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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 304370212
Report Date: 05/18/2021
Date Signed: 05/18/2021 10:51:29 AM



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
03/12/2021 and conducted by Evaluator Cindy Nguyen
PUBLIC
COMPLAINT CONTROL NUMBER: 06-CC-20210312163001
FACILITY NAME:FULBRIGHT MONTESSORI ACADEMYFACILITY NUMBER:
304370212
ADMINISTRATOR:BERGMAN, JULIEFACILITY TYPE:
850
ADDRESS:20411 JAMES BAY CIRCLETELEPHONE:
(949) 583-9292
CITY:LAKE FORESTSTATE: CAZIP CODE:
92630
CAPACITY:110CENSUS: 67DATE:
05/18/2021
UNANNOUNCEDTIME BEGAN:
09:15 AM
MET WITH:Director, Julie BergmanTIME COMPLETED:
11:15 AM
ALLEGATION(S):
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Staff enforced unusual punishment
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Nguyen conducted an unannounced investigate the above allegation. This is a continuation of the investigation initiated on 3/18/2021. LPA talked with Director, Julie Bergman and discussed the purpose of the investigation inspection. Census was taken in individual classrooms. The overall census observed was 67 preschool children with 8 staff members.

During today's inspection staffing ratios were being met and the facility was operating within its licensed capacity. A review of staff criminal records indicates all facility staff or individuals who require caregiver background checks have received a criminal record clearance or exemption and a child abuse index clearance.

Continued on Page 2
Substantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Judy HansonTELEPHONE: (714) 703-2807
LICENSING EVALUATOR NAME: Cindy NguyenTELEPHONE: (714) 296-3608
LICENSING EVALUATOR SIGNATURE:

DATE: 05/18/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/18/2021
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 06-CC-20210312163001
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: FULBRIGHT MONTESSORI ACADEMY
FACILITY NUMBER: 304370212
VISIT DATE: 05/18/2021
NARRATIVE
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Page 2

On 3/13/2021 a complaint was filed with the Licensing Office. Complainant alleged, staff enforced unusual punishment during nap time by having the child sit on their cot and look at a book anywhere from 15 minutes to two hours (the duration of naptime) if the child doesn’t nap.

During the investigation LPA conducted one physical inspection via tele-inspection, one physical inspection, interviewed 4 staff members, obtained classroom schedules, incident reports/documentation's, parent’s handbook, admission agreement, and a copy of the children's roster. During interviews with the staff in regard to staff enforced unusual punishment during nap time by having the child sit on their cot and look at a book anywhere from 15 minutes to two hours (the duration of naptime) if the child doesn’t nap, staff interviewed stated, we tried to pat the children on their back to help calm them to sleep. When they can’t go to sleep, we give them materials, look for things that are quiet for them to do on their cot, so they do not wake up other children. A teacher will sit with the child to calm them to sleep, we sometimes bring them back of the classroom, and that child who doesn’t nap, can play in the back of the classroom. The facility nap time is approximately 12:30pm to around 2:30pm. There need to be enough staff available to meet the needs of the children if wake and want to get up/off the mats prior to 2:30 PM. When the children are awake, there should be appropriate staffing to allow these children to engage in an activity off their mats in another room as to not disturb the other napping children. Best practice for a reasonable amount of time for children who do not sleep to remain at rest is 20 to 30 minutes.

Based on LPA observations, interviews which were conducted and record reviews of classroom schedules, incident reports/documentation's, parent’s handbook, admission agreement, the preponderance of evidence was met, therefore the above allegation is found to be SUBSTANTIATED. California Code of Regulations, Title 22 101230 (b)(3) is being cited on the attached LIC 9099D

An exit interview was completed. The report was reviewed and discussed. Appeal Rights and deficiencies were discussed. The facility representative was provided a copy of their appeal rights (LIC 9058 12/15) and their signature on this form acknowledges receipt of these rights. All appeals must be in writing and received by the licensing office within 15 business days.
SUPERVISOR'S NAME: Judy HansonTELEPHONE: (714) 703-2807
LICENSING EVALUATOR NAME: Cindy NguyenTELEPHONE: (714) 296-3608
LICENSING EVALUATOR SIGNATURE:

DATE: 05/18/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/18/2021
LIC9099 (FAS) - (06/04)
Page: 2 of 5
Control Number 06-CC-20210312163001
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: FULBRIGHT MONTESSORI ACADEMY
FACILITY NUMBER: 304370212
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/18/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Deficiency Dismissed
Type B
05/25/2021
Section Cited
CCR
101230(b)(3)
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Activities (b) All children shall be given an opportunity to nap or rest without distraction or disturbance from other activities at the center. (3) No child shall be forced to stay awake or to stay in the napping area longer than the normal napping period. This requirement is not met as evidenced by:
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Director will conduct a training & send in a plan for the children that doesn’t nap. A sign in sheet will be provided to the Department by the due date 5/25/21.
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Based on the staff interviews, when children can’t go to sleep, we give them materials, look for things that are quiet for them to do on their cot, so they do not wake up other children. Somemetimes if the child doesn’t sleep, the child is brought to the back of the classroom, where the child can play. The facility nap time is around 12:30pm to around 2:30pm. This poses a potential health and safety risk to the children in care.
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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: Judy HansonTELEPHONE: (714) 703-2807
LICENSING EVALUATOR NAME: Cindy NguyenTELEPHONE: (714) 296-3608
LICENSING EVALUATOR SIGNATURE:

DATE: 05/18/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/18/2021
LIC9099 (FAS) - (06/04)
Page: 3 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, 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
03/12/2021 and conducted by Evaluator Cindy Nguyen
PUBLIC
COMPLAINT CONTROL NUMBER: 06-CC-20210312163001

FACILITY NAME:FULBRIGHT MONTESSORI ACADEMYFACILITY NUMBER:
304370212
ADMINISTRATOR:BERGMAN, JULIEFACILITY TYPE:
850
ADDRESS:20411 JAMES BAY CIRCLETELEPHONE:
(949) 583-9292
CITY:LAKE FORESTSTATE: CAZIP CODE:
92630
CAPACITY:110CENSUS: 67DATE:
05/18/2021
UNANNOUNCEDTIME BEGAN:
09:15 AM
MET WITH:Director, Julie BergmanTIME COMPLETED:
11:15 AM
ALLEGATION(S):
1
2
3
4
5
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7
8
9
Facility did not adhere to admission agreement
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Nguyen conducted an unannounced investigate the above allegations. This is a continuation of the investigation initiated on 3/18/2021. LPA talked with Director, Julie Bergman and discussed the purpose of the investigation inspection. Census was taken in individual classrooms. The overall census observed was 67 preschool children with 8 staff members.

During today's inspection staffing ratios were being met and the facility was operating within its licensed capacity. A review of staff criminal records indicates all facility staff or individuals who require caregiver background checks have received a criminal record clearance or exemption and a child abuse index clearance.

Continued on Page 2
Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Judy HansonTELEPHONE: (714) 703-2807
LICENSING EVALUATOR NAME: Cindy NguyenTELEPHONE: (714) 296-3608
LICENSING EVALUATOR SIGNATURE:

DATE: 05/18/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/18/2021
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 4 of 5
Control Number 06-CC-20210312163001
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: FULBRIGHT MONTESSORI ACADEMY
FACILITY NUMBER: 304370212
VISIT DATE: 05/18/2021
NARRATIVE
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Page 2

On 3/13/2021 a complaint was filed with the Licensing Office. Complainant alleged, facility did not adhere to admission agreement by telling the child’s parents that the facility is not able to meet the needs of Child #1 (C1) and the parent needed to find alternative care.

During the investigation LPA conducted one physical inspection via tele-inspection, one physical inspection, interviewed 4 staff members, obtained classroom schedules, incident reports/documentation's, parent’s handbook, admission agreement, and a copy of the children's roster. Fulbright Montessori Academy Admission Agreement stated “Fulbright Montessori reserves the right to dismiss a child from the program if staff feels the needs of the family, the child/the individual, or the developmental needs are not being met, and/or if her/his needs as a child or their behavior interferes with the rights of the other children attending a safe and nurturing program.” When questioned about allegation #2, all staff stated they have tried different technique with the C1 but were unsuccessful. For example, during circle time, C1 didn’t want to sit and kept getting up, disrupting the activity. Staff #2 (S2) tried placing C1 next to S2, however, C1 refused, and would run around the classroom touching everything. On 02/26/21, during transitioning to group time, S2 was helping C1 to sit for circle time, C1 tried to bite S2 but missed S2 hand and child bit herself instead leaving teeth mark on the child left arm. The bite did not break skin but did leave teeth imprints on skin/arm area of C1. On 03/01/21, during group time, C1 kept trying to run away, when S2 intervene to stop the child from running off, child bit S2 on the right hand. The child had a hard time adjusting to the new classroom environment due to new class size being larger, having a total of 12 students instead of 2 students.



Based on LPA observations, interviews which were conducted and record reviews of classroom schedules, incident reports/documentation's, parent’s handbook, admission agreement, the preponderance of evidence was not met, therefore the above allegation is found to be UNSUBSTANTIATED. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation(s) did or did not occur, therefore the allegations are UNSUBSTANTIATED.

An exit interview was completed. The report was reviewed and discussed. Appeal Rights were discussed. The facility representative was provided a copy of their appeal rights (LIC 9058 12/15) and their signature on this form acknowledges receipt of these rights. All appeals must be in writing and received by the licensing office within 15 business days.
SUPERVISOR'S NAME: Judy HansonTELEPHONE: (714) 703-2807
LICENSING EVALUATOR NAME: Cindy NguyenTELEPHONE: (714) 296-3608
LICENSING EVALUATOR SIGNATURE:

DATE: 05/18/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/18/2021
LIC9099 (FAS) - (06/04)
Page: 5 of 5