198011974-3-12-2024-54-CC-KCHS-D3AVFV-20240312162434

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198011974
Report Date: 03/12/2024
Date Signed: 03/12/2024 09:03:33 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
10/25/2023 and conducted by Evaluator Dayna Chambers

PUBLIC

COMPLAINT CONTROL NUMBER: 54-CC-20231025154653

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: 6	DATE:	03/12/2024
		UNANNOUNCED	TIME BEGAN:	08:30 AM
MET WITH:	Lead Teacher, Vijayalaxmi Shadagopan		TIME COMPLETED:	09:30 AM

ALLEGATION(S):

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9

Child sustained bruising while in care.

INVESTIGATION FINDINGS:

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On March 12, 2024, at 8:30am, this complaint inspection was conducted by Dayna Chambers, Licensing Program Analyst (LPA), for the purpose of delivering findings for the above pending allegation. Upon Arrival there were 6 infants with 2 staff. LPA was greeted by the Lead Teacher, Vijayalaxmi Shadagopan, who guided LPA on a tour of the center.
During the investigation conducted by the Department, interviews were conducted with Parents and Staff. Due to the age of children in care, interviews were not conducted. Reports from outside agencies were requested; the reports were received and reviewed.
During the investigation, it was noted that child #1 did have bruising; however, there was no information or disclosure as to how or who may have caused the bruising.
Based on the evidence and interviews, the above allegation is found to be unsubstantiated at this time.
The notice of site visit was posted where the parent/guardian of children enter and exit the facility. The notice of site visit shall remain posted for 30 consecutive days. Failure to maintain posting as required will result in a $100.00 civil penalty. The exit interview conducted with the Lead Teacher, Vijayalaxmi Shadagopan, in lieu of Director Cassandra Wijeyewickrema, who was not present during the visit. The appeal rights were explained. A copy of the appeal rights (LIC9058 01/16) was provided. The signature on this report acknowledges receipt of the Licensee’s rights.

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Dayna Chambers
LICENSING EVALUATOR SIGNATURE:	DATE: 03/12/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/12/2024

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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