304371234-3-15-2021-06-CC-RLOZ-BZ8W4L-20210318165741

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 304371234
Report Date: 03/15/2021
Date Signed: 03/15/2021 12:42:13 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
01/07/2021 and conducted by Evaluator Ryan Joseph Chan

COMPLAINT CONTROL NUMBER: 06-CC-20210107105114

FACILITY NAME:	GUIDEPOST MONTESSORI AT LAS FLORES		FACILITY NUMBER:	304371234
ADMINISTRATOR:	HSU, AMANDA		FACILITY TYPE:	830
ADDRESS:	28672 DEERPATH		TELEPHONE:	(949) 339-2010
CITY:	RANCHO STA MARGARITA	STATE: CA	ZIP CODE:	92688
CAPACITY:	42	CENSUS: 25	DATE:	03/15/2021
		UNANNOUNCED	TIME BEGAN:	11:15 AM
MET WITH:	Krista Bartolome - Director		TIME COMPLETED:	12:39 PM

ALLEGATION(S):

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Child not being supervised resulting in child sustaining injury

INVESTIGATION FINDINGS:

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Tele-Investigation due to Covid-19 State of Emergency

On 03/15/21 Licensing Program Analyst (LPA), Ryan Chan conducted a Tele- investigation via Zoom to deliver the finding regarding an allegation stating a child was not being supervised resulting in child sustaining injury. LPA met with Director Krista Bartolome via Zoom application. LPA notified the director that due to Covid-19 and Department of Public Health (DPH) guidelines of social distancing a tele investigation is conducted. There was a total of 25 children under the infant program with 8 staff at the facility.

A review of the Facility Personnel Report Summary on 03/15/21 indicates all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions.

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Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Rina Lopez	TELEPHONE: (714) 703-2808
LICENSING EVALUATOR NAME: Ryan Joseph Chan	TELEPHONE: (714) 287-0708
LICENSING EVALUATOR SIGNATURE:	DATE: 03/15/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/15/2021

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 4

Control Number 06-CC-20210107105114

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: GUIDEPOST MONTESSORI AT LAS FLORES	FACILITY NUMBER: 304371234
	VISIT DATE: 03/15/2021

NARRATIVE

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On 01/07/2021 the Orange County Child Care Office received a complaint allegation stating on 12/17/20, a child was not being supervised resulting in child sustaining injury.

At the initial phase of this investigation, LPA discovered the facility was going through a director change, the director is called the Head of School for this facility. For the remainder of the report the Head of School will be referred to as director. The alleged incident took place on 12/17/20, the director at the time was S5 (see confidential names list dated 03/15/21) who no longer worked at the facility by the time the complaint was filed by the reporting party (RP) but was still interviewed. S1 was acting Director until a new director was appointed effective 01/25/21.

During the investigation, LPA conducted interviews on 01/12/21, 01/22/21, 02/02/21, 02/10/21, and 03/09/21 with 5 staff members and 7 parents. Children were not interviewed due to being non-verbal. LPA also reviewed facility’s children’s roster and staff’s roster. Interviews revealed subject child, C1 (see confidential names list dated 03/15/21) either fell or jumped off the play structure where there is an opening. On 12/17/20, the day of the incident, there were 7 children in the outdoor play area with 3 staff: S1, S2, and S3 (see confidential names list dated 03/15/21). Staff and children were spread out in the outdoor play area: S1 was with 2 children, S2 was with 3 children, and S3 was with 2 children. S2 was with C1 and 2 other children when the incident happened. C1 was on the play structure when S2 knelt down to assist another child who had just come down the slide but was agitated and was rolling around in the wood chips and consequently had wood chips on the child’s face. When S2 tried to assist another child and knelt down is when C1 fell or jumped off the play structure. Staff interviews revealed inconsistencies in the location of S2 in relation to C1, some staff say S2 was right next to the opening where C1 fell while others stated S2 was between 5 to 10 feet away from the opening where C1 fell as S2 was tending to the other child. There were no other children on the play structure as C1 was the last one to come down. Per staff interviews, C1 did not cry at first but began to cry after being consoled. C1 was carried inside the classroom where C1 informed staff of pain in the ankle and an ice pack was placed on the injury. Interviews with C1 did not provide a definitive answer so it is unknown whether C1 jumped or fell off the play structure. Some staff members speculate C1 may have jumped as C1 has jumped off other structures like benches and picnic tables and describe C1 as an energetic child.
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SUPERVISOR'S NAME: Rina Lopez	TELEPHONE: (714) 703-2808
LICENSING EVALUATOR NAME: Ryan Joseph Chan	TELEPHONE: (714) 287-0708
LICENSING EVALUATOR SIGNATURE:	DATE: 03/15/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/15/2021

