<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198011974
Report Date: 01/08/2024
Date Signed: 01/08/2024 11:27:51 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, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
This is an official report of an unannounced visit/investigation of a complaint received in our office on
12/14/2023 and conducted by Evaluator Raul Navarro
PUBLIC
COMPLAINT CONTROL NUMBER: 54-CC-20231214140547
FACILITY NAME:MONTESSORI ON ELM PRESCHOOL + KINDERGARTENFACILITY NUMBER:
198011974
ADMINISTRATOR:WIJEYEWICKREMA, CASSANDRAFACILITY TYPE:
830
ADDRESS:930 ELM AVENUETELEPHONE:
(562) 570-8080
CITY:LONG BEACHSTATE: CAZIP CODE:
90813
CAPACITY:24CENSUS: 16DATE:
01/08/2024
UNANNOUNCEDTIME BEGAN:
09:40 AM
MET WITH:Vijayalaxmi ShadagopanTIME COMPLETED:
11:50 AM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Staff did not administer first aide to child's injury
Staff did not ensure that child's diapering needs were met
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analyst (LPA) Raul Navarro conducted an unannounced complaint inspection on 01/08/2024. LPA Navarro arrived at 09:40am and met with Facility Representative Vijayalaxmi Shadagopan. There were 16 infants present with five staff during today's inspection.

During the course of the investigation, LPA conducted interview with the complainant, staff, and parents. LPA also reviewed documents. Children were not interviewed because they are infants and non verbal. Interviews conducted with staff and children were not consistent with the allegations made by the Complainant. Due to conflicting statements made by the complainant and interviews conducted with the licensee, staff, and parents, the allegation that staff did not administer first aide to child's injury and staff did not ensure that child's diapering needs were met are unsubstantiated. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is unsubstantiated.
- Report continues on the next page
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Karen Chambers
LICENSING EVALUATOR NAME: Raul Navarro
LICENSING EVALUATOR SIGNATURE:

DATE: 01/08/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/08/2024
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 5
Control Number 54-CC-20231214140547
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 CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: MONTESSORI ON ELM PRESCHOOL + KINDERGARTEN
FACILITY NUMBER: 198011974
VISIT DATE: 01/08/2024
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
 Exit interview was conducted with Facility Representative, Vijayalaxmi Shadagopan. The notice of site visit was given and must remain posted for 30 days.
SUPERVISORS NAME: Karen Chambers
LICENSING EVALUATOR NAME: Raul Navarro
LICENSING EVALUATOR SIGNATURE:

DATE: 01/08/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/08/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 5
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 CENTER DR 200B
MONTEREY PARK, CA 91754
This is an official report of an unannounced visit/investigation of a complaint received in our office on
12/14/2023 and conducted by Evaluator Raul Navarro
PUBLIC
COMPLAINT CONTROL NUMBER: 54-CC-20231214140547

FACILITY NAME:MONTESSORI ON ELM PRESCHOOL + KINDERGARTENFACILITY NUMBER:
198011974
ADMINISTRATOR:WIJEYEWICKREMA, CASSANDRAFACILITY TYPE:
830
ADDRESS:930 ELM AVENUETELEPHONE:
(562) 570-8080
CITY:LONG BEACHSTATE: CAZIP CODE:
90813
CAPACITY:24CENSUS: 16DATE:
01/08/2024
UNANNOUNCEDTIME BEGAN:
09:40 AM
MET WITH:Vijayalaxmi Shadagopa- Facility RepresentativeTIME COMPLETED:
11:50 AM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Staff is providing care to children without required training
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analyst (LPA) Raul Navarro conducted an unannounced complaint inspection on 01/08/2024 at 09:40am. LPA met with Facility Representative to discuss the above allegation. At the time of arrival LPA observed 16 children in care with five staff.

During the course of the investigation LPA Navarro toured the facility, interviewed the Licensee and staff, and reviewed staff files. Complainant stated staff in the infant room does not have the qualifications to be a teacher. During interviews with the Licensee and staff and file review, it was determined that staff did not have proof of qualifications to be an infant teacher. Interviews conducted and file review were consistent with their facts establishing that the allegation had occurred and that the facility did not take the actions needed to prevent it. The allegation of staff is providing care to children without required training is Substantiated. The preponderance of evidence has been met, therefore the above allegation is found to be substantiated. A technical violation was cited in the attached LIC 9099D.
Report continues on the next page.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Karen Chambers
LICENSING EVALUATOR NAME: Raul Navarro
LICENSING EVALUATOR SIGNATURE:

DATE: 01/08/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/08/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 3 of 5
Control Number 54-CC-20231214140547
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 CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: MONTESSORI ON ELM PRESCHOOL + KINDERGARTEN
FACILITY NUMBER: 198011974
VISIT DATE: 01/08/2024
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
Exit interview was conducted with Facility Representative Vijayalaxmi Shadagopan.

A "Notice of Site Visit" and copy of the report was issued. Notice of Site Visit must remain posted for 30 days. Failure to do so will result in a $100.00 civil penalty.
SUPERVISORS NAME: Karen Chambers
LICENSING EVALUATOR NAME: Raul Navarro
LICENSING EVALUATOR SIGNATURE:

DATE: 01/08/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/08/2024
LIC9099 (FAS) - (06/04)
Page: 4 of 5
Control Number 54-CC-20231214140547
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 CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: MONTESSORI ON ELM PRESCHOOL + KINDERGARTEN
FACILITY NUMBER: 198011974
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/08/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
01/22/2024
Section Cited
CCR
101416.2(b)
1
2
3
4
5
6
7
101416.2-Infant Care Teacher Qualifications and duties (b)- Prior to employment, an infant care teacher shall have completed, with passing grades, at least three postsecondary semesters or equivalent quarter units in early childhood education or child development, and three postsecondary
1
2
3
4
5
6
7
Per facility representative, staff will not be allowed to be in the infant room until they have completed the units. Facility will provide a staff roster for qualified teachers to be in the infant facility and qualified teachers in the preschool facility.
8
9
10
11
12
13
14
semester or equivalent quarter units related to the care of infants, at an accredited or approved college or university. This requirement was not met as evidenced by file review. Staff #3 did not have infant units on file. This is a potential risk to the health and safety of the children in care.
8
9
10
11
12
13
14
1
2
3
4
5
6
7
1
2
3
4
5
6
7
1
2
3
4
5
6
7
1
2
3
4
5
6
7
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISORS NAME: Karen Chambers
LICENSING EVALUATOR NAME: Raul Navarro
LICENSING EVALUATOR SIGNATURE:

DATE: 01/08/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/08/2024
LIC9099 (FAS) - (06/04)
Page: 5 of 5