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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 304371150
Report Date: 08/11/2021
Date Signed: 08/11/2021 03:34:41 PM



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
05/14/2021 and conducted by Evaluator Sherene Hawkins
PUBLIC
COMPLAINT CONTROL NUMBER: 06-CC-20210514083726
FACILITY NAME:INT'L CHRISTIAN MONTESSORI ACADEMY OF COSTA MESAFACILITY NUMBER:
304371150
ADMINISTRATOR:MAIDA, CECILEFACILITY TYPE:
830
ADDRESS:2950 MCCLINTOCK WAYTELEPHONE:
(714) 966-0303
CITY:COSTA MESASTATE: CAZIP CODE:
92626
CAPACITY:24CENSUS: 18DATE:
08/11/2021
UNANNOUNCEDTIME BEGAN:
02:02 PM
MET WITH:Kari Kimbrough TIME COMPLETED:
04:00 PM
ALLEGATION(S):
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Staff are not maintaining ratios.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Hawkins conducted a follow up investigation on August 11, 2021 at 2:02 p.m. regarding a complaint allegation of lack of supervision which was initiated on May 19, 2021. During today’s visit LPA provided the complaint findings to the director, Kari Kimbrough. Upon arrival Director Kimbrough and LPA toured the center including all activity/classroom areas, the isolation area, restroom and outdoor play areas. Current census observed was nine infants, nine toddlers and five staff supervising in the orange and yellow classrooms. A review of staff records on this date indicates that all facility staff or other individuals who required caregiver background checks have received criminal record and child abuse index clearances or exemptions.

On May 14, 2021 the Department received a complaint alleging that the facility was operating out of ratio leaving one teacher alone to supervise up to eight toddlers in the orange classroom. During the investigation, LPA interviewed six staff, eight parents, and reviewed facility records. Staff interviewed reported that the ratio for the infants is 1:4 and for toddlers is 1:6. ***continued on page 2***
Substantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Judy HansonTELEPHONE: (714) 703-2807
LICENSING EVALUATOR NAME: Sherene HawkinsTELEPHONE: (949) 466-1624
LICENSING EVALUATOR SIGNATURE:

DATE: 08/11/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/11/2021
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 3
Control Number 06-CC-20210514083726
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: INT'L CHRISTIAN MONTESSORI ACADEMY OF COSTA MESA
FACILITY NUMBER: 304371150
VISIT DATE: 08/11/2021
NARRATIVE
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page 2

Several staff interviewed reported that the Orange classroom has been out of ratio on several occasions in the morning and afternoon when staff step away to use the restroom or just leave the room to speak with others. Other staff states that the infant (yellow room) is always in ratio, however the toddler (orange room) has been out of ratio, but not often. Staff interviewed reported the most recent time the Orange classroom was not in ratio was on May 19, 2021 with one staff, Staff #3 (S3), being alone with seven to eight toddlers in care. Staff states that the director is aware that the class is out of ratio when staff steps away to use the restroom. Parents reported no concerns of the care and supervision being provided. Children were not interviewed due to the young age and developmental level. During facility inspections, LPA Hawkins observed the facility to be in compliance with required ratios during multiple facility inspections.

Based on interviews conducted, the facility staff are not maintaining ratios in the toddler classroom. This poses an immediate health and safety risk to the children in care. Therefore, the preponderance of evidence standard has been met, therefore, the above allegation of staff not maintaining ratios is found to be substantiated. Health & Safety Code 1596.956(4) is being cited on the attached LIC 9099D.




This report cites a Type A violation and shall be provided to parents/guardians of children currently enrolled and to parents/guardians of children newly enrolled at the facility during the next 12 months. Parents/guardians must sign Form LIC 9224 to be kept in each child's file.

Exit interview was conducted with director Kari Kimbrough. The report and citation were read and reviewed with the director. 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. Appeal Rights explained. A copy of their appeal rights (LIC 9058) was given and signatures on this form acknowledges receipt of these rights. All appeals must be in writing and received by the licensing office within 15 business days. The first level appeal is to regional manager; address is above on the report
SUPERVISOR'S NAME: Judy HansonTELEPHONE: (714) 703-2807
LICENSING EVALUATOR NAME: Sherene HawkinsTELEPHONE: (949) 466-1624
LICENSING EVALUATOR SIGNATURE:

DATE: 08/11/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/11/2021
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 06-CC-20210514083726
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: INT'L CHRISTIAN MONTESSORI ACADEMY OF COSTA MESA
FACILITY NUMBER: 304371150
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/11/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
08/12/2021
Section Cited
HSC
1596.956(4)
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H&S Code 1596.956 (4)
Child day care centers serving infants; optional toddler program; departmental guidelines and regulations
(4) A ratio of six children to each teacher shall be maintained for all children in attendance at the toddler program... This requirement was not met as evidenced by:
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Director stated staff will be retrained in regards to supervion and review ratio guidelines. Director will provide training staff sign in sheets and subject matter covered in training. Director will email proof of training to LPA Hawkins by due date 8/13/21.
Email: Sherene.Hawkins@dss.ca.gov
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facility staff not maintaining ratios in the toddler classroom leaving staff alone with up to 7 or 8 toddlers for short periods of time. This poses an immediate risk to the health and safety of 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: Sherene HawkinsTELEPHONE: (949) 466-1624
LICENSING EVALUATOR SIGNATURE:

DATE: 08/11/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/11/2021
LIC9099 (FAS) - (06/04)
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