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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 191225566
Report Date: 05/04/2022
Date Signed: 05/05/2022 10:31:32 AM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
This is an official report of an unannounced visit/investigation of a complaint received in our office on
03/16/2022 and conducted by Evaluator Lisa Clayton
COMPLAINT CONTROL NUMBER: 30-CC-20220316133227
FACILITY NAME:MONTESSORI CHILDREN'S ACADEMIEFACILITY NUMBER:
191225566
ADMINISTRATOR:WAHEEDA HAMIDFACILITY TYPE:
850
ADDRESS:2400 W. BURBANK BLVD.TELEPHONE:
(818) 842-1812
CITY:BURBANKSTATE: CAZIP CODE:
91506
CAPACITY:82CENSUS: 39DATE:
05/04/2022
UNANNOUNCEDTIME BEGAN:
11:30 AM
MET WITH:NINA KOULAX, OWNERTIME COMPLETED:
03:00 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
PERSONAL RIGHTS: Daycare child had access to an unsafe object.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On 05/042022, LPA Clayton conducted an un-announced visit to deliver the findings of the above allegations. LPA was greeted by Owner Nina Koulax and the Director Angela Pogosyan. Also present were 6 teachers and 39 children in care.
LPA toured the facility for Health & Safety inspection, and observed children being handled and supervised appropriately.

It was alleged that a daycare child had access to an unsafe object. Based on LPAs interviews with staff and parents, the above allegation(s) is found to be UNSUBSTANTIATED, meaning that although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation(s) did or did not occur.
Exit interview conducted and report was reviewed with Nina Koulax, Owner .
A notice of site visit was given and must remain posted for 30 days.
Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Mary RuizTELEPHONE: (424) 301-3061
LICENSING EVALUATOR NAME: Lisa ClaytonTELEPHONE: (424) 301-3206
LICENSING EVALUATOR SIGNATURE:

DATE: 05/04/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/04/2022
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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