197414804-7-8-2022-17-CC-GMIE-CGFVHT-20220718162741

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197414804
Report Date: 07/08/2022
Date Signed: 07/08/2022 11:48:14 AM

Substantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117

This is an official report of an unannounced visit/investigation of a complaint received in our office on
05/26/2022 and conducted by Evaluator Francisco Pedroza

PUBLIC

COMPLAINT CONTROL NUMBER: 17-CC-20220526085947

FACILITY NAME:	MONTESSORI SCHOOL OF AGOURA		FACILITY NUMBER:	197414804
ADMINISTRATOR:	MARIA T. HOSKINS		FACILITY TYPE:	850
ADDRESS:	28124 DRIVER AVE.		TELEPHONE:	(818) 991-8936
CITY:	AGOURA HILLS	STATE: CA	ZIP CODE:	91301
CAPACITY:	57	CENSUS: 19	DATE:	07/08/2022
		UNANNOUNCED	TIME BEGAN:	09:20 AM
MET WITH:	Maria "Terri" Hoskins		TIME COMPLETED:	10:20 AM

ALLEGATION(S):

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Personal Rights - Day care children are being injured by other day care child while in care.
Reporting Requirements - Incidents are not being reported.

INVESTIGATION FINDINGS:

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On July 8, 2022 at 9:25 AM, Licensing Program Analysts (LPA's) Francisco Pedroza and Rona Chavez conducted an unannounced inspection to close a complaint investigation. LPA's met with Owner Karen Kunstler and Director Maria "Terri" Hoskins and informed her the purpose of the inspection. Director provided LPA's a tour of the facility inside and out. There was 19 children in care at the time of the inspection.

Allegation(s) stated a day care children are being injured by a day care child while in care and incidents are not being reported. Investigation included two unannoucned inspection, interviews with staff, parents, and record reviews. Staff provided information on their protocols on how they address when a child is injured while in care. Staff advised they provided more one-on-one care for children that exibit behavioal issues and work with the child's guardian(s).

Continued on 9099-C

Substantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Maria Mueller	TELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Francisco Pedroza	TELEPHONE: (805) 689-6267
LICENSING EVALUATOR SIGNATURE:	DATE: 07/08/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/08/2022

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 17-CC-20220526085947

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117

FACILITY NAME: MONTESSORI SCHOOL OF AGOURA	FACILITY NUMBER: 197414804
	VISIT DATE: 07/08/2022

NARRATIVE

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During the course of the investigation, LPA gathered information during record reviews, LPA observed documented incidents where children were involved in an altercation on 5/20/22. During the incident C1 had bitten C2 on the left shoulder breaking the skin. The incident was not reported to Community Care Licensing (CCL). Parent interviews corroborated with the incident that occurred. Records showed the facility was in correct staff to child ratio during the incident. Director advised LPA that they did have a meeting with C1's guardian(s). At the conclusion of the meeting, the parent decided to withdrawal C1 from the program.

Based on LPAs observations and interviews which were conducted and record review(s), the preponderance of evidence standard has been met, therefore the above allegation(s) is found to be SUBSTANTIATED.
A Technical Violation was issued today for the above allegation(s).

No deficiencies cited during today's inspection.

Exit interview conducted with Owner and Director.

THE NOTICE OF SITE VISIT WAS POSTED AS REQUIRED BY H&S CODE SEC. 1596.817.

SUPERVISOR'S NAME: Maria Mueller	TELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Francisco Pedroza	TELEPHONE: (805) 689-6267
LICENSING EVALUATOR SIGNATURE:	DATE: 07/08/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/08/2022

LIC9099 (FAS) - (06/04)

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