LITTLE FLOWERS MONTESSORI, INC

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25On 6/25/2024 at 10:20AM, Licensing Program Analyst (LPA) Jaleesa Jackson conducted a Case Management visit following an Unusual incident that occurred on 6/5/24. Present for the inspection were 21 staff, 180 preschool age children, and 9 toddlers. Director self reported the incident on 6/6/24. LPA conducted a staff interview and record review. LPA Jackson spoke with the facility Director Maggie Balthazar about the incident that happened on 6/5/24. C1 was crying in the classroom and S1 tried to pick up the child to sooth them. S1 grabbed C1 to pick them up. C1 did not want to be picked up and resisted. The incident resulted in visible red marking underneath the child's arms. There is 1 deficiency being cited today. See 809-D for deficiency. A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with Director Maggie Balthazar. SUPERVISORS NAME: Jason Jang LICENSING EVALUATOR NAME: Jaleesa Jackson LICENSING EVALUATOR SIGNATURE: DATE: 06/25/2024 I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/25/2024 This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC809 (FAS) - (06/04)Page: 1 of 2 FACILITY NAME: LITTLE FLOWERS MONTESSORI, INC FACILITY NUMBER: 013418197 DEFICIENCY INFORMATION FOR THIS PAGE: VISIT DATE: 06/25/2024 Deficiency Type POC Due Date / Section NumberDEFICIENCIESPLAN OF CORRECTIONS(POCs) Type B 07/25/2024 Section Cited CCR 101223(a)(1) 1 2 3 4 5 6 7 The licensee shall ensure that each child is accorded the following personal rights: (1) To be accorded dignity in his/her personal relationships with staff and other persons.1 2 3 4 5 6 7Director will have a mandatory all staff meeting and review the Personal Rights video. Director will send the meeting agenda as well as the sign in sheet for all staff present to LPA by email by POC date. 8 9 10 11 12 13 14This requirement was not met as evidenced by: Based on interview and record review S1 grabbed and picked up C1 while C1 resisted resulted in visible marks under C1's underarms which posed a potential risk to the health, safety, or personal rights to persons in care.8 9 10 11 12 13 14 1 2 3 4 5 6 71 2 3 4 5 6 7 1 2 3 4 5 6 71 2 3 4 5 6 7 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:Jason Jang LICENSING EVALUATOR NAME:Jaleesa Jackson LICENSING EVALUATOR SIGNATURE: DATE: 06/25/2024 I acknowledge receipt of this form and understand my appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/25/2024

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25On 6/25/2024 at 10:20AM, Licensing Program Analyst (LPA) Jaleesa Jackson conducted a Case Management visit following an Unusual incident that occurred on 6/5/24. Present for the inspection were 21 staff, 180 preschool age children, and 9 toddlers. Director self reported the incident on 6/6/24. LPA conducted a staff interview and record review. LPA Jackson spoke with the facility Director Maggie Balthazar about the incident that happened on 6/5/24. C1 was crying in the classroom and S1 tried to pick up the child to sooth them. S1 grabbed C1 to pick them up. C1 did not want to be picked up and resisted. The incident resulted in visible red marking underneath the child's arms. There is 1 deficiency being cited today. See 809-D for deficiency. A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with Director Maggie Balthazar. SUPERVISORS NAME: Jason Jang LICENSING EVALUATOR NAME: Jaleesa Jackson LICENSING EVALUATOR SIGNATURE: DATE: 06/25/2024 I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/25/2024 This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC809 (FAS) - (06/04)Page: 1 of 2 FACILITY NAME: LITTLE FLOWERS MONTESSORI, INC FACILITY NUMBER: 013418197 DEFICIENCY INFORMATION FOR THIS PAGE: VISIT DATE: 06/25/2024 Deficiency Type POC Due Date / Section NumberDEFICIENCIESPLAN OF CORRECTIONS(POCs) Type B 07/25/2024 Section Cited CCR 101223(a)(1) 1 2 3 4 5 6 7 The licensee shall ensure that each child is accorded the following personal rights: (1) To be accorded dignity in his/her personal relationships with staff and other persons.1 2 3 4 5 6 7Director will have a mandatory all staff meeting and review the Personal Rights video. Director will send the meeting agenda as well as the sign in sheet for all staff present to LPA by email by POC date. 8 9 10 11 12 13 14This requirement was not met as evidenced by: Based on interview and record review S1 grabbed and picked up C1 while C1 resisted resulted in visible marks under C1's underarms which posed a potential risk to the health, safety, or personal rights to persons in care.8 9 10 11 12 13 14 1 2 3 4 5 6 71 2 3 4 5 6 7 1 2 3 4 5 6 71 2 3 4 5 6 7 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:Jason Jang LICENSING EVALUATOR NAME:Jaleesa Jackson LICENSING EVALUATOR SIGNATURE: DATE: 06/25/2024 I acknowledge receipt of this form and understand my appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/25/2024

