WALNUT INTERNATIONAL MONTESSORI PRESCHOOL

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

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 08/25/25, Licensing Program Analyst (LPA) Kruz Long conducted an unannounced case management inspection. LPA met with Carolina Diaz, Assistant Director and explained the purpose of the visit. There are 110 children enrolled and 87 are present in 5 different classrooms.. The purpose of the visit is to deliver investigation findings for an incident that occurred on 08/05/25 and was reported to the department on 08/05/25. The self reported incident is regarding food services. During the course of the investigation, LPA obtained a copy of the children allergy list, interviewed Staff #1 (S1) and Staff #2 (S2) in the office and toured the preschool classrooms with the Assistant Director. According to the interviews with Staff #1(S1) and Staff #2(S2), S2 gave Child #1(C1) a cookie which contained nut ingredients which cause an allergic reaction. LPA toured the classrooms and verified that an allergy list is posted in every classroom and S2 should have been aware of C1's allergy. Upon receipt of the licensing report. Licensee shall post report documenting Type A citation along with Notice of Site Visit Form in an area accessible for review for 30 days or a civil penalty of $100 will be assessed. Licensee shall also provide a copy of the report documenting Type A citation and any report resulting from a Non-Compliance Conference to all parents of currently enrolled children along with form LIC 9224 (Acknowledgement of Receipt of Licensing Report) for signature. Completed form shall be placed in child's file. Licensee shall also provide report and form to parents of newly enrolled children for the next 12 months. An exit Interview was conducted, a copy of this report and appeal rights along with Notice of Site visit was provided to the Assistant Director. NAME OF LICENSING PROGRAM MANAGER: Ana Chico NAME OF LICENSING PROGRAM ANALYST: Kruz Long LICENSING PROGRAM ANALYST SIGNATURE: DATE: 08/25/2025 I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/25/2025 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 3 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 correc

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 08/25/25, Licensing Program Analyst (LPA) Kruz Long conducted an unannounced case management inspection. LPA met with Carolina Diaz, Assistant Director and explained the purpose of the visit. There are 110 children enrolled and 87 are present in 5 different classrooms.. The purpose of the visit is to deliver investigation findings for an incident that occurred on 08/05/25 and was reported to the department on 08/05/25. The self reported incident is regarding food services. During the course of the investigation, LPA obtained a copy of the children allergy list, interviewed Staff #1 (S1) and Staff #2 (S2) in the office and toured the preschool classrooms with the Assistant Director. According to the interviews with Staff #1(S1) and Staff #2(S2), S2 gave Child #1(C1) a cookie which contained nut ingredients which cause an allergic reaction. LPA toured the classrooms and verified that an allergy list is posted in every classroom and S2 should have been aware of C1's allergy. Upon receipt of the licensing report. Licensee shall post report documenting Type A citation along with Notice of Site Visit Form in an area accessible for review for 30 days or a civil penalty of $100 will be assessed. Licensee shall also provide a copy of the report documenting Type A citation and any report resulting from a Non-Compliance Conference to all parents of currently enrolled children along with form LIC 9224 (Acknowledgement of Receipt of Licensing Report) for signature. Completed form shall be placed in child's file. Licensee shall also provide report and form to parents of newly enrolled children for the next 12 months. An exit Interview was conducted, a copy of this report and appeal rights along with Notice of Site visit was provided to the Assistant Director. NAME OF LICENSING PROGRAM MANAGER: Ana Chico NAME OF LICENSING PROGRAM ANALYST: Kruz Long LICENSING PROGRAM ANALYST SIGNATURE: DATE: 08/25/2025 I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/25/2025 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 3 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 correc