191201813-4-8-2022-33-CC-CGAN-CDWSKQ-20220428135708

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 191201813
Report Date: 04/08/2022
Date Signed: 04/08/2022 01:48:18 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

This is an official report of an unannounced visit/investigation of a complaint received in our office on
03/04/2022 and conducted by Evaluator Anomeh Eivazian

PUBLIC

COMPLAINT CONTROL NUMBER: 33-CC-20220304092958

FACILITY NAME:	GLENDALE MONTESSORI SCHOOL		FACILITY NUMBER:	191201813
ADMINISTRATOR:	ANDREA VENTURA		FACILITY TYPE:	850
ADDRESS:	413 WEST DORAN		TELEPHONE:	(818) 240-9415
CITY:	GLENDALE	STATE: CA	ZIP CODE:	91203
CAPACITY:	73	CENSUS: 42	DATE:	04/08/2022
		UNANNOUNCED	TIME BEGAN:	01:00 PM
MET WITH:	Andrea Ventura, Director and Anita Tuchrello, Principal		TIME COMPLETED:	02:10 PM

ALLEGATION(S):

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Lack of supervision resulting in day care child being injured by another day care child

INVESTIGATION FINDINGS:

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Licensing Program Analysts (LPA) Anomeh Eivazian and David Kurdogolyan conducted an unannounced complaint inspection to the above facility for the purpose of delivering the complaint finding. On 04/08/2022 LPAs arrived at 1:00 p.m. met with Andrea Ventura, Director and Anita Tuchrello, Principal. Andrea Ventura guided analysts on a tour of the facility. During this inspection there were 42 children present in the facility.

During this investigation, LPA Eivazian conducted interviews with staff and two children. LPA obtained a copy of facility roster and children sing in/out sheet for the week of 02/28/2022.

Based on interviews that were conducted with staff#1, staff#2, and staff#3, they observed staff#2 and staff#3 were on the sand playground with children and observed child#1 and child#2 were playing with wooden blocks, but they did not observe the moment that incident occurred. Per staff interivews, on 03/03/2022,

REPORT CONTINUES ON NEXT PAGE 1 of 2

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Christina Gabelman	TELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Anomeh Eivazian	TELEPHONE: (323) 981-3391
LICENSING EVALUATOR SIGNATURE:	DATE: 04/08/2022

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/08/2022

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

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Control Number 33-CC-20220304092958

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: GLENDALE MONTESSORI SCHOOL	FACILITY NUMBER: 191201813
	VISIT DATE: 04/08/2022

NARRATIVE

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child #2 went to staff#2 who was on the sand playground and complaint about the pain on the left side on the face and staff#2 observed blood on the left side of the face of child#2 by the end of eyebrow line. Per staff#2, child#2 was taken to the office, first aid was applied and parent was informed. Child#2 was picked up and received glue on the injury.

Based on child#1 and child#2 interviews, they were playing Start Wars on the sand playground and child#1 accidentally hit child#2 with wooden block. Per child#2, staff#2 was on the sand playground who assisted child#2.

Based on LPA Eivazian sing in/out sheet review for 03/03/2022, teacher child ratio requirement was met on the day of incident.

Although the allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore at this time the above allegation is Unsubstantiated.

The Notice of Site Visit (LIC 9213) was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

Exit interview conducted and report was reviewed with the Andrea Ventura, Director and Anita Tuchrello, Principal at 2:10 p.m..

REPORT END 2 of

SUPERVISOR'S NAME: Christina Gabelman	TELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Anomeh Eivazian	TELEPHONE: (323) 981-3391
LICENSING EVALUATOR SIGNATURE:	DATE: 04/08/2022

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/08/2022

LIC9099 (FAS) - (06/04)

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