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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376701528
Report Date: 12/14/2022
Date Signed: 12/14/2022 12:59:15 PM

Document Has Been Signed on 12/14/2022 12:59 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, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108
FACILITY NAME:MY MONTESSORI SCHOOL CORONADO, LLCFACILITY NUMBER:
376701528
ADMINISTRATOR:CORINA TELLEZFACILITY TYPE:
850
ADDRESS:1123 8TH STREETTELEPHONE:
(619) 870-6459
CITY:CORONADOSTATE: CAZIP CODE:
92118
CAPACITY: 30TOTAL ENROLLED CHILDREN: 28CENSUS: 22DATE:
12/14/2022
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
10:05 AM
MET WITH:Corina TellezTIME COMPLETED:
12:30 PM
NARRATIVE
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On 12/14/22 at 10:05am, Licensing Program Analyst (LPA), Martha Malane arrived at the facility to conduct a case management inspection for the purpose of a capacity increase. Upon arrival, LPA met with Director, Corina Tellez and proceeded to tour the facility. There were 22 children and four (4) staff members present. Hours of operation are Monday - Friday from 8:00am - 3:45pm. At 10:20am, Administrator, Jimena Barrull arrived at the facility.

The facility is licensed for 30 preschool children (age 2 – kindergarten). The licensee is requesting a capacity increase to 42 preschool children (age 2 – kindergarten). Classrooms A and B previously measured a total of 1,486.44 square feet which is sufficient to accommodate 42 children. The outdoor activity spaces previously measured a total of 2,979.85 square feet which is sufficient to accommodate 39 children. There is one (1) portable sink located on patio 1 and one (1) portable sink located in classroom B. A plan of operation is on file and approved for the use of the portable sinks. There is a restroom near patio 1 containing one (1) sink and three (3) toilets. There are sufficient toilets and sinks to accommodate 45 children.

During the inspection, at 10:11am, LPA observed Child 1 (C1) and C2 in the patio 1 area unsupervised returning to classroom A from the restroom. At 10:33am C3 was observed unsupervised in the patio 1 area on their way to the restroom.

Per Title 22, Division 12, Chapter 1, of the California Code of Regulations, one (1) Type A deficiency was cited on the attached LIC 809D.



LPA informed Director, Corina Tellez that this report dated 12/14/22 documents one (1) Type A citation, which shall be posted for 30 consecutive days as there is an immediate risk to the health, safety, or personal rights of children in care. Also, LPA informed Director, Corina Tellez to provide a copy of this licensing report dated 12/14/22 that documents a Type A citation 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. See LIC809C continuation...
SUPERVISORS NAME: Tulam Vu
LICENSING EVALUATOR NAME: Martha Malane
LICENSING EVALUATOR SIGNATURE: DATE: 12/14/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/14/2022
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108
FACILITY NAME: MY MONTESSORI SCHOOL CORONADO, LLC
FACILITY NUMBER: 376701528
VISIT DATE: 12/14/2022
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 A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification. LPA provided Director, Corina Tellez with a blank LIC 9224 form.

The following corrections are required:


1. Director will submit a plan of correction to ensure children are provided visual supervision at all times.
2. Licensee to submit an updated LIC200A to decrease the requested capacity to 39 due to outdoor activity space.

LIC 9213 Notice of Site Visit is provided and required to be posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

Exit interview conducted with Director, Corina Tellez.
SUPERVISORS NAME: Tulam Vu
LICENSING EVALUATOR NAME: Martha Malane
LICENSING EVALUATOR SIGNATURE:

DATE: 12/14/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/14/2022
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 12/14/2022 12:59 PM - It Cannot Be Edited


Created By: Martha Malane On 12/14/2022 at 11:37 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
, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108

FACILITY NAME: MY MONTESSORI SCHOOL CORONADO, LLC
FACILITY NUMBER: 376701528

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/14/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
12/15/2022
Section Cited
CCR
101229(a)(1)

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101229(a)(1) Responsibility for Providing Care and Supervision No child(ren) shall be left without the supervision of a teacher at any time... Supervision shall include visual observation. This requirement is not met as evidenced by:
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Director stated all staff will be trained on the requirements of Supervision by 12/15/22. Evidence of this training will be submitted to Licensing by 12/15/22. Director stated she will submit a plan of correction to ensure children are provided visual supervision at all times.
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Based on LPA observation and interviews, staff did not ensure children were provided visual supervision at all times while using the restroom which poses an immediate health and safety risk to children 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:Tulam Vu
LICENSING EVALUATOR NAME:Martha Malane
LICENSING EVALUATOR SIGNATURE:
DATE: 12/14/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/14/2022


LIC809 (FAS) - (06/04)
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