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25On 6/25/2024 at 10:20AM, Licensing Program Analyst (LPA) Jaleesa Jackson conducted a Case Management visit following an Unusual incident that occurred on 6/5/24. Present for the inspection were 21 staff, 180 preschool age children, and 9 toddlers. Director self reported the incident on 6/6/24. LPA conducted a staff interview and record review. LPA Jackson spoke with the facility Director Maggie Balthazar about the incident that happened on 6/5/24. C1 was crying in the classroom and S1 tried to pick up the child to sooth them. S1 grabbed C1 to pick them up. C1 did not want to be picked up and resisted. The incident resulted in visible red marking underneath the child's arms. There is 1 deficiency being cited today. See 809-D for deficiency. A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with Director Maggie Balthazar. SUPERVISORS NAME: Jason Jang LICENSING EVALUATOR NAME: Jaleesa Jackson LICENSING EVALUATOR SIGNATURE: DATE: 06/25/2024 I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/25/2024 This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC809 (FAS) - (06/04)Page: 1 of 2 FACILITY NAME: LITTLE FLOWERS MONTESSORI, INC FACILITY NUMBER: 013418197 DEFICIENCY INFORMATION FOR THIS PAGE: VISIT DATE: 06/25/2024 Deficiency Type POC Due Date / Section NumberDEFICIENCIESPLAN OF CORRECTIONS(POCs) Type B 07/25/2024 Section Cited CCR 101223(a)(1) 1 2 3 4 5 6 7 The licensee shall ensure that each child is accorded the following personal rights: (1) To be accorded dignity in his/her personal relationships with staff and other persons.1 2 3 4 5 6 7Director will have a mandatory all staff meeting and review the Personal Rights video. Director will send the meeting agenda as well as the sign in sheet for all staff present to LPA by email by POC date. 8 9 10 11 12 13 14This requirement was not met as evidenced by: Based on interview and record review S1 grabbed and picked up C1 while C1 resisted resulted in visible marks under C1's underarms which posed a potential risk to the health, safety, or personal rights to persons in care.8 9 10 11 12 13 14 1 2 3 4 5 6 71 2 3 4 5 6 7 1 2 3 4 5 6 71 2 3 4 5 6 7 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:Jason Jang LICENSING EVALUATOR NAME:Jaleesa Jackson LICENSING EVALUATOR SIGNATURE: DATE: 06/25/2024 I acknowledge receipt of this form and understand my appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/25/2024

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25On 6/25/2024 at 10:20AM, Licensing Program Analyst (LPA) Jaleesa Jackson conducted a Case Management visit following an Unusual incident that occurred on 6/5/24. Present for the inspection were 21 staff, 180 preschool age children, and 9 toddlers. Director self reported the incident on 6/6/24. LPA conducted a staff interview and record review. LPA Jackson spoke with the facility Director Maggie Balthazar about the incident that happened on 6/5/24. C1 was crying in the classroom and S1 tried to pick up the child to sooth them. S1 grabbed C1 to pick them up. C1 did not want to be picked up and resisted. The incident resulted in visible red marking underneath the child's arms. There is 1 deficiency being cited today. See 809-D for deficiency. A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with Director Maggie Balthazar. SUPERVISORS NAME: Jason Jang LICENSING EVALUATOR NAME: Jaleesa Jackson LICENSING EVALUATOR SIGNATURE: DATE: 06/25/2024 I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/25/2024 This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC809 (FAS) - (06/04)Page: 1 of 2 FACILITY NAME: LITTLE FLOWERS MONTESSORI, INC FACILITY NUMBER: 013418197 DEFICIENCY INFORMATION FOR THIS PAGE: VISIT DATE: 06/25/2024 Deficiency Type POC Due Date / Section NumberDEFICIENCIESPLAN OF CORRECTIONS(POCs) Type B 07/25/2024 Section Cited CCR 101223(a)(1) 1 2 3 4 5 6 7 The licensee shall ensure that each child is accorded the following personal rights: (1) To be accorded dignity in his/her personal relationships with staff and other persons.1 2 3 4 5 6 7Director will have a mandatory all staff meeting and review the Personal Rights video. Director will send the meeting agenda as well as the sign in sheet for all staff present to LPA by email by POC date. 8 9 10 11 12 13 14This requirement was not met as evidenced by: Based on interview and record review S1 grabbed and picked up C1 while C1 resisted resulted in visible marks under C1's underarms which posed a potential risk to the health, safety, or personal rights to persons in care.8 9 10 11 12 13 14 1 2 3 4 5 6 71 2 3 4 5 6 7 1 2 3 4 5 6 71 2 3 4 5 6 7 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:Jason Jang LICENSING EVALUATOR NAME:Jaleesa Jackson LICENSING EVALUATOR SIGNATURE: DATE: 06/25/2024 I acknowledge receipt of this form and understand my appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/25/2024

