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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 304371029
Report Date: 02/11/2020
Date Signed: 02/11/2020 02:00:19 PM

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:SPECTRUM MONTESSORI AT WOODBURYFACILITY NUMBER:
304371029
ADMINISTRATOR:NIXON, LURAFACILITY TYPE:
830
ADDRESS:5725 TRABUCO ROADTELEPHONE:
(949) 825-5589
CITY:IRVINESTATE: CAZIP CODE:
92620
CAPACITY:48CENSUS: 41DATE:
02/11/2020
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
12:50 PM
MET WITH:Lura NIxon, DirectorTIME COMPLETED:
02:45 PM
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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, Lura Nixon. The inspection was conducted in response to an Unusual Incident Report received on 1/29/20, in which an adult #1 (See Confidential Names List LIC811) had discovered that their child, child #1 had found 3 ibuprofen pills. The adult #1 then spoke with a staff #1, who informed a staff #2. The director reported the incident to the licensing office on 1/29/20, in a timely fashion.

An inspection was conducted today, 2/11/20, to investigate into this reported unusual incident. During the course of the investigation, staff and a child, child #2, were interviewed about the reported incident, a physical plant inspection was conducted, and census of children was taken. From the the information obtained from today's inspection, it was determined that a child #1 and a child #2 had found a total of 3 ibuprofen pills in a toddler room (T1). The classrooms were searched and inspected by staff and director and no other medication accessible to children was found. It was unable to be determined where the 3 pills came from, but the director has met with staff and emailed a notice informing them that all medication must be stored and locked away in the director's office. Proof of this will be submitted to LPA via email, and documented with this incident in the facility file. It was observed by LPA that all staff belongings in the classrooms, were out of reach of the children. This incident has been determined to be an isolated event, and the facility has taken all necessary measures to ensure that a similar incident does not occur again. The facility reacted appropriately and timely, and reported the incident in a timely fashion. No violations were issued during today's visit, as a result of this reported unusual incident.

Exit interview was conducted. 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.
SUPERVISOR'S NAME: Judy HansonTELEPHONE: (714) 703-2807
LICENSING EVALUATOR NAME: Dean ValenciaTELEPHONE: (714) 215-6737
LICENSING EVALUATOR SIGNATURE:

DATE: 02/11/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/11/2020
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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