304370957-11-30-2021-06-CC-JHAN-C9CVXZ-20211203155021

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 304370957
Report Date: 11/30/2021
Date Signed: 11/30/2021 11:17:45 AM

Unsubstantiated

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
10/21/2021 and conducted by Evaluator Dean Valencia

PUBLIC

COMPLAINT CONTROL NUMBER: 06-CC-20211021154430

FACILITY NAME:	MILESTONES MONTESSORI OF IRVINE		FACILITY NUMBER:	304370957
ADMINISTRATOR:	GOLDEN, KRISTEL		FACILITY TYPE:	830
ADDRESS:	16601 ARMSTRONG AVENUE		TELEPHONE:	(949) 553-0555
CITY:	IRVINE	STATE: CA	ZIP CODE:	92606
CAPACITY:	40	CENSUS: 31	DATE:	11/30/2021
		UNANNOUNCED	TIME BEGAN:	09:15 AM
MET WITH:	Kristel Golden, Director		TIME COMPLETED:	11:45 AM

ALLEGATION(S):

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Reporting party suspects that an injury did not occur as documented by staff.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Dean Valencia conducted an unannounced complaint inspection on today's date, 11/30/2021, to deliver findings of a complaint investigation. This is a continuation of an investigation initiated on 10/28/2021. LPA met with director Kristel Golden. At 10am the director guided LPA on a tour of the facility and census of children was taken. At the time of the census LPA observed 31 infants and 10 staff. On 10/21/2021 a complaint was filed with the Department alleging an injury did not occur as documented by staff. It was alleged that a ouch report provided indicating a child, child #1 (see Confidential Namses List LIC811) bit themselves on the wrist/arm, was not accurate. The reporting party suspected that child #1 was bitten by another child instead. During the course of the investigation, LPA interviewed director, administrator and 5 other staff, several parents, and conducted 2 separate physical plant inspections on different dates, and reviewed documentation provided by the facility the allegation. During LPA's observations of children in the classrooms, LPA was able to observe that staff exhibited appropriate and compliant supervision and interactions with the infants.
(continued on LIC9099C)

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Judy Hanson
LICENSING EVALUATOR NAME: Dean Valencia
LICENSING EVALUATOR SIGNATURE:	DATE: 11/30/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/30/2021

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-20211021154430

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: MILESTONES MONTESSORI OF IRVINE	FACILITY NUMBER: 304370957
	VISIT DATE: 11/30/2021

NARRATIVE

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(page 2)
Staff were interviewed by LPA on 10/28/21, and during the interviews staff exhibited knowledge of supervision and reporting requirement regulations, and protocol, and stated they are always supervising all children at all times, and understand they are to report injuries needing attention to parents, accurately. Facility staff interviewed stated that they provided an "oops report" and call was made to authorized representative of child #1, and have stated that "oops report" was reported accurately to the authorized representative.

Parents were interviewed on 11/29/2021, and had generally positive feedback regarding the facility, and had no issues related to this reported allegation. From these interviews with staff, parents, observations of the classrooms, and review of facility documentation related to the allegation there was insufficient information to create a preponderance of evidence to support this allegation.

Based on all this information the preponderance of evidence standard for this allegation was not met, therefore the above allegation is found to be unsubstantiated. From all of the available information obtained by LPA during the course of the investigation, that there is insufficient evidence indicating that an injury did not occur as documented by staff. Based on all of the information LPA was able to obtain, LPA was not able to determine that this allegation was false or untrue. Therefore LPA cannot make the determination that this allegation is unfounded; and the most accurate finding would remain at unsubstantiated.

Although the allegation may have happened or are valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur; therefore, the allegation is unsubstantiated. Exit interview was conducted, and report was reviewed and discussed. Notice of Site Visit was posted during the visit. 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 per day. The facility was provided a copy of their appeal rights (LIC 9058 12/15) and their signature on this form acknowledges receipt of these rights.

SUPERVISORS NAME: Judy Hanson
LICENSING EVALUATOR NAME: Dean Valencia
LICENSING EVALUATOR SIGNATURE:	DATE: 11/30/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/30/2021

LIC9099 (FAS) - (06/04)

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