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25On 6/25/2024 at 10:20AM, Licensing Program Analyst (LPA) Jaleesa Jackson conducted a Case Management visit following an Unusual incident that occurred on 6/5/24. Present for the inspection were 21 staff, 180 preschool age children, and 9 toddlers. Director self reported the incident on 6/6/24. LPA conducted a staff interview and record review. LPA Jackson spoke with the facility Director Maggie Balthazar about the incident that happened on 6/5/24. C1 was crying in the classroom and S1 tried to pick up the child to sooth them. S1 grabbed C1 to pick them up. C1 did not want to be picked up and resisted. The incident resulted in visible red marking underneath the child's arms. There is 1 deficiency being cited today. See 809-D for deficiency. A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with Director Maggie Balthazar. SUPERVISORS NAME: Jason Jang LICENSING EVALUATOR NAME: Jaleesa Jackson LICENSING EVALUATOR SIGNATURE: DATE: 06/25/2024 I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/25/2024 This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC809 (FAS) - (06/04)Page: 1 of 2 FACILITY NAME: LITTLE FLOWERS MONTESSORI, INC FACILITY NUMBER: 013418197 DEFICIENCY INFORMATION FOR THIS PAGE: VISIT DATE: 06/25/2024 Deficiency Type POC Due Date / Section NumberDEFICIENCIESPLAN OF CORRECTIONS(POCs) Type B 07/25/2024 Section Cited CCR 101223(a)(1) 1 2 3 4 5 6 7 The licensee shall ensure that each child is accorded the following personal rights: (1) To be accorded dignity in his/her personal relationships with staff and other persons.1 2 3 4 5 6 7Director will have a mandatory all staff meeting and review the Personal Rights video. Director will send the meeting agenda as well as the sign in sheet for all staff present to LPA by email by POC date. 8 9 10 11 12 13 14This requirement was not met as evidenced by: Based on interview and record review S1 grabbed and picked up C1 while C1 resisted resulted in visible marks under C1's underarms which posed a potential risk to the health, safety, or personal rights to persons in care.8 9 10 11 12 13 14 1 2 3 4 5 6 71 2 3 4 5 6 7 1 2 3 4 5 6 71 2 3 4 5 6 7 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:Jason Jang LICENSING EVALUATOR NAME:Jaleesa Jackson LICENSING EVALUATOR SIGNATURE: DATE: 06/25/2024 I acknowledge receipt of this form and understand my appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/25/2024

Type A citation - immediate risk to health, safety, or personal rights

Type B citation - potential risk if not corrected

Type B citation - potential risk if not corrected

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25On 6/25/2024 at 10:20AM, Licensing Program Analyst (LPA) Jaleesa Jackson conducted a Case Management visit following an Unusual incident that occurred on 6/5/24. Present for the inspection were 21 staff, 180 preschool age children, and 9 toddlers. Director self reported the incident on 6/6/24. LPA conducted a staff interview and record review. LPA Jackson spoke with the facility Director Maggie Balthazar about the incident that happened on 6/5/24. C1 was crying in the classroom and S1 tried to pick up the child to sooth them. S1 grabbed C1 to pick them up. C1 did not want to be picked up and resisted. The incident resulted in visible red marking underneath the child's arms. There is 1 deficiency being cited today. See 809-D for deficiency. A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with Director Maggie Balthazar. SUPERVISORS NAME: Jason Jang LICENSING EVALUATOR NAME: Jaleesa Jackson LICENSING EVALUATOR SIGNATURE: DATE: 06/25/2024 I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/25/2024 This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC809 (FAS) - (06/04)Page: 1 of 2 FACILITY NAME: LITTLE FLOWERS MONTESSORI, INC FACILITY NUMBER: 013418197 DEFICIENCY INFORMATION FOR THIS PAGE: VISIT DATE: 06/25/2024 Deficiency Type POC Due Date / Section NumberDEFICIENCIESPLAN OF CORRECTIONS(POCs) Type B 07/25/2024 Section Cited CCR 101223(a)(1) 1 2 3 4 5 6 7 The licensee shall ensure that each child is accorded the following personal rights: (1) To be accorded dignity in his/her personal relationships with staff and other persons.1 2 3 4 5 6 7Director will have a mandatory all staff meeting and review the Personal Rights video. Director will send the meeting agenda as well as the sign in sheet for all staff present to LPA by email by POC date. 8 9 10 11 12 13 14This requirement was not met as evidenced by: Based on interview and record review S1 grabbed and picked up C1 while C1 resisted resulted in visible marks under C1's underarms which posed a potential risk to the health, safety, or personal rights to persons in care.8 9 10 11 12 13 14 1 2 3 4 5 6 71 2 3 4 5 6 7 1 2 3 4 5 6 71 2 3 4 5 6 7 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:Jason Jang LICENSING EVALUATOR NAME:Jaleesa Jackson LICENSING EVALUATOR SIGNATURE: DATE: 06/25/2024 I acknowledge receipt of this form and understand my appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/25/2024