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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 304371465
Report Date: 08/06/2025
Date Signed: 09/09/2025 04:03:32 PM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE COUNTY CC RO, 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
05/28/2025 and conducted by Evaluator Alma Castro
PUBLIC
COMPLAINT CONTROL NUMBER: 06-CC-20250528112547
FACILITY NAME:SMILES MONTESSORI CHILDCAREFACILITY NUMBER:
304371465
ADMINISTRATOR:AHN, SUNG JAFACILITY TYPE:
830
ADDRESS:2261 NORTH ORANGE OLIVE ROADTELEPHONE:
(714) 283-2857
CITY:ORANGESTATE: CAZIP CODE:
92865
CAPACITY:20CENSUS: 8DATE:
08/06/2025
UNANNOUNCEDTIME BEGAN:
01:35 PM
MET WITH:Licensee, Sung JaTIME COMPLETED:
03:40 PM
ALLEGATION(S):
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Staff did not provide adequate supervision to children resulting in child sustaining injuries.
Staff did not ensure that child was provided proper medical attention.
INVESTIGATION FINDINGS:
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*** This report was amended to correct/change the report issued on 08/06/2025 from Confidential to Public for the record. ***
On 8/6/2025, Licensing Program Analyst (LPA), Alma Castro, conducted an unannounced subsequent visit to the facility to deliver the findings for a complaint that was initiated on 06/04/2025. LPA met with the director, Sung Ja Ahn (also known as Ms. Annie) and explained the reason for the visit. LPA was led on a tour of the facility and observed a total of 8 infants and 2 staff.

On 05/28/2025, the Orange County Regional Child Care Licensing Office received a complaint with the allegations listed as: (1) Staff did not provide adequate supervision to children resulting in child sustaining injuries and (2) Staff did not ensure that child, Child 1 (C1) was provided proper medical attention.

On 06/04/2025, LPA made an unannounced visit to the facility and interviewed staff. Facility representative provided LPA with children’s roster, Admissions Agreement and other pertinent documents.

Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Nguyen K Tran
LICENSING EVALUATOR NAME: Alma Castro
LICENSING EVALUATOR SIGNATURE:

DATE: 09/09/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/09/2025
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 5
Control Number 06-CC-20250528112547
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE COUNTY CC RO, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
FACILITY NAME: SMILES MONTESSORI CHILDCARE
FACILITY NUMBER: 304371465
VISIT DATE: 08/06/2025
NARRATIVE
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During investigation, LPA conducted observations of the facility’s teacher-child interactions and engagement with children in care. LPA reviewed the subject child’s file. LPA also attempted to interview five (5) current/former teachers, but only four (4) were interviewed, contacted seven (7) parents, but only five (5) responded and were interviewed. Due to age, infants were not eligible to be interviewed.

During staff interviews, all interviewees stated that they have been CPR/1st Aid trained. All four (4) interviewed staff stated that they apply first aid when a child gets hurt. During the course of staff interviews, it was discovered that Staff 1 (Staff 1) applied an ice pack to C1’s forehead after the injury occurred. During parent interviews, 3 out 5 parents did not disclose concerns regarding the allegation. Infants, children under 24 months, did not qualify to be interviewed.

The Orange County Regional Child Care Licensing Office has investigated the complaint alleging 1) Staff did not provide adequate supervision to children resulting in child sustaining injuries and (2) Staff did not ensure that child was provided proper medical attention. Based on the information gathered from LPA’s interviews, observations and record reviews, although the allegations may have happened or are valid, there was not a preponderance of evidence to prove the alleged allegations: 1) Staff did not provide adequate supervision to children resulting in child sustaining injuries and (2) Staff did not ensure that child was provided proper medical attention. Therefore, these allegations are unsubstantiated.

A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with the director, Sung Ja Ahn (also known as Ms. Annie).

