198011974-10-12-2020-54-CC-KCHS-BW7RZB-20201211122736

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198011974
Report Date: 10/12/2020
Date Signed: 10/12/2020 09:46:17 AM

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
03/10/2020 and conducted by Evaluator Raul Navarro

PUBLIC

COMPLAINT CONTROL NUMBER: 54-CC-20200310103744

FACILITY NAME:	MONTESSORI ON ELM PRESCHOOL + KINDERGARTEN		FACILITY NUMBER:	198011974
ADMINISTRATOR:	WIJEYEWICKREMA, CASSANDRA		FACILITY TYPE:	830
ADDRESS:	930 ELM AVENUE		TELEPHONE:	(562) 570-8080
CITY:	LONG BEACH	STATE: CA	ZIP CODE:	90813
CAPACITY:	24	CENSUS: 1	DATE:	10/12/2020
		UNANNOUNCED	TIME BEGAN:	09:07 AM
MET WITH:	1		TIME COMPLETED:	09:45 AM

ALLEGATION(S):

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Facility staff handled day care child in a rough manner
Facility staff yell at children in care
Facility staff made inappropriate comment towards day care child
Facility staff are restraining day care children in highchairs
Facility staff are not adequately trained
Day care children are not being accorded safe, healthful and comfortable accommodations
Facility is not being kept clean/sanitary

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Raul Navarro conducted an unannounced complaint inspection. LPA met with Director Ayomi Rathanayaka who guided LPA on a tour of the facility. There was 1 child and one staff present during today's inspection.

During the course of the investigation LPA Navarro conducted interviews with the Complainant, Licensee, Director, and Parents. LPA did was unable to conduct interviews with children due to children being non-verbal. LPA interviewed staff who deny the allegations. Staff interviewed did not make any corroborating statements. LPA interviewed parents. There were no corroborating statements made. Although the above 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 allegations are unsubstantiated.

*Report continues on the next page

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Karen Chambers	TELEPHONE: (323) 980-4934
LICENSING EVALUATOR NAME: Raul Navarro	TELEPHONE: 323-981-3388
LICENSING EVALUATOR SIGNATURE:	DATE: 10/12/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/12/2020

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 54-CC-20200310103744

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: 10/12/2020

NARRATIVE

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Exit interview was conducted with Director Ayomi Rathnayaka. The Director was provided a copy of their appeal rights (LIC 9058) and their signature on this form acknowledges receipt of these forms.

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

SUPERVISOR'S NAME: Karen Chambers	TELEPHONE: (323) 980-4934
LICENSING EVALUATOR NAME: Raul Navarro	TELEPHONE: 323-981-3388
LICENSING EVALUATOR SIGNATURE:	DATE: 10/12/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/12/2020

LIC9099 (FAS) - (06/04)

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