

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The licensee shall ensure that personnel records are maintained.... Each personnel record shall contain:
(10) A signed and dated copy of a Notice - Employee Rights (LIC 9052 [3/03]).
This requirement was not met as evidence by:
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Licensee stated she will ensure staff file are complete with LIC 9052, health screening, TB, LIC 9108, immunization / Tuberculosis records and credentials no later than 8/29/2025.
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Based on record review, the licensee did not comply with the section cited above by not ensuring all staff member have required employment documents which poses a potential health and safety risk to persons in care.
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Type B
08/04/2025
Section Cited
CCR101216(i)(2)

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(i) Prior to employment or initial presence in the child care center, all employees and volunteers subject to a criminal record review shall: 2) Request a transfer of a criminal record clearance as specified in Section 101170(f)
This requirement was not met as evidence by:
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Licensee stated she will submit LIC 9182 Background check transfer form to the Department no later than 8/4/2025 and register for Guardian to track background clearances for future employees.
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Based on Licensee's admission and record review ,the licensee did not comply with the section cited above by not ensuring all staff members with criminal record clearances were associated to the facility 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.
Tulam Vu
NAME OF LICENSING PROGRAM MANAGER:
Angela Nguyen
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 07/30/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/30/2025


LIC809 (FAS) - (06/04)
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