304370106-4-25-2022-06-CC-PMAA-CE56S9-20220504210334

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 304370106
Report Date: 04/25/2022
Date Signed: 04/25/2022 12:23:50 PM

Substantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

This is an official report of an unannounced visit/investigation of a complaint received in our office on
02/09/2022 and conducted by Evaluator Stella Gutierrez

PUBLIC

COMPLAINT CONTROL NUMBER: 06-CC-20220209154113

FACILITY NAME:	HILLSIDE MONTESSORI		FACILITY NUMBER:	304370106
ADMINISTRATOR:	NADESAN, AJANTHA		FACILITY TYPE:	830
ADDRESS:	19900 EL TORO ROAD		TELEPHONE:	(949) 858-8818
CITY:	SILVERADO CANYON	STATE: CA	ZIP CODE:	92676
CAPACITY:	10	CENSUS: 6	DATE:	04/25/2022
		UNANNOUNCED	TIME BEGAN:	09:00 AM
MET WITH:	Ajantha Nadesan, director		TIME COMPLETED:	09:30 AM

ALLEGATION(S):

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Personal Rights/Conduct Inimical- Facility has an outbreak of COVID-19

INVESTIGATION FINDINGS:

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On 04/25/2022 Licensing Program Analyst, Stella Gutierrez arrived at Hillside Montessori School for the purpose of concluding a complaint investigation and to deliver findings of the above mention allegations. LPA was met by Ajantha Nadesan, director and was explained the reason for today’s visit.
On 02/09/2022 A complaint was received at The Orange County Regional Child Care Program Office that the representatives at Hillside Montessori School were not adhering to COVID-19 Guidelines which resulted a facility outbreak of COVID-19.

During the investigation LPA, Gutierrez conducted a complaint Investigation inspection on 02/15/2022. LPA interviewed 1 preschool staff wearing a mask, 3 infants (Under age 2) that were not required and not recommended to wear a mask. Director was observed not to be wearing mask during the inspection. Staff stated that she wears a mask every day while indoors at the facility. LPA contacted 6 parents and conducted interviews in relation to the alleged allegation 03/09/2022 and 03/10/2022.

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Substantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Patricia Magana	TELEPHONE: (714) 703-2821
LICENSING EVALUATOR NAME: Stella Gutierrez	TELEPHONE: (714) 293-5262
LICENSING EVALUATOR SIGNATURE:	DATE: 04/25/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/25/2022

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 06-CC-20220209154113

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME: HILLSIDE MONTESSORI	FACILITY NUMBER: 304370106
	VISIT DATE: 04/25/2022

NARRATIVE

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Parents interviewed were consistent with staff interview statements that masks are not required, nor have they ever witnessed the staff wearing masks upon drop of in the AM hours or PM hours at the Hillside Montessori.

Prior to 03/12/2022 Child care providers must comply with requirements in the Guidance for the Use of Face Coverings issued by the California Department of Public Health (CDPH). This public health order was issued under the authority of Health and Safety Code sections 120125, 120140, 120175, 120195, and 131080. At the time of the incident the CDPH Guidance for the Use of Face Coverings (July 28, 2021) required that all individuals in child care settings wear face coverings while indoors, regardless of vaccination status. The director failed to ensure the personal rights of children in care to safe and healthful accommodations, and engaged in conduct inimical to the health, welfare, and safety of the children in care, in that the staff were not encouraged to wear face coverings while indoors at Hillside Montessori as required by the State Public Health Officer order dated June 11, 2021 requiring compliance with CDPH Guidance for the use of face coverings. and the Cal/OSHA COVID-19 Prevention Emergency Temporary Standards (ETS). An exemption to the order face coverings did not apply.

Based of observation on 02/15//2022 and interviews conducted the allegations of Personal Rights conduct inimical will be substantiated. A substantiated finding means that the complaint is substantiated, and the allegation is valid because the preponderance of the evidence standard has been met. The following violations were revealed and are being cited in accordance with California Code of Regulations, Title 22, Division 12, Chapter 1, article 6, Section 101223 (a)(2) and Health and Safety Code Section 1596.8897 (2), please refer to attached 9099 (D). Exit interview conducted and report was reviewed with the director, Ajantha Nadesan. Appeal Rights and deficiencies were discussed. The facility representative was provided a copy of their appeal rights (LIC 9058) and their signature on this form acknowledges receipt of these rights. All appeals must be in writing and received by the Regional Office within 15 business days.

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SUPERVISOR'S NAME: Patricia Magana	TELEPHONE: (714) 703-2821
LICENSING EVALUATOR NAME: Stella Gutierrez	TELEPHONE: (714) 293-5262
LICENSING EVALUATOR SIGNATURE:	DATE: 04/25/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/25/2022

LIC9099 (FAS) - (06/04)

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Control Number 06-CC-20220209154113

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME: HILLSIDE MONTESSORI	FACILITY NUMBER: 304370106
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 04/25/2022

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 04/25/2022 Section Cited CCR 101223(a)(2)	1 2 3 4 5 6 7	101223 Personal Rights (a) The licensee shall ensure that each child is accorded the following personal rights: (2) To be accorded safe, healthful and comfortable accommodations, furnishings and equipment to meet his/her needs.	1 2 3 4 5 6 7	New health order took effect on 03/12/2022 that mask requirements have been moved from required to strongly recommended. Type b deficiency cleared during today's inspection. No further action.
	8 9 10 11 12 13 14	This requirement was not met as evidence by interviews and observation. The facility representative did not require all staff to wear a mask while indoors at the facility.	8 9 10 11 12 13 14
Type B 04/25/2022 Section Cited HSC 1596.8897(2)	1 2 3 4 5 6 7	Health and Safety Code Section 1596.8897 reads: (2) Engaged in conduct which is inimical to the health, morals, welfare, or safety of either an individual in or receiving services from the facility, or the people of the State of California.	1 2 3 4 5 6 7	New health order took effect on 03/12/2022 that mask requirements have been moved from required to strongly recommended. Type b deficiency cleared during today's inspection. No further action.
	8 9 10 11 12 13 14	This requirement was not met as evidence by observations and interviews conducted. The director did not comply with the California Department of Public Health (CDPH) public health order to require all individuals (excluding infants in care) , regardless of vaccination status to wear mask indoors in child care settings.	8 9 10 11 12 13 14

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: Patricia Magana	TELEPHONE: (714) 703-2821
LICENSING EVALUATOR NAME: Stella Gutierrez	TELEPHONE: (714) 293-5262
LICENSING EVALUATOR SIGNATURE:	DATE: 04/25/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/25/2022

LIC9099 (FAS) - (06/04)

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