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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376700368
Report Date: 10/24/2023
Date Signed: 10/24/2023 10:12:54 AM

Document Has Been Signed on 10/24/2023 10:12 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 SE CC RO, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501
FACILITY NAME:KIDS TOWN MONTESSORI SCHOOLFACILITY NUMBER:
376700368
ADMINISTRATOR:HODAEE, MEHRMAHFACILITY TYPE:
850
ADDRESS:867 SYCAMORE AVENUETELEPHONE:
(858) 344-9902
CITY:VISTASTATE: CAZIP CODE:
92081
CAPACITY: 155TOTAL ENROLLED CHILDREN: 155CENSUS: 44DATE:
10/24/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Assistant Director Mahsa NajafiTIME COMPLETED:
10:30 AM
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This is an amended report to a visit conducted on 8/10/2023.

On October 24, 2023 at 9:30 AM, Licensing Program Analyst (LPA) William Chancellor made an unannounced for a Case Management visit at Kids Town Montessori School to deliver an amended report for an annual conducted on August 10, 2023. LPA met with Assistant Director Mahsa Najafi to correct errors in the report pertaining to the amount of uncleared adults in the center due to a guardian error. It must be noted that while this is a automatic Type A citation in our system regarding fingerprints, this is not an egregious citation or deficiency. Ultimately, Staff 2 immediately got their fingerprints done, using the correct livescan form and cleared all requirements through Guardian, rectifying the issue.



Facility was toured and census was taken.

An exit interview was conducted, signatures were obtained for the amended pages and a copy of this report was provided to Assistant Director Mahsa Najafi. A notice of site visit was also provided and facility representative was reminded the notice must be posted for 30 consecutive days.
SUPERVISORS NAME: Pauline Beschorner
LICENSING EVALUATOR NAME: William M Chancellor Jr.
LICENSING EVALUATOR SIGNATURE: DATE: 10/24/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/24/2023
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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