LIC9099 (FAS) - (06/04)

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Control Number 06-CC-20210107105114

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: GUIDEPOST MONTESSORI AT LAS FLORES	FACILITY NUMBER: 304371234
	VISIT DATE: 03/15/2021

NARRATIVE

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Immediately after the incident C1’s parent was called who then came to the facility. A staff member interviewed stated the parent was advised to take C1 to get seen by a doctor. Staff interviews revealed there was a discrepancy whether or not the facility was informed if the child was taken to the doctor. One staff member stated the parent confirmed the child was taken to a doctor’s appointment the same day as a result of the injury from the incident and the information was relayed to upper management while other staff members stated they were not informed by the parent or any staff the child was seen by a doctor. Staff interviews revealed no other child has fallen from the play structure that they were aware of, only C1. Due to the rarity of this incident at this facility where a child fell from a play structure and was injured, whether or not the child was taken to the doctor for the injuries, this incident should have been reported to licensing.

Parents interviewed liked the facility and stated their children seemed to like the facility as well. Parents did not have any concerns with the care and supervision provided at this facility and would recommend this facility to other parents.

Based on LPA's interviews conducted on 01/12/21, 01/22/21, 02/02/21, 02/10/21, and 03/09/21 with 5 staff members and 7 parents, there was not enough evidence to substantiate the allegation stating a child was not being supervised resulting in child sustaining injury, therefore, the allegation was found to be unsubstantiated. This agency has investigated the complaint alleging a lack of supervision; although the allegation may have happened or is valid, there is not enough preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is unsubstantiated.

However, because the facility failed to report this incident to licensing, a technical violation is being issued. Based on interviews conducted and records reviewed this facility failed to report any unusual incident or child absence that threatens the physical or emotional health or safety of any child. California Code of Regulations, Title 22, Division 12, Chapter 1, Section 101212 (d)(1(C), is/are being cited on the attached LIC 9102TV. Facility was advised to complete an Unusual Incident Report form LIC 624 for this incident to be received by the licensing office within 7 days. Facility was advised that for any unusual incident that occurs in the facility a call must be placed with licensing within 24 hours and to send the unusual incident form LIC 624 within 7 days.
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SUPERVISOR'S NAME: Rina Lopez	TELEPHONE: (714) 703-2808
LICENSING EVALUATOR NAME: Ryan Joseph Chan	TELEPHONE: (714) 287-0708
LICENSING EVALUATOR SIGNATURE:	DATE: 03/15/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/15/2021

LIC9099 (FAS) - (06/04)

Page: 3 of 4

Control Number 06-CC-20210107105114

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: GUIDEPOST MONTESSORI AT LAS FLORES	FACILITY NUMBER: 304371234
	VISIT DATE: 03/15/2021

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 4 Exit interview was conducted. 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.

SUPERVISOR'S NAME: Rina Lopez	TELEPHONE: (714) 703-2808
LICENSING EVALUATOR NAME: Ryan Joseph Chan	TELEPHONE: (714) 287-0708
LICENSING EVALUATOR SIGNATURE:	DATE: 03/15/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/15/2021

LIC9099 (FAS) - (06/04)

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