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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 304371203
Report Date: 03/25/2021
Date Signed: 03/26/2021 08:59:27 AM



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
11/12/2020 and conducted by Evaluator Mila Quinto
PUBLIC
COMPLAINT CONTROL NUMBER: 06-CC-20201112113134
FACILITY NAME:LIMAI MONTESSORI ACADEMYFACILITY NUMBER:
304371203
ADMINISTRATOR:JANKI SHAHFACILITY TYPE:
850
ADDRESS:5309 BEACH BLVDTELEPHONE:
(714) 690-0112
CITY:BUENA PARKSTATE: CAZIP CODE:
90621
CAPACITY:139CENSUS: 35DATE:
03/25/2021
UNANNOUNCEDTIME BEGAN:
10:30 AM
MET WITH:Janki Shah, DirectorTIME COMPLETED:
12:00 PM
ALLEGATION(S):
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Comingling Toddler and Preschool
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA), Mila Quinto conducted investigation visit to the facility via facetime to deliver the findings of the complaint initiated on 11/12/2020 regarding comingling the preschool and toddler option children in the preschool classroom during lunch and naptime. LPA met with Director, Janki Shah. The Covid-19 Emergency Response questionnaires were asked. LPA observed the following: Maple Tree Room; 8 children, 2 staff; Palm Tree Room 11 children, 2 staff; Bamboo Tree Room 16 children, 2 staff.

A review of facility personnel report summary on this date (3/25/21) indicates that all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions.

Substantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Rina LopezTELEPHONE: (714) 703-2808
LICENSING EVALUATOR NAME: Mila QuintoTELEPHONE: (714) 293-6471
LICENSING EVALUATOR SIGNATURE:

DATE: 03/25/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/25/2021
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 6
Control Number 06-CC-20201112113134
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: LIMAI MONTESSORI ACADEMY
FACILITY NUMBER: 304371203
VISIT DATE: 03/25/2021
NARRATIVE
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Page 2

The complainant alleged the toddler option and preschool co-mingle during lunch and nap time in the preschool classrooms. LPA interviewed 7 staff members which includes the director. The 3 of the 7 staff interviewed stated they have not witnessed comingling in the preschool classrooms; 4 of the staff members stated the toddler option children are moved to the preschool classroom with the other preschoolers during lunch and naptime due to staff shortage; there are times when the toddler option children stay with the preschool after naptime. On 1/21/21, LPA interviewed 3 qualified preschool children who stated they go to another classroom in the morning and during lunch. The response of the 3 preschool children were not relevant to the allegation. The toddler option children were not interviewed due to being nonverbal.
Based on LPA’s interviews with 7 staff members including the director of which 4 staff confirmed the toddler option children comingle with the preschool children during lunch and naptime. The preponderance of evidence standard has been met; therefore, the comingling allegation of toddler program and preschool is found to be SUBSTANTIATED. California Code of Regulations, 101216.4(a)(1) is being cited on the attached LIC9099D.

Appeal Rights was explained. A copy of appeal rights (LIC 9058 1/16) will be provided through email and their signatures on this form acknowledges receipt of these rights. (The "Read Receipt" or licensee's email is in lieu of a signature). First level appeal is to Regional Manager, address is above on the report.
Exit interview was conducted.
SUPERVISOR'S NAME: Rina LopezTELEPHONE: (714) 703-2808
LICENSING EVALUATOR NAME: Mila QuintoTELEPHONE: (714) 293-6471
LICENSING EVALUATOR SIGNATURE:

DATE: 03/25/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/25/2021
LIC9099 (FAS) - (06/04)
Page: 2 of 6
Control Number 06-CC-20201112113134
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: LIMAI MONTESSORI ACADEMY
FACILITY NUMBER: 304371203
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/25/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
03/25/2021
Section Cited
CCR
101216.4(a)(1)
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101216.4(a)(1) PRESCHOOL PROGRAM WITH TODDLER COMPONENT ..No child in the toddler program shall be placed in the preschool program before the age of 30 months...
This requirement is not met as evidenced by:
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The director umderstands to follow CCR guideline in place to ensure toddler option and preschool children are not to be comingled.
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Based on interiviews, the facility failed to separate the toddler classroom and the preschool classroom during lunch and naptime.
This poses a potential safety risk to 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: Rina LopezTELEPHONE: (714) 703-2808
LICENSING EVALUATOR NAME: Mila QuintoTELEPHONE: (714) 293-6471
LICENSING EVALUATOR SIGNATURE:

DATE: 03/25/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/25/2021
LIC9099 (FAS) - (06/04)
Page: 3 of 6
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
11/12/2020 and conducted by Evaluator Mila Quinto
PUBLIC
COMPLAINT CONTROL NUMBER: 06-CC-20201112113134

FACILITY NAME:LIMAI MONTESSORI ACADEMYFACILITY NUMBER:
304371203
ADMINISTRATOR:JANKI SHAHFACILITY TYPE:
850
ADDRESS:5309 BEACH BLVDTELEPHONE:
(714) 690-0112
CITY:BUENA PARKSTATE: CAZIP CODE:
90621
CAPACITY:139CENSUS: 35DATE:
03/25/2021
UNANNOUNCEDTIME BEGAN:
10:30 AM
MET WITH:Janki Shah, DirectorTIME COMPLETED:
12:00 PM
ALLEGATION(S):
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Ratio
Lack of Supervision (Child playing in the bathroom)
Broken Toilet (Physical Plant)

INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA), Mila Quinto conducted investigation visit to the facility via facetime to deliver the findings of the complaint initiated on 11/12/2020 regarding 1) over ratio in the classroom, 2) child was playing in the bathroom toilet during transition time of lunch and nap time and, 3) a broken toilet in the Palm classroom. LPA met with Director, Janki Shah. The Covid-19 Emergency Response questionnaires were asked. LPA observed the following: Maple Tree Room; 8 children, 2 staff; Palm Tree Room 11 children, 2 staff; Bamboo Tree Room 16 children, 2 staff.

