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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 374845327
Report Date: 07/28/2021
Date Signed: 07/28/2021 11:48:21 AM



STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501
This is an official report of an unannounced visit/investigation of a complaint received in our office on
06/29/2021 and conducted by Evaluator James Wilkerson
PUBLIC
COMPLAINT CONTROL NUMBER: 10-CC-20210629083249
FACILITY NAME:PEPPERTREE MONTESSORIFACILITY NUMBER:
374845327
ADMINISTRATOR:GARCIA, LYNNFACILITY TYPE:
830
ADDRESS:427 COLLEGE BLVD, STE ITELEPHONE:
(760) 940-1931
CITY:OCEANSIDESTATE: CAZIP CODE:
92057
CAPACITY:40CENSUS: 29DATE:
07/28/2021
UNANNOUNCEDTIME BEGAN:
11:00 AM
MET WITH:Lynn GarciaTIME COMPLETED:
11:50 AM
ALLEGATION(S):
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Staff handled child in a rough manner
INVESTIGATION FINDINGS:
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Licensing Program Analysts (LPAs) James Wilkerson & Joanne Domingo arrived at this facility to conclude an investigation into the above allegation. An initial visit was conducted on 07/01/21 and extended at that time. During today's visit, LPAs toured the facility and conducted census. During the course of this investigation, interviews were conducted with staff, past and present. It was alleged that a staff member had gotten frustrated with a child in the infant room and lifted the child up by an arm and swung the infant over a child safety gate. Interviews with staff were conflicting as staff stated that they have never observed any incident such as this, while other staff stated that they did observe this happening. Because LPAs received the conflicting information from the staff interviews, it cannot be determined if the above allegation is true or not true. A preponderance of evidence cannot be made.

Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the allegation did or did not occur, therefore the allegation is UNSUBSTANTIATED. SEE LIC 9099C for continuance of report.

Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Dawn ParkerTELEPHONE: (951) 320-2101
LICENSING EVALUATOR NAME: James WilkersonTELEPHONE: (951) 218-7031
LICENSING EVALUATOR SIGNATURE:

DATE: 07/28/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/28/2021
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 2
Control Number 10-CC-20210629083249
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501
FACILITY NAME: PEPPERTREE MONTESSORI
FACILITY NUMBER: 374845327
VISIT DATE: 07/28/2021
NARRATIVE
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An exit interview was conducted, appeal rights discussed and provided along with a copy of this report on this date.

A Notice of Site Visit was posted.

A copy of this report must be made available to the public, upon request for three years.

SUPERVISOR'S NAME: Dawn ParkerTELEPHONE: (951) 320-2101
LICENSING EVALUATOR NAME: James WilkersonTELEPHONE: (951) 218-7031
LICENSING EVALUATOR SIGNATURE:

DATE: 07/28/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/28/2021
LIC9099 (FAS) - (06/04)
Page: 2 of 2