300606452-8-19-2026-06-CC-NKTN-DXCP63-20260827110136

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 300606452
Report Date: 08/19/2026
Date Signed: 08/19/2026 10:19:49 AM

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
07/30/2026 and conducted by Evaluator Dean Thompson

PUBLIC

COMPLAINT CONTROL NUMBER: 06-CC-20260730083932

FACILITY NAME:	APPLETREE MONTESSORI		FACILITY NUMBER:	300606452
ADMINISTRATOR:	KELLY, ANTONIA		FACILITY TYPE:	850
ADDRESS:	25542 JERONIMO RD		TELEPHONE:	(949) 770-2707
CITY:	MISSION VIEJO	STATE: CA	ZIP CODE:	92691
CAPACITY:	109	CENSUS: 44	DATE:	08/19/2026
		UNANNOUNCED	TIME BEGAN:	08:00 AM
MET WITH:	Amy Desouza		TIME COMPLETED:	10:30 AM

ALLEGATION(S):

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Lack of supervision resulted in child sustaining an injury.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Thompson conducted an unannounced complaint investigation. This is a continuation of the investigation initiated on 08/03/2026. Upon arrival, LPA met with facility representative Amy Desouza, to deliver complaint findings. There were 14 toddlers with four staff and 30 preschool age children with four staff present during the visit.

A review of the facility personnel report Summary indicates all facility staff or other individuals who required caregiver background checks have received criminal record and child abuse index clearances or exemptions.

The Orange County Childcare Office received a complaint on 07/30/2026, with one allegation (1) Lack of supervision resulted in child sustaining an injury.

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Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Nguyen K Tran
LICENSING EVALUATOR NAME: Dean Thompson
LICENSING EVALUATOR SIGNATURE:	DATE: 08/19/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/19/2026

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 06-CC-20260730083932

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: APPLETREE MONTESSORI	FACILITY NUMBER: 300606452
	VISIT DATE: 08/19/2026

NARRATIVE

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During the investigation, LPA reviewed video recordings, interviewed three staff, attempted to interview child #1 (C1), reviewed staff files, reviewed C1 file, and obtained the facility roster.

Reporting Party (RP) alleges, Lack of supervision resulted in child sustaining an injury. RP mentioned C1 hit their mouth on a metal bar when they were jumping off the play structure. The RP checked the child's mouth and observed a loose tooth. RP, also mentioned during pickup they observe a little blood on the face of C1. On 08/03/2026, LPA interviewed three staff, two of whom were directly supervising C1 on 07/24/2026, inside the classroom and play yards. All staff interviewed stated they were not aware of C1 sustaining any injuries while in care on 07/24/2026. All staff stated C1 did not come to them regarding any pain and did not observe C1 crying the day of 07/24/2026.

On 08/03/2026, LPA reviewed four separate video recordings from the play yards which C1 was playing on. During all four recordings reviewed, facility was operating within its licensed capacity and within compliance of staffing ratios. In the videos reviewed, staff are seen roaming the play yards and interacting with children.

Video recording #1 shows C1 entering the Pirate Ship play yard at approximately 8:43 AM and exiting the play yard at approximately 9:01 AM. Video recording #2 shows C1 entering the Pirate Ship play yard at approximately 10:46 AM and exiting the play yard at approximately 11:20 AM. Video recording #3 shows C1 entering the side play yard at approximately 2:48 PM and exiting the play yard at approximately 3:15 PM. Video recording #4 shows C1 entering the side play yard at approximately 4:55 PM and exiting the play yard at approximately 5:23 PM. While reviewing all four videos, LPA observed C1 doing normal children activities such climbing, running, jumping, sliding, swinging, and interacting with other children. LPA did not observe C1 crying in any of the videos or hitting their face against any objects or anyone. LPA could not determine if there was blood, coloring on the face, marks, or bruises on C1 face.

At approximately 5:44 PM, LPA observed C1 exit the facility. While exiting the facility, C1 face was not captured on the video recording.

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SUPERVISORS NAME: Nguyen K Tran
LICENSING EVALUATOR NAME: Dean Thompson
LICENSING EVALUATOR SIGNATURE:	DATE: 08/19/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/19/2026

LIC9099 (FAS) - (06/04)

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Control Number 06-CC-20260730083932

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: APPLETREE MONTESSORI	FACILITY NUMBER: 300606452
	VISIT DATE: 08/19/2026

NARRATIVE

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On 08/03/2026, LPA attempted to interview C1, C1 did not qualify to be interviewed

On 08/03/2026, LPA contacted five parents via phone call. Out of five parents called, LPA was able to interview four parents. Parents interviewed did not divulge any information pertaining to the allegation.

Based on LPA observation of the video recordings, interviews with three staff, and parents, there was not enough evidence to substantiate the allegation.

The Orange County Childcare Office has investigated the complaint alleging (1) lack of supervision resulted in child sustaining an injury: 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.

In the areas that were evaluated, no deficiencies were observed of the California Code of Regulations, Title 22, Division 12 at the time of the visit.

A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with facility representative Amy Desouza.

SUPERVISORS NAME: Nguyen K Tran
LICENSING EVALUATOR NAME: Dean Thompson
LICENSING EVALUATOR SIGNATURE:	DATE: 08/19/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/19/2026

LIC9099 (FAS) - (06/04)

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