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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 304370699
Report Date: 06/18/2021
Date Signed: 06/18/2021 01:05:02 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
04/29/2021 and conducted by Evaluator Cindy Nguyen
PUBLIC
COMPLAINT CONTROL NUMBER: 06-CC-20210429140927
FACILITY NAME:OLAM JEWISH MONTESSORI OF BETH JACOBFACILITY NUMBER:
304370699
ADMINISTRATOR:KREISBERG. DAWNFACILITY TYPE:
850
ADDRESS:3880 MICHELSONTELEPHONE:
(949) 786-5230
CITY:IRVINESTATE: CAZIP CODE:
92612
CAPACITY:45CENSUS: 0DATE:
06/18/2021
UNANNOUNCEDTIME BEGAN:
12:15 PM
MET WITH:Interim Director, Symone SassTIME COMPLETED:
01:00 PM
ALLEGATION(S):
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Unqualified staff left alone with children
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Cindy Nguyen conducted an unannounced inspection to investigate the above allegation. This is a continuation of the investigation initiated on 05/05/2021. LPA met with the Interim Director, Symone Sass and discussed the above allegation. LPA toured the facility inside and outside. No children were present during today's inspection due to summer break and summer camp will start up on Monday 6/21/21.

A review of staff criminal clearance records on this date indicates all facility residents, staff, or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions.

Continued on Page 9099C
Substantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Judy HansonTELEPHONE: (714) 703-2807
LICENSING EVALUATOR NAME: Cindy NguyenTELEPHONE: (714) 296-3608
LICENSING EVALUATOR SIGNATURE:

DATE: 06/18/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/18/2021
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 6
Control Number 06-CC-20210429140927
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: OLAM JEWISH MONTESSORI OF BETH JACOB
FACILITY NUMBER: 304370699
VISIT DATE: 06/18/2021
NARRATIVE
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Page 9099C

On 04/29/2021 a complaint was filed with the Licensing Office. Complainant alleged that unqualified staff left alone with the children.

During the investigation LPA conducted 2 physical inspections, interviewed 9 staff members, 8 children, parents, and reviewed staff transcripts. Staff #1 (S1) and Staff #7 (S7) admitted that there was one incident in the afternoon when unqualified staff was left alone with the 7 children for about 5-15 minutes due to shortage of staff on that day, and the director was in a meeting. Based on the review of staff transcripts it was observed transcripts for S7 and S9 do not show completion of ECE units to be fully qualified preschool teachers.

Based on LPA’s observations, interviews which were conducted and review of staff transcripts, the preponderance of evidence was met, therefore the above allegation is found to be SUBSTANTIATED. California Code of Regulations, Title 22 101216.1 (b) is being cited on the attached LIC 9099D.

Exit interview was conducted with Interim Director, Symone Sass. Report reviewed and discussed. Notice of Site Visit was posted during the visit. Director 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. Appeal rights provided and explained. The director/licensee was provided a copy of their appeal rights (LIC 9058 12/16) and their signature on this form acknowledges receipt of these rights.
SUPERVISOR'S NAME: Judy HansonTELEPHONE: (714) 703-2807
LICENSING EVALUATOR NAME: Cindy NguyenTELEPHONE: (714) 296-3608
LICENSING EVALUATOR SIGNATURE:

DATE: 06/18/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/18/2021
LIC9099 (FAS) - (06/04)
Page: 2 of 6
Control Number 06-CC-20210429140927
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: OLAM JEWISH MONTESSORI OF BETH JACOB
FACILITY NUMBER: 304370699
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/18/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
06/30/2021
Section Cited
CCR
101216.1(b)
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101216.1 Teacher Qualifications and Duties. (b) Prior to employment, a teacher shall meet the requirements. This requirement is not met as evidenced by:
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Director agreed to ensured that all staff will comply with Title 22 regulations and never leave unqualified staff to supervise children.

The director will send in a letter of understanding to CCL by due 6/30/21 with all staff signature.
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Based on the staff interviews, S7 doesn’t have the ECE units and was left alone with 7 children for about 5-15 minutes due to short staff. This poses a potential safety risk to the children in care.
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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.
SUPERVISOR'S NAME: Judy HansonTELEPHONE: (714) 703-2807
LICENSING EVALUATOR NAME: Cindy NguyenTELEPHONE: (714) 296-3608
LICENSING EVALUATOR SIGNATURE:

DATE: 06/18/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/18/2021
LIC9099 (FAS) - (06/04)
Page: 3 of 6
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
04/29/2021 and conducted by Evaluator Cindy Nguyen
COMPLAINT CONTROL NUMBER: 06-CC-20210429140927