****Korean Translator ID Lucas IA120 through Focus Interpreting used during this inspection****

SUPERVISORS NAME: Nguyen K Tran
LICENSING EVALUATOR NAME: Alma Castro
LICENSING EVALUATOR SIGNATURE:

DATE: 08/06/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/06/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 5
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE COUNTY CC RO, 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
05/28/2025 and conducted by Evaluator Alma Castro
PUBLIC
COMPLAINT CONTROL NUMBER: 06-CC-20250528112547

FACILITY NAME:SMILES MONTESSORI CHILDCAREFACILITY NUMBER:
304371465
ADMINISTRATOR:AHN, SUNG JAFACILITY TYPE:
830
ADDRESS:2261 NORTH ORANGE OLIVE ROADTELEPHONE:
(714) 283-2857
CITY:ORANGESTATE: CAZIP CODE:
92865
CAPACITY:20CENSUS: 8DATE:
08/06/2025
UNANNOUNCEDTIME BEGAN:
01:35 PM
MET WITH:Licensee, Sung JaTIME COMPLETED:
03:40 PM
ALLEGATION(S):
1
2
3
4
5
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7
8
9
Staff did not provide parent with incident report.
INVESTIGATION FINDINGS:
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On 05/28/2025, the Orange County Regional Child Care Licensing Office received a complaint with the allegations listed as: (3) Staff did not provide parent with incident report.

On 06/04/2025, LPA made an unannounced visit to the facility and interviewed staff. Facility representative provided LPA with children’s roster, Admissions Agreement and other pertinent documents.

During the investigation, LPA conducted observations of the facility’s teacher-child interactions and engagement with children in care. LPA reviewed the subject child’s file. LPA also attempted to interview five (5) current/former teachers, but only four (4) were interviewed, contacted seven (7) parents, but only five (5) responded and were interviewed. Due to age, infants were not eligible to be interviewed. During the course of infant staff interviews, it was discovered that three (3) out of (3) infant teachers acknowledged that the child had sustained injuries at the facility on May 21, 2025.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Nguyen K Tran
LICENSING EVALUATOR NAME: Alma Castro
LICENSING EVALUATOR SIGNATURE:

DATE: 08/06/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/06/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 3 of 5
Control Number 06-CC-20250528112547
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE COUNTY CC RO, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
FACILITY NAME: SMILES MONTESSORI CHILDCARE
FACILITY NUMBER: 304371465
VISIT DATE: 08/06/2025
NARRATIVE
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During LPA’s record review, there was no documentation to support that the parent/caregiver was notified of the injury. There was no record of a written incident report.

The Orange County Regional Child Care Licensing Office has investigated the complaint alleging Staff did not provide parent with incident report. Based on information gathered from LPA’s observations, interviews and record reviews, the preponderance of evidence standard has been met, therefore the allegation is substantiated. The following type B deficiency will be cited according to California Code of Regulations, Title 22, Division 12 & Chapter 1, Section 101212(f) Reporting Requirements.

A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with the director, Sung Ja Ahn (also known as Ms. Annie).

****Korean Translator ID Lucas IA120 through Focus Interpreting used during this inspection****

SUPERVISORS NAME: Nguyen K Tran
LICENSING EVALUATOR NAME: Alma Castro
LICENSING EVALUATOR SIGNATURE:

DATE: 08/06/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/06/2025
LIC9099 (FAS) - (06/04)
Page: 4 of 5
Control Number 06-CC-20250528112547
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE COUNTY CC RO, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME: SMILES MONTESSORI CHILDCARE
FACILITY NUMBER: 304371465
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/06/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
08/13/2025
Section Cited
CCR
101212(f)
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101212(f) The items specified in (d)(1)(A) through (H) above shall also be reported to the child's authorized representative. This requirement was not met as evidenced by:
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Licensee states that they will review the regulation in detail and submit a written declaration stating they understand and plan to adhere to this requirement.
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Based on interviews, observations and record review, the licensee did not comply with the section cited above in that, 3 out of 3 staff did not notify the child's authorized representative of C1's injury which poses a potential health, safety or personal rights risk to persons in care. There was also no documentation regarding the incident.
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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.
SUPERVISORS NAME: Nguyen K Tran
LICENSING EVALUATOR NAME: Alma Castro
LICENSING EVALUATOR SIGNATURE:

DATE: 08/06/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/06/2025
LIC9099 (FAS) - (06/04)
Page: 5 of 5