304371166-7-18-2023-06-CC-JHAN-CU3TJF-20230725144612

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 304371166
Report Date: 07/18/2023
Date Signed: 07/18/2023 10:13:09 AM

Unsubstantiated

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
05/30/2023 and conducted by Evaluator Carmen Odom

PUBLIC

COMPLAINT CONTROL NUMBER: 06-CC-20230530144650

FACILITY NAME:	MONTESSORI SCHOOL OF SAN CLEMENTE, LLC		FACILITY NUMBER:	304371166
ADMINISTRATOR:	MARZETT, DANIELLE		FACILITY TYPE:	830
ADDRESS:	1141 PUERTA DEL SOL		TELEPHONE:	(949) 276-4160
CITY:	SAN CLEMENTE	STATE: CA	ZIP CODE:	92673
CAPACITY:	21	CENSUS: 15	DATE:	07/18/2023
		UNANNOUNCED	TIME BEGAN:	09:30 AM
MET WITH:	Lyndy Moore - Director		TIME COMPLETED:	10:30 AM

ALLEGATION(S):

1
2
3
4
5
6
7
8
9

Staff do not provide appropriate supervision to infants in care.
Infant in care sustained injuries from being left unattended by facility staff.
Staff do not follow proper general sanitation practices.

INVESTIGATION FINDINGS:

1
2
3
4
5
6
7
8
9
10
11
12
13

Licensing Program Analysts (LPA) Odom conducted an unannounced complaint investigation. This is a continuation of the investigation initiated on 06/07/2023. Upon arrival LPA met with Director, Lyndy Moore to deliver complaint findings. Director guided LPA on a tour of the facility. LPA took census, at 9:30am LPA observed a total of 15 infants with 5 staff members in the infant rooms. During the inspection it was determined the facility is operating within its licensed capacity and within compliance of staffing ratios.

A review of staff records on this date indicated that all facility staff or other individuals who required caregiver background checks have received criminal record and child abuse index clearances or exemptions.

Continue to page 2

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Judy Hanson	TELEPHONE: (714) 703-2807
LICENSING EVALUATOR NAME: Carmen Odom	TELEPHONE: (714) 703-2819
LICENSING EVALUATOR SIGNATURE:	DATE: 07/18/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/18/2023

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-20230530144650

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: MONTESSORI SCHOOL OF SAN CLEMENTE, LLC	FACILITY NUMBER: 304371166
	VISIT DATE: 07/18/2023

NARRATIVE

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32

Page 2
The department received a complaint on 05/30/23 alleging 1) staff do not provide appropriate supervision to infants in care, 2) infants in care sustained injuries from being left unattended, and 3) staff do not follow proper sanitation practices. Reporting Party (RP) stated their infant had rug burn on their nose and mouth possibly when infant was placed on the ground for tummy time and staff were not properly supervising. RP stated they have also observed staff not wearing gloves and washing their hands before and after changing diapers.

During the investigation LPA Odom interviewed director, 3 staff members, 1 parent, conducted a facility inspection, and reviewed the children’s roster, personnel report, infant program, infant needs and service plan, LPA took pictures. LPA did not interview children, children are nonverbal.

During the investigation, Staff #4 (S4) was interviewed on 06/07/23. S4 stated do not recall any infants with rug burns on their face. S4 stated facility staff are familiar with the incident report process they will notify director or front office staff to check the injury, then an incident report will be written up on ProCare app that’s sent directly to the family and director will call the parents as well. Staff also provide a daily report on the ProCare app regarding feedings, nap times, diaper changes, and additional communicate to the parents regarding any concerns or mild stones. S4 stated staff are to supervise the infants by making sure they are always in their physical view when awake or sleeping. Staff are trained on supervision and infant personal care.

During the investigation, 3 staff members were interviewed on 06/07/23. None of the staff recall an infant having a rug burn on their nose or mouth. All the staff stated if there is an incident, they will notify the front office staff or the director to check the injury and staff will write an incident report on the application where parents will receive it directly. All the staff stated they constantly maintain supervision of the infants by having 1 staff in the napping area with the infants, and 2 staff on the other side changing diapers, feeding, and playing with the infants. Staff will sit on the ground with the infants for tummy time. All the staff stated the process for changing diapers begins by laying out the changing paper, put on gloves, lay infant down, one hand on infant, grab diaper and wipes, toss gloves, throw the paper away, wash hands and clean the mat with bleach and water.
Continue to page 3

SUPERVISOR'S NAME: Judy Hanson	TELEPHONE: (714) 703-2807
LICENSING EVALUATOR NAME: Carmen Odom	TELEPHONE: (714) 703-2819
LICENSING EVALUATOR SIGNATURE:	DATE: 07/18/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/18/2023

LIC9099 (FAS) - (06/04)

Page: 2 of 3

Control Number 06-CC-20230530144650

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: MONTESSORI SCHOOL OF SAN CLEMENTE, LLC	FACILITY NUMBER: 304371166
	VISIT DATE: 07/18/2023

NARRATIVE

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32

Page 3
On 7/13/23 LPA Odom attempted interviewing 13 parents, however only 1 parent was available for interview. Parent #1 (P1) stated the childcare center does provide good care of the children. P1 stated they do not have any concern regarding their health and safety, but they can improve on their communication with parents.

LPA Odom inspected the rugs, padded large floor mats, cleanliness of the classrooms and diaper changing tables. Changing tables had box of gloves, changing mat was clean, there was a roll of disposable paper that goes over the changing mat, and bottles of cleaning solutions to clean the changing mat. LPA observed 2 staff feeding and changing diapers and 1 staff in the nap area.

Based on LPA’s facility inspection, observations, interviews conducted with director, 3 staff, 1 parents and records reviewed it was determined there was insufficient evidence that there was an infant who sustained a rug burn in the childcare center and staff were not supervising properly nor that the facility does not practice sanitary diaper changes. Although the allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegations are Unsubstantiated.

Exit interview was conducted with Director Lyndy Moore. Notice of Site Visit was posted during the visit. 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. Director was provided a copy of their appeal rights (LIC 9058 01/16) and their signature on this form acknowledges receipt of these rights. First level appeals should be sent to the regional manager to the address listed above.

SUPERVISOR'S NAME: Judy Hanson	TELEPHONE: (714) 703-2807
LICENSING EVALUATOR NAME: Carmen Odom	TELEPHONE: (714) 703-2819
LICENSING EVALUATOR SIGNATURE:	DATE: 07/18/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/18/2023

LIC9099 (FAS) - (06/04)

Page: 3 of 3