FACILITY NAME:OLAM JEWISH MONTESSORI OF BETH JACOBFACILITY NUMBER:
304370699
ADMINISTRATOR:KREISBERG. DAWNFACILITY TYPE:
850
ADDRESS:3880 MICHELSONTELEPHONE:
(949) 786-5230
CITY:IRVINESTATE: CAZIP CODE:
92612
CAPACITY:45CENSUS: 0DATE:
06/18/2021
UNANNOUNCEDTIME BEGAN:
12:15 PM
MET WITH:Interim Director, Symone SassTIME COMPLETED:
01:00 PM
ALLEGATION(S):
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9
A daycare child sustained unexplained injury while in care.
Facility is operating out of ratio.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Cindy Nguyen conducted an unannounced inspection to investigate the above allegations. This is a continuation of the investigation initiated on 05/05/2021. LPA met with the Interim Director, Symone Sass and discussed the above allegations. LPA toured the facility inside and outside. No children were present during today's inspection due to summer break and summer camp will start up on Monday 6/21/21.

A review of staff criminal clearance records on this date indicates all facility residents, staff, or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions.

Continued on Page 9099C
Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Judy HansonTELEPHONE: (714) 703-2807
LICENSING EVALUATOR NAME: Cindy NguyenTELEPHONE: (714) 296-3608
LICENSING EVALUATOR SIGNATURE:

DATE: 06/18/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/18/2021
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 4 of 6
Control Number 06-CC-20210429140927
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: OLAM JEWISH MONTESSORI OF BETH JACOB
FACILITY NUMBER: 304370699
VISIT DATE: 06/18/2021
NARRATIVE
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Page 9099C

On 04/29/2021 a complaint was filed with the Licensing Office. Complainant alleged (1) the facility has been operating out of ratio with 15 children to 1 teacher before lunch and in the afternoon. Complaint also alleged (2) child #1 (C1) had a cut on his arm, and the staff didn’t know how child got the cut.

During the investigation LPA conducted 2 physical inspections, interviewed 9 staff members, 8 children, parents, review personnel report, obtained staff timecard, reviewed children’s sign in/out and incident reports, and obtained a copy of the children's roster. All staff interviewed denied of operating out of ratio. Staff stated maximum number of children present in classrooms #1 is 13 and in room #2 there are no more than 11 children. Each classroom has at least two staff members. Staff stated there are never more than twelve children with one staff. The children are being sign in & out in the front, which allows the office staff know how many we have at all the times.

LPA completed a review of staff timecards and children’s sign-in/out sheets for the week of 04/21/21 to 04/23/21. After a thorough review, the documentation doesn’t support the allegation. Based on the records reviewed, there were enough staff present to maintain ratio with the number of children signed in. Children were interviewed but were not able to identify if there was ever a time when only one staff was in the room. All parents interviewed stated the facility is great. Due to COVID-19 the facility is not allowing parents inside. The children are currently being drop off at the front gate of the school. No parent expressed any concerns about the facility being out of ratio.

With regards to allegation #2, all staff interviewed denied injury occurred while the child was in care. Staff stated the child normally will cry if hurt. On the day of the incident, the child in question never expressed any distress and staff didn’t observe any sign of injury to the child while in care. A scratch was observed on the forearm of the child under the long sleeve shirt. One staff stated that this would have been observed when the child washed hands. Parent of the child in question stated the child usually has a lot of scratches/cuts all the times from normal play. Upon arrival at home, the parent observed the scratch. When interviewed the parent didn’t express any concern about care and supervision. Other parents interviewed also didn’t have any concerns about care and supervision.

Continued on Page 9099C
SUPERVISOR'S NAME: Judy HansonTELEPHONE: (714) 703-2807
LICENSING EVALUATOR NAME: Cindy NguyenTELEPHONE: (714) 296-3608
LICENSING EVALUATOR SIGNATURE:

DATE: 06/18/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/18/2021
LIC9099 (FAS) - (06/04)
Page: 5 of 6
Control Number 06-CC-20210429140927
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: OLAM JEWISH MONTESSORI OF BETH JACOB
FACILITY NUMBER: 304370699
VISIT DATE: 06/18/2021
NARRATIVE
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Page 9099C

Based on LPA observations, interviews which were conducted and record reviews, the preponderance of evidence was not met, therefore the above allegations are found to be UNSUBSTANTIATED. Although the allegations may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation(s) did or did not occur, therefore the allegation is UNSUBSTANTIATED.

Exit interview was conducted with Interim Director, Symone Sass. Report reviewed and discussed. Notice of Site Visit was posted during the visit. Director 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. Appeal rights provided and explained. The director/licensee was provided a copy of their appeal rights (LIC 9058 12/16) and their signature on this form acknowledges receipt of these rights.
SUPERVISOR'S NAME: Judy HansonTELEPHONE: (714) 703-2807
LICENSING EVALUATOR NAME: Cindy NguyenTELEPHONE: (714) 296-3608
LICENSING EVALUATOR SIGNATURE:

DATE: 06/18/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/18/2021
LIC9099 (FAS) - (06/04)
Page: 6 of 6