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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 304371430
Report Date: 01/31/2023
Date Signed: 01/31/2023 02:52:34 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, 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
11/04/2022 and conducted by Evaluator Patricia Duron
PUBLIC
COMPLAINT CONTROL NUMBER: 06-CC-20221104122353
FACILITY NAME:MONTESSORI OF LAGUNA NIGUELFACILITY NUMBER:
304371430
ADMINISTRATOR:PULIYANDA, ANNAFACILITY TYPE:
850
ADDRESS:31171 NIGUEL ROADTELEPHONE:
(949) 661-5437
CITY:LAGUNA NIGUELSTATE: CAZIP CODE:
92677
CAPACITY:60CENSUS: 34DATE:
01/31/2023
UNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Director, Anna Puliyanda TIME COMPLETED:
12:45 PM
ALLEGATION(S):
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Facility Staff member yelled at, and in front of, day care child (ren).
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPAs) Patricia Duron and Giselle Lucero conducted an unannounced complaint visit to deliver the complaint findings. LPAs met with Director, Anna Puliyanda and Licensee Yuetong Abby Zhu Census was taken. The overall census observed was 6 staff and 34 children. A review of staff criminal clearance records on this date indicates that all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions.
On 11/4/2022 a complaint was filed with the Licensing office stating Facility staff member yelled at, and in front of, daycare child (ren). Reporting Party (RP) stated they witnessed a staff member yelled at another staff member in the children’s presence.
During the course of investigation, LPA interviewed licensee, Yuetong Abby Zhu, 6 staff members, 5 children, 3 parents, and reviewed records.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Thuy Ho
LICENSING EVALUATOR NAME: Patricia Duron
LICENSING EVALUATOR SIGNATURE:

DATE: 01/31/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/31/2023
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 5
Control Number 06-CC-20221104122353
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: MONTESSORI OF LAGUNA NIGUEL
FACILITY NUMBER: 304371430
VISIT DATE: 01/31/2023
NARRATIVE
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During the initial inspection dated 11/8/2022, LPA interviewed staff, 3 out of 5 staff stated they have witnessed S1 yelled at S7 with children present. 3 out of 5 staff stated two staff had an argument in the presence of the children.

LPA Duron contacted five parents by phone and was able to interview three parents. All interviewed parents stated they did not have any concern with facility.

LPA attempted to interview 5 children and only 2 children qualified for an interview. There’s no disclosure was made by the 2 interviewed children.

Based on LPA’s interviews and reviewing records, the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED. California Code of Regulations, Title 22, Division 12, Chapter 1 Section 101223(a)(1) Personal Rights. Please refer to attached 9099D for documentation of deficiencies.

An exit interview was completed. The report was reviewed and discussed. Appeal Rights were provided. The facility representative was provided a copy of their appeal rights 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. Any proposed changes to the physical plant, including telephone number, shall be immediately reported to the Department.

Also, LPA Patricia Duron informed the licensee, Yuetong Abby Zhu to provide a copy of this licensing report dated 1/31/2023 that documents any Type A citation(s) to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification.

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.

SUPERVISORS NAME: Thuy Ho
LICENSING EVALUATOR NAME: Patricia Duron
LICENSING EVALUATOR SIGNATURE:

DATE: 01/31/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/31/2023
LIC9099 (FAS) - (06/04)
Page: 3 of 5
Control Number 06-CC-20221104122353
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: MONTESSORI OF LAGUNA NIGUEL
FACILITY NUMBER: 304371430
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/31/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Request Denied
Type A
01/31/2023
Section Cited
CCR
101223(a)(1)
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101223(a)(1) Personal Rights. (a) The licensee shall ensure that each child is accorded the following personal rights: (1) To be accorded dignity in his/her personal relationships with staff and other persons. This requirement is not met as evidence by:
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Written Statement, our goal is to have all the stafff understand and respect the children's personal rights, and staff's personal rights. Handling the situations in a professional manner. Written Statement provided on January 31, 2023.
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Based on LPA’s interview, 3 staff disclosed S1 yelled at S7 in the present of the children. This action poses an immediate risk to the health and safety to the child 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.
SUPERVISORS NAME: Thuy Ho
LICENSING EVALUATOR NAME: Patricia Duron
LICENSING EVALUATOR SIGNATURE:

