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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198015474
Report Date: 06/04/2024
Date Signed: 06/04/2024 11:49:48 AM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
This is an official report of an unannounced visit/investigation of a complaint received in our office on
05/23/2024 and conducted by Evaluator Shushanik Safaryan
COMPLAINT CONTROL NUMBER: 33-CC-20240523120116

FACILITY NAME:MONTROSE CHRISTIAN MONTESSORI SCHOOLFACILITY NUMBER:
198015474
ADMINISTRATOR:RIMA CHRISTINA DIBIEFACILITY TYPE:
850
ADDRESS:2545 HONOLULU AVENUETELEPHONE:
(818) 249-2319
CITY:MONTROSESTATE: CAZIP CODE:
91020
CAPACITY:105CENSUS: 40DATE:
06/04/2024
UNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Sharon LeeTIME COMPLETED:
12:15 PM
ALLEGATION(S):
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Staff did not prevent day care child from being injured by another child
INVESTIGATION FINDINGS:
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On 06/04/24, Licensing Program Analyst (LPA) Shushanik Safaryan conducted an unannounced complaint inspection regarding the allegations above . Upon arrival . LPA met with Facility Representative , Sharon Lee , who guided LPA on a tour of the facility . During the tour, LPA observed three cameras in the facility , per facility representative it records exit gates and not the sand play area. During the visit LPA observed 40 children with 6 staff members .

Complaint alleged that staff did not prevent day care child from being injured by another child .
During the investigation, LPA obtained information that facility provides parents with communication memos regarding the incidents in the facility . During the paperwork review , LPA obtained communication memo from the December 19, 2023 , which indicated Child#2-bit Child #1 on the right arm during the playtime . In the process of the investigation LPA interviewed 7 staff members , obtained children and staff sign in sheets from the date of the incident , obtained declaration . Based on the information obtained 14 children were present with 3 staff members during the incident .
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Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Claudia Guangorena
LICENSING EVALUATOR NAME: Shushanik Safaryan
LICENSING EVALUATOR SIGNATURE:

DATE: 06/04/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/04/2024
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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Control Number 33-CC-20240523120116
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: MONTROSE CHRISTIAN MONTESSORI SCHOOL
FACILITY NUMBER: 198015474
VISIT DATE: 06/04/2024
NARRATIVE
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Staff # 1 and staff #5 were present on the incident day but cannot recall the incident from last December . Per staff # 4 incident happened in the sand area .Child #2 was playing tag with child #1. Child #1 was holding shovel and child #2 was chasing him , when child #2 came close , he suddenly bit child`s #1 right arm . Per staff #4 she was stationed in the front of the sand box and observed the incident . Per staff #4 incident took place very quick to prevent it from the happening .

Based on LPA`s 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. Based on the information obtained LPA determined that there was adequate supervision on the day of injury, and it was not possible to prevent the injury from happening.

Per California Code of Regulations Title 22, Division 12, no deficiency was cited on this day .

Exit interview conducted with Facility Representative , Sharon Lee . The Notice of site visit , report and Appeal Rights were explained and provided to licensee on 06/04/24.


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.

SUPERVISORS NAME: Claudia Guangorena
LICENSING EVALUATOR NAME: Shushanik Safaryan
LICENSING EVALUATOR SIGNATURE:

DATE: 06/04/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/04/2024
LIC9099 (FAS) - (06/04)
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