304371233-8-22-2023-06-CC-ANUZ-CUXV92-20230822161338

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 304371233
Report Date: 08/22/2023
Date Signed: 08/22/2023 04:14:42 PM

Document Has Been Signed on 08/22/2023 04:14 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE CO CHILD CARE, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME:	GUIDEPOST MONTESSORI AT LAS FLORES		FACILITY NUMBER:	304371233
ADMINISTRATOR:	BEYDOUN, MAHA		FACILITY TYPE:	850
ADDRESS:	28672 DEERPATH		TELEPHONE:	(949) 339-2010
CITY:	RANCHO STA MARGARITA	STATE: CA	ZIP CODE:	92688
CAPACITY: 77	TOTAL ENROLLED CHILDREN: 77	CENSUS: 25	DATE:	08/22/2023
TYPE OF VISIT:	Case Management - Incident	UNANNOUNCED	TIME BEGAN:	09:15 AM
MET WITH:	Director, Maha Beydoun		TIME COMPLETED:	04:30 PM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	Licensing Program Analyst (LPA) Aiddee Nunez conducted an unannounced case management investigation for the incident which the facility self-reported to licensing office on 6/16/2023. LPA and the facility representative toured the facility inside and outside, and the floor and yard plan were verified. Census was taken in individual classrooms. The overall census observed was 25 preschool children with 5 preschool staff. During the inspection it was determined the facility is operating within its licensed capacity and within compliance of staff to child ratios. A review of the Facility Personnel Report Summary on this date indicates all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions. This is a continuation investigation from 6/21/23. On 6/16/23 director, Maha Beydoun submitted an unusual incident/injury report (LIC 624) to the Orange County Regional office. According to the incident report, on 6/15/23 a child#1 (C1) was standing on a chair in the classroom, while waving his arms the chair fell out from under him landing on his back causing him to fracture his back bones. On 6/21/23 LPA Nunez interviewed 4 staff and 5 children about the incident that happened on 6/15/23 in CH3. On 7/21/23 LPA Nunez interviewed C1’s parent (P1). Also, on 8/22/23 LPA Nunez interviewed the director and S1. Page 1 of 2

SUPERVISORS NAME: Thuy Ho
LICENSING EVALUATOR NAME: Aiddee Nunez
LICENSING EVALUATOR SIGNATURE:	DATE: 08/22/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/22/2023

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

LIC809 (FAS) - (06/04)

Page: 1 of 3

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE CO CHILD CARE, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME: GUIDEPOST MONTESSORI AT LAS FLORES	FACILITY NUMBER: 304371233
	VISIT DATE: 08/22/2023

NARRATIVE

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32

C1’s Parent (P1) stated that a week before the incident, C1 was having pain in his back. P1 stated that C1 was complaining that C1’s back hurt. P1 stated that C1’s other parent (P2) called the school to see if something had happened at the school. S1 told P2 that C1’s back may have hurt because he was rolling on the classroom floor. On Saturday morning (6/10/23) C1 was still complaining that his back hurt and then that following week the incident happened so P1 believes that's why C1’s injury was severe.

However, due to the severity of C1’s injury and from the information available to the LPA it is determined that the facility had violated Title 22 Regulation section 101229(a)(1) related to Supervision. The deficiency is being cited on the attached 809D.

This is a Type 'A' violation the Director 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. The licensee is to keep Acknowledgement Receipt (LIC9224) signed by parents in each child’s file.

An exit interview was completed. The report was reviewed and discussed with the director. Appeal Rights were discussed. The director was provided with a copy of their appeal rights (LIC 9058) 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. 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.

End of Report

Page 2 of 2

SUPERVISORS NAME: Thuy Ho
LICENSING EVALUATOR NAME: Aiddee Nunez
LICENSING EVALUATOR SIGNATURE:	DATE: 08/22/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/22/2023

LIC809 (FAS) - (06/04)

Page: 2 of 3

Document Has Been Signed on 08/22/2023 04:14 PM - It Cannot Be Edited

Created By: Aiddee Nunez On 08/22/2023 at 10:06 AM

Link to Parent Document Below:

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME: GUIDEPOST MONTESSORI AT LAS FLORES	FACILITY NUMBER: 304371233
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 08/22/2023

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Request Denied Type A 09/05/2023 Section Cited CCR 101229(a)(1)	1 2 3 4 5 6 7	101229 Care and Supervision (a) The licensee shall provide care and supervision as necessary to meet the children's needs. (1) No child shall be left without the supervision of a teacher at any time, Supervision shall include visual observation. This requirement is not met as evidenced by:	1 2 3 4 5 6 7	The director will have a staff a meeting and provide supervision training and will have sceniors to practice. The director will provide a list of the signatures of the staff that attended the meeting and will send the proof to the LPA via email by the POC due date.
	8 9 10 11 12 13 14	Based on LPA interviews, S1 failed to provide supervision for C1. There was absence of supervision when S1 did not walk over to help C1 get down from the chair which cause C1 to severely injured his back. This poses an immediate Health and Safety risk to the children in care.	8 9 10 11 12 13 14
	1 2 3 4 5 6 7		1 2 3 4 5 6 7
	1 2 3 4 5 6 7		1 2 3 4 5 6 7

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:

Thuy Ho

LICENSING EVALUATOR NAME:

Aiddee Nunez

LICENSING EVALUATOR SIGNATURE:

DATE: 08/22/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/22/2023

LIC809 (FAS) - (06/04)

Page: 3 of 3