DATE: 01/31/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/31/2023
LIC9099 (FAS) - (06/04)
Page: 2 of 5
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
11/04/2022 and conducted by Evaluator Patricia Duron
PUBLIC
COMPLAINT CONTROL NUMBER: 06-CC-20221104122353

FACILITY NAME:MONTESSORI OF LAGUNA NIGUELFACILITY NUMBER:
304371430
ADMINISTRATOR:PULIYANDA, ANNAFACILITY TYPE:
850
ADDRESS:31171 NIGUEL ROADTELEPHONE:
(949) 661-5437
CITY:LAGUNA NIGUELSTATE: CAZIP CODE:
92677
CAPACITY:60CENSUS: 34DATE:
01/31/2023
UNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Director, Anna Puliyanda TIME COMPLETED:
12:45 PM
ALLEGATION(S):
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Facility staff member called day care child an inappropriate name.
Facility staff member did not meet day care child's diapering needs.
Facility staff member did not adequately supervise day care children.
Facility staff member did not allow day care child to drink water.
Day care children sustained injuries while in care.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Patricia Duron conducted an unannounced complaint visit to deliver the complaint findings. LPA met with licensee, Yuetong Abby Zhu.Census was taken. The overall census observed was 6 staff and 34 children. A review of staff criminal clearance records on this date indicates that all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions.
On 11/4/2022 a complaint was filed with the Licensing office stating Facility staff member called day care child an inappropriate name. Facility staff member did not meet day care child's diapering needs. Facility staff member did not adequately supervise day care children. Facility staff member did not allow day care child to drink water. Day care children sustained injuries while in care.
RP stated the following: they witnessed a facility staff member call a child a inappropriate name; staff member did not change child’s diaper while in care; a staff member left the children unattended in the classroom; a staff member did not allow children to drink water during nap time, and a few day care children received mark on their face caused by a staff member.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Thuy Ho
LICENSING EVALUATOR NAME: Patricia Duron
LICENSING EVALUATOR SIGNATURE:

DATE: 01/31/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/31/2023
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 5
Control Number 06-CC-20221104122353
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: MONTESSORI OF LAGUNA NIGUEL
FACILITY NUMBER: 304371430
VISIT DATE: 01/31/2023
NARRATIVE
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During the course of investigation, LPA interviewed licensee, Yuetong Abby Zhu, 6 staff, 5 children, 3 parents, and reviewed records.

During the initial inspection dated 11/8/2022, LPA’s observed staff supervising children. Each classroom was in ratio and the children were engaged in activities. During the transition to nap time, LPA observed children were using restroom, and diapers were being changed prior to children resting on their cots. 5 out of 5 staff stated children are able to use restroom and drink water during nap time. All 5 interviewed staff members denied witnessing any staff called the children inappropriate names or leaving the children unattended in the classroom. LPA observed facility’s diaper changing procedure of providing information to parents/ authorized representatives via Brightwheel app. No staff members have witnessed any mark on the children’s face after being care for by the staff. Licensee stated authorized representatives are informed when their child is injured while in care.

LPA Duron contacted five parents by phone and was able to interview three parents. All interviewed parents stated they did not have any concern with facility. LPA attempted to interview 5 children and only 2 children qualified for an interview. There’s no disclosure was made by the 2 interviewed children.

Based on the information gathered from LPAs’ interviews, observation, and reviewing records, there is insufficient evidence to corroborate the allegations of Licensee is Facility staff member called day care child an inappropriate name. Facility staff member did not meet day care child's diapering needs. Facility staff member did not adequately supervise day care children. Facility staff member did not allow day care child to drink water. Day care children sustained injuries while in care. Although the allegations may have happened or are valid, there is not a preponderance of evidence to prove the allegations did or did not occur in the day care facility, therefore the allegations are UNSUBSTANTIATED.

An exit interview was completed. The report was reviewed and discussed. Appeal Rights were provided. The facility representative was provided a copy of their appeal rights 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. Any proposed changes to the physical plant, including telephone number, shall be immediately reported to the Department.



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.
SUPERVISORS NAME: Thuy Ho
LICENSING EVALUATOR NAME: Patricia Duron
LICENSING EVALUATOR SIGNATURE:

DATE: 01/31/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/31/2023
LIC9099 (FAS) - (06/04)
Page: 5 of 5