304371465-5-8-2026-06-CC-TNGN-DTZLKW-20260512085012

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 304371465
Report Date: 05/08/2026
Date Signed: 05/08/2026 12:30:37 PM

Substantiated

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
04/21/2026 and conducted by Evaluator Sarah Garcia

PUBLIC

COMPLAINT CONTROL NUMBER: 06-CC-20260421101053

FACILITY NAME:	SMILES MONTESSORI CHILDCARE		FACILITY NUMBER:	304371465
ADMINISTRATOR:	AHN, SUNG JA		FACILITY TYPE:	830
ADDRESS:	2261 NORTH ORANGE OLIVE ROAD		TELEPHONE:	(714) 283-2857
CITY:	ORANGE	STATE: CA	ZIP CODE:	92865
CAPACITY:	20	CENSUS: 2	DATE:	05/08/2026
		UNANNOUNCED	TIME BEGAN:	08:48 AM
MET WITH:	Facility representative, Sung Ja "Annie" Ahn		TIME COMPLETED:	11:00 AM

ALLEGATION(S):

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Physical Plant-Facility failed to provide an infant outdoor activity space physically separate from space used by preschool children.

INVESTIGATION FINDINGS:

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On 5/8/26 at 8:48am, Licensing Program Analyst (LPA), Sarah Garcia and Licensing Program Manager (LPM) Tina Nguyen conducted an unannounced complaint inspection to deliver the findings for the above allegation. This is a continuation of the investigation initiated on 04/29/26. Upon arrival, LPA and LPM met with facility representative, Sung Ja Ahn. Facility representative guided LPA on a walkthrough of the facility and conducted a census. Total census is 2 children with 1 staff. LPA utilized Korean translation interpreter ID #56229864 to conduct visit. LPA Soo Jin Jung assisted with Korean translation interpretation via telephone.

A review of Facility Report Summary on this date indicated that all facility staff or other individuals who required caregiver background checks have received criminal record and child abuse index clearances or exemptions.

(continue to page 2)

Substantiated

Estimated Days of Completion:

SUPERVISORS NAME: Tina Nguyen
LICENSING EVALUATOR NAME: Sarah Garcia
LICENSING EVALUATOR SIGNATURE:	DATE: 05/08/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/08/2026

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 7

Control Number 06-CC-20260421101053

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: SMILES MONTESSORI CHILDCARE	FACILITY NUMBER: 304371465
	VISIT DATE: 05/08/2026

NARRATIVE

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(Page 2)
The Department received a complaint on 04/21/2026. During the course of the investigation, on 05/02/2026, there was an additional allegation regarding facility failing to provide an infant outdoor activity space physically separate from space used by preschool children.

LPA interviewed the Reporting Party (RP) for further information. RP stated Child #1 (C1) was on a tricycle used for preschool children and the C1 fell and hit their head on the concrete. Rp states a few days later C1 was fighting with another child and C1 fell and hit head in the same exact spot. RP stated the child was in the main outdoor area which is for the big kids.

During today's visit, LPA interviewed 2 staff. LPA utilized Korean translation interpreter ID #98477919 and #39214402.

During the investigation, LPA Garcia interviewed 3 staff, authorized representatives, and reviewed the facility roster and April incidents.

During staff interviews on 4/29/2026, Staff 1 (S1) stated they provide visual supervision to the children at all times and report incidents in a timely manner. Staff 2 (S2) stated on 4/13/26 they were watching C1 by themselves at approximately 7am in the preschool yard and as C1 grabbed the bicycle handle, it went sideways and C1 fell and bumped head. S2 applied an ice pack, completed an incident report, and notified parents