A review of facility personnel report summary on this date (3/25/21) indicates that all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions.
Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Rina LopezTELEPHONE: (714) 703-2808
LICENSING EVALUATOR NAME: Mila QuintoTELEPHONE: (714) 293-6471
LICENSING EVALUATOR SIGNATURE:

DATE: 03/25/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/25/2021
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 4 of 6
Control Number 06-CC-20201112113134
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: LIMAI MONTESSORI ACADEMY
FACILITY NUMBER: 304371203
VISIT DATE: 03/25/2021
NARRATIVE
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Page 2

The complainant alleged the preschool classroom was over ratio due to comingling the preschool and toddler option children from 12:30 p.m. to closing starting in October 2020. During the investigation on November 17, 2020, LPA Quinto interviewed Director, Janki Shah whom stated there are 3 classrooms being used: The Maple room is being used for the toddler option program and the 6:1 ratio. The Palm and Bamboo rooms are being used for the preschool program.

On 11/17/2020, LPA reviewed the staff attendance, children’s sign in/sign out and the children’s roster for the month of October 2020. The Palm room had 18 children and Bamboo Room had 13 children enrolled. During the process of the investigation, LPA interviewed 7 staff including the Director who stated they have not witnessed over ratio in the classrooms. Children were not interviewed due to the timeframe of the ratio.

Based on the information gathered from LPA’s interviews with the Director and 6 staff members who stated they have not witnessed the classroom being out of ratio and LPAs review of staff attendance and children’s sign in/sign out for 10/2020 indicated that the facility would have been within ratio. Although the allegation may have happened or is valid, the Department was not able to determine the operation of the daily staffs’ responsibilities. There was not enough preponderance of evidence to prove the alleged of over ratio in the classroom, therefore the allegation is unsubstantiated.

On 11/17/2020, LPA interviewed the 6 staff members which included the director regarding a toddler option child who wondered off in the bathroom during transition time. The 5 out of 6 staff stated they did not witness or have knowledge of a child who wondered off in the bathroom. The 1 staff member stated the child from the toddler option briefly ran to the bathroom during the transition and a staff member quickly directed the child back in the classroom. Children were not interviewed due to children being nonverbal.

Based on the interviews with 6 staff members including the Director of which 5 staff did not witness any children running to the bathroom unsupervised. However, 1 of the 6 staff members witnessed a child running to the bathroom, but the child was seen by another staff member. There was not enough evidence to substantiate the lack of supervision when child ran off to the bathroom.
SUPERVISOR'S NAME: Rina LopezTELEPHONE: (714) 703-2808
LICENSING EVALUATOR NAME: Mila QuintoTELEPHONE: (714) 293-6471
LICENSING EVALUATOR SIGNATURE:

DATE: 03/25/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/25/2021
LIC9099 (FAS) - (06/04)
Page: 5 of 6
Control Number 06-CC-20201112113134
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: LIMAI MONTESSORI ACADEMY
FACILITY NUMBER: 304371203
VISIT DATE: 03/25/2021
NARRATIVE
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Page 3

This agency has investigated the complaint alleging child wondered off in the bathroom; although the allegation may have happened or is valid, there is not enough preponderance of evidence to prove the lack of supervision did or did not occur, therefore the allegation is unsubstantiated.

The complainant alleged there was only one working toilet in the Palm classroom. During the investigation on 11/17/20, LPA observed the 2 preschool classrooms had 4 working toilets. However, one of the toilets in Palm room was flushing in a much slower rate. The Maple room had 2 toilets of which one was broken. LPA reviewed the toddler option children roster and there were 6 children attending. Although there was 1 broken toilet, the 1:15 toilet ratio meets the requirement. LPA interviewed 5 staff members who did not indicate of a broken toilet in any of the classrooms. However, 1 of the 6 staff members indicated one of the toilets in the Palm room was not flushing properly. There were no children interviewed due to the children were nonverbal. During the follow up tele-inspection tour of the facility, the director showed the newly installed toilet in the Maple Room and provided a copy of the work order receipt dated 11/19/20.


Based on LPA’s interviews with 6 staff members including the director of which 5 staff did not indicate a broken toilet; 1 staff indicated one of the toilets in the Palm room was not flushing properly. There was not enough evidence to substantiate the broken toilet in the Palm room. This agency has investigated the complaint alleging the broken toilet allegation; although the allegation may have happened or is valid, there is not enough preponderance of evidence to substantiate a broken toilet, therefore the allegation is unsubstantiated.

Appeal Rights was explained. A copy of appeal rights (LIC 9058 1/16) will be provided through email and their signatures on this form acknowledges receipt of these rights. (The "Read Receipt" or licensee's email is in lieu of a signature). First level appeal is to Regional Manager, address is above on the report.
Exit interview was conducted.
Report ends here.
SUPERVISOR'S NAME: Rina LopezTELEPHONE: (714) 703-2808
LICENSING EVALUATOR NAME: Mila QuintoTELEPHONE: (714) 293-6471
LICENSING EVALUATOR SIGNATURE:

DATE: 03/25/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/25/2021
LIC9099 (FAS) - (06/04)
Page: 6 of 6