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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 197419019
Report Date: 11/28/2022
Date Signed: 11/28/2022 09:17:03 AM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO CC NORTH, 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
09/09/2022 and conducted by Evaluator Denise Miranda
PUBLIC
COMPLAINT CONTROL NUMBER: 30-CC-20220909130706
FACILITY NAME:BEVERLYWOOD MONTESSORI PRESCHOOLFACILITY NUMBER:
197419019
ADMINISTRATOR:TORRES, IZAFACILITY TYPE:
850
ADDRESS:1653 SOUTH ROBERTSON BOULEVARDTELEPHONE:
(310) 552-1155
CITY:LOS ANGELESSTATE: CAZIP CODE:
90035
CAPACITY:37CENSUS: 31DATE:
11/28/2022
UNANNOUNCEDTIME BEGAN:
07:55 AM
MET WITH:Iza Torres, Director TIME COMPLETED:
09:30 PM
ALLEGATION(S):
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Child left the childcare unsupervised due to lack of supervision
Licensee did not inform child's authorized person of incident
Childcare gate is in disrepair

INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Denise Miranda conducted an unannounced complaint inspection to the above facility on 11/28/2022. LPA arrived at 7:55AM and met with Iza Torres, Director, who guided analyst on a tour of the facility. There were 31 children with 4 staff and Director upon arrival.

During the investigation LPA interviewed Staff, interviewed parent of Child#1, obtained a copy of the children's roster, obtained copies of supporting documentation, and took pictures of the gate area that Child #1 used to leave the facility without supervision and the area that Child #1 was found at.

Information provided by the reporting party indicates that Child #1 left the childcare undetected and unsupervised and that the Licensee did not inform Child#1’s authorized parents of incident. In addition, reporting party indicated that the child care gate is in disrepair.
Substantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Lisa RiosTELEPHONE: (424) 301-3072
LICENSING EVALUATOR NAME: Denise MirandaTELEPHONE: (424) 301-3055
LICENSING EVALUATOR SIGNATURE:

DATE: 11/28/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/28/2022
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 1 of 4
Control Number 30-CC-20220909130706
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: BEVERLYWOOD MONTESSORI PRESCHOOL
FACILITY NUMBER: 197419019
VISIT DATE: 11/28/2022
NARRATIVE
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Director disclosed that they did not notice that Child#1 left the childcare unsupervised and Staff#1 and Staff#2 notified Director of Child #1 missing when the parents came to pick up their child.
Staff#1 and Staff#2 disclosed that they noticed that Child #1 was missing when parents arrived to pick up their child and realized that Child #1 was not outside in the outdoor area. Parents were notified only when the facility found Child #1. Staff #1 and Staff #2 also disclosed that the incident occurred on 09/06/22.
The facility has gates located in the back yard that give access to an alley. The main gate had a lock and a coil chain. Per Director, Staff #1 and Staff #2, the coil chain provided a gap that can be opened wide enough for a child to squeeze through. Child #1 was able to leave through this opening at the gate.
Parent of Child #1 disclosed that the Director told them that their child left the childcare unsupervised after they found their child was found.
Based on LPAs observations and interviews which were conducted, the preponderance of evidence standard has been met, therefore the above allegations are found to be SUBSTANTIATED. California Code of Regulations, Title 22, is being cited on the attached deficiencies page.
A copy of this report shall be provided to the parent/guardian of children currently enrolled by the next business day or immediately upon return. A copy of this report shall also be provided to the parent/guardian of any newly enrolled children for the next 12 months (1 year). The Acknowledgement form must be maintained in each child’s file immediately upon receipt from parent.Director was provided with a copy of the parent Acknowledgement of Receipt of Licensing Reports Form during this visit.

The Notice of Site Visit (LIC 9213) – must remain posted for 30 days during the hours of operation after each site visit by a licensing representative. Failure to maintain posting as required will result in a civil penalty of $100.00.

Exit interview was conducted with Iza Torres, Director, including, but not limited to Provider Rights, Appeal Procedures and Agencies Consultative Role. A copy of this report was provided to Director, Iza Torres, along with Appeal Rights and LIC 9213 Notice of Site Visit.

SUPERVISOR'S NAME: Lisa RiosTELEPHONE: (424) 301-3072
LICENSING EVALUATOR NAME: Denise MirandaTELEPHONE: (424) 301-3055
LICENSING EVALUATOR SIGNATURE:

DATE: 11/28/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/28/2022
LIC9099 (FAS) - (06/04)
Page: 3 of 4
Control Number 30-CC-20220909130706
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME: BEVERLYWOOD MONTESSORI PRESCHOOL
FACILITY NUMBER: 197419019
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/28/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
11/29/2022
Section Cited
CCR
101229(a)(1)
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Responsibility for Providing Care and Supervision. a) The licensee shall provide care and supervision... (1) No child(ren) shall be left without the supervision of a teacher at any time…This requirement was not met as evidenced by: On 09/6/2022 child#1 left the childcare unsupervised due to lack of supervision left the
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Director agrees to provide training for all staff: “Supervising Children in Child Care Centers” video to the Child Safety/Supervision. Director created a Protocol regarding Child Safety/Supervision and submited on 09/16/2022.
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facility. Child was found over 10 minutes later with two adults (unknow). This poses a immediately health and safety risk to children in care.

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Director will submitted no later than tomorrow a copy of the training and Staff attendance. Please see link: https://ccld.childcarevideos.org/child-care-center-operators/supervising-children-in-child-care-centers/
Type A
11/28/2022
Section Cited
CCR
101238(a)
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Buildings and Grounds. The child care center shall be ……in good repair at all times to ensure the safety and well-being of children, employees and visitors. This requirement was not met as evidenced by: On 09/06/2022 Child left the childcare unsupervised due to lack of
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Director provided a declaration that all gates will be check all times and make sure they are in good repair, to ensure the safety and well-being of children in care.
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supervision left the facility, using the back gate that had a lock and a coil chain, however the coil chain had a gap enough for the child leave the facility. This poses a immediately health and safety risk to children in care.

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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: Lisa RiosTELEPHONE: (424) 301-3072
LICENSING EVALUATOR NAME: Denise MirandaTELEPHONE: (424) 301-3055
LICENSING EVALUATOR SIGNATURE:

DATE: 11/28/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/28/2022
LIC9099 (FAS) - (06/04)
Page: 2 of 4
Control Number 30-CC-20220909130706
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME: BEVERLYWOOD MONTESSORI PRESCHOOL
FACILITY NUMBER: 197419019
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/28/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
11/28/2022
Section Cited
CCR
101212(d)(1)(A)
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Reporting Requirements. The items specified in (d)(1)(A) through (H) above shall also be reported to the child's authorized representative. This requirement was not met as evidenced by:
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Director provided a declaration that she understand that she shall report to the child's authorized representitive/parents, any type of incident immediately.
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On 09/06/2022 Child left the childcare unsupervised due to lack of supervision left the facility, Director informed that child#1 parents, that child#1 was not present after the facltiy found the child.
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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: Lisa RiosTELEPHONE: (424) 301-3072
LICENSING EVALUATOR NAME: Denise MirandaTELEPHONE: (424) 301-3055
LICENSING EVALUATOR SIGNATURE:

DATE: 11/28/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/28/2022
LIC9099 (FAS) - (06/04)
Page: 4 of 4