374845328-11-9-2022-10-CC-PBER-CL6S4G-20221114123245

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 374845328
Report Date: 11/09/2022
Date Signed: 11/09/2022 05:16:35 PM

Substantiated

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
10/07/2022 and conducted by Evaluator Andrea Taylor

PUBLIC

COMPLAINT CONTROL NUMBER: 10-CC-20221007150512

FACILITY NAME:	PEPPERTREE MONTESSORI		FACILITY NUMBER:	374845328
ADMINISTRATOR:	HOWARD, KAYLA		FACILITY TYPE:	850
ADDRESS:	427 COLLEGE WAY, STE I		TELEPHONE:	(760) 940-1931
CITY:	OCEANSIDE	STATE: CA	ZIP CODE:	92057
CAPACITY:	92	CENSUS: 30	DATE:	11/09/2022
		UNANNOUNCED	TIME BEGAN:	12:45 PM
MET WITH:	Cheryl Gillins-Director		TIME COMPLETED:	02:30 PM

ALLEGATION(S):

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Personal Rights

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Taylor conducted a complaint inspection on today's date due to a complaint received in the licensing office on 10/7/22. LPA Taylor toured the facility, inside and out. Census was taken. There were 30 preschool children and 3 staff present during this inspection. A review of staff criminal clearance records on 11/9/22 indicates that all facility staff or other individuals who require caregiver background checks have received.
During a prior complaint inspection conducted on 10/12/22 LPA Taylor interviewed staff and children, obtained a current children’s roster.
On October 6, 2022 this agency received an allegation that a childcare staff inappropriately disciplined a child while in care. Confidential interviews disclosed that this staff member picked child up, held the child while walking with child across the room and sat child down in a chair. Other confidential interviews and record reviews confirmed the incident occurred. It was revealed that this staff member not the staff who was supervising the child at this time. Regulations state that corporal punishment and other humiliating, or frightening techniques are prohibited.

Substantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Pauline Beschorner	TELEPHONE: (951) 782-6641
LICENSING EVALUATOR NAME: Andrea Taylor	TELEPHONE: (951) 782-4200
LICENSING EVALUATOR SIGNATURE:	DATE: 11/09/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/09/2022

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

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Control Number 10-CC-20221007150512

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: 374845328
	VISIT DATE: 11/09/2022

NARRATIVE

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Based on LPAs observations and interviews which were conducted and record reviews, the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED. California Code of Regulations, 101223-Personal Rights (a)(3) is being cited on the LIC 9099D attached to Complaint received on 10/6/22 with the exact allegation.

In the areas that were evaluated, the facility was not in compliance and violation, in accordance with California Code of Regulations, Health & Safety 1596.7995(a)(1), is being cited on the attached LIC 9099D.

The facility representative was informed that the “Notice of Site Visit” must be posted for 30 consecutive days. Failure to post will result in Civil Penalties of $100.00. The “Notice of Site Visit” must be posted on or adjacent to the door. Failure to post Type A reports for 30 days will result in a Civil Penalty of $100.00

If the facility receives a Type A violation, the licensee shall post and provide copies of the report to parents/guardians of the children in care at the facility by the next business day and shall provide to the parents/guardians of children newly enrolled at the facility during the next 12 months. In addition, the licensee shall immediately post upon receipt the Proof of Correction for 30 consecutive days, and provide a copy to current and enrolling parents. The licensee is to keep Acknowledgement Receipt (LIC 9224) signed by parents in each child’s file.

An exit interview was completed. The report was reviewed and discussed. Appeal Rights and deficiencies were discussed. The facility representative was provided a copy of their appeal rights (LIC 9058 12/15) and their signature on this form acknowledges receipt of these rights. All appeals must be in writing and received by the Licensing office within 15 business days.

SUPERVISOR'S NAME: Pauline Beschorner	TELEPHONE: (951) 782-6641
LICENSING EVALUATOR NAME: Andrea Taylor	TELEPHONE: (951) 782-4200
LICENSING EVALUATOR SIGNATURE:	DATE: 11/09/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/09/2022

LIC9099 (FAS) - (06/04)

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