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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 304370495
Report Date: 03/05/2024
Date Signed: 03/05/2024 01:03:39 PM


Document Has Been Signed on 03/05/2024 01:03 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE CO CHILD CARE, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868



FACILITY NAME:IRVINE MONTESSORI SCHOOLFACILITY NUMBER:
304370495
ADMINISTRATOR:CABRERA, RUBYFACILITY TYPE:
850
ADDRESS:17575 CARTWRIGHT ROADTELEPHONE:
(949) 752-7217
CITY:IRVINESTATE: CAZIP CODE:
92614
CAPACITY:197CENSUS: 74DATE:
03/05/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
09:15 AM
MET WITH:Director, Ruby CabreraTIME COMPLETED:
12:10 PM
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Licensing Program Analyst (LPA) Aiddee Nunez conducted an unannounced case management incident inspection in response to a self-report Unusual Incident dated 2/27/2024. LPA met with Director Ruby Cabrera. LPA observed 65 preschool age children and 9 staff members. In the toddler option program LPA observed 9 toddler age children and 2 staff members. A review of staff criminal clearance records on this date indicates that all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions.

On 2/27/2024 a self-reported Unusual Incident Report (UIR) was filed with the Licensing Office. The facility reported that on 2/26/24, Parent #1 (P1) spoke with Staff #3 (S3) regarding an incident P1 witnesses through the classroom window while picking up own child. P1 stated P1 witness Staff#4 (S4) yank a Child #1 (C1) by the arm.

During today’s visit, LPA obtained an updated copy of the children’s roster, personnel report, S4 information, and interviewed 3 staff members. The children were not interviewed due to the children being non-verbal. Due to insufficient information available at this time, the reported incident needs further investigation.

Exit interview was conducted with Director Ruby Cabrera. The Notice of Site Visit was posted. Director 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.
SUPERVISOR'S NAME: Thuy HoTELEPHONE: (714) 703-2800
LICENSING EVALUATOR NAME: Aiddee NunezTELEPHONE: 714-703-2800
LICENSING EVALUATOR SIGNATURE:
DATE: 03/05/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/05/2024
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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