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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 304370495
Report Date: 09/24/2019
Date Signed: 09/24/2019 10:08:18 AM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
FACILITY NAME:IRVINE MONTESSORI SCHOOLFACILITY NUMBER:
304370495
ADMINISTRATOR:SHARIFF, FAZREENFACILITY TYPE:
850
ADDRESS:17575 CARTWRIGHT ROADTELEPHONE:
(949) 752-7217
CITY:IRVINESTATE: CAZIP CODE:
92614
CAPACITY:197CENSUS: 82DATE:
09/24/2019
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
08:20 AM
MET WITH:Fazreen Shariff, DirectorTIME COMPLETED:
10:20 AM
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An inspection was conducted at the facility by LPA Dean Valencia. The facility file was reviewed prior to this inspection being conducted. A review of staff records indicates all facility staff or individuals who require caregiver background checks have received a criminal record clearances or exemptions and a child abuse index clearance. LPA Valencia met with Director Fazreen Shariff.

Today's inspection was conducted in response to an Unusual Incident Report received on 9/11/2019, in which a staff #3 (See Confidential Names List LIC811) had reported to staff #1, that she had seen a staff #2 potentially violate the child's personal rights by excluding a child from the group, and corporally punishing a child, child #1. Staff #1 then reported the incident to Licensing in a timely fashion, compliant with reporting requirement regulations. An inspection was conducted today, 9/24/19, to investigate into this unusual incident. During the course of the investigation staff related to the reported unusual incident were interviewed, a physical plant inspection was conducted, census of children was taken, and records related to the incident were reviewed and obtained. During the inspection the facility had 17 staff and 82 children present. LPA was able to determine through interviews, that there is not a preponderance of evidence to support that the staff #2 had excluded the child nor corporally punished the child #1, and did not violate the child's personal rights, nor any children's personal rights related to this reported incident. Based on the information obtained during today's inspection regarding this reported incident, it was determined that the facility staff did not violated Title 22 Regulations related to children's Personal Rights. No violations were issued during today's visit, as a result of this reported unusual incident.

The Notice of Site Visit was posted. Facility representative was informed that the notice of site visit must be posted for 30 consecutive days. Failure to post will result in civil penalties of $100. There were no Title 22 deficiencies cited during today's inspection.
SUPERVISOR'S NAME: Judy HansonTELEPHONE: (714) 703-2807
LICENSING EVALUATOR NAME: Dean ValenciaTELEPHONE: (714) 215-6737
LICENSING EVALUATOR SIGNATURE:

DATE: 09/24/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/24/2019
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC809 (FAS) - (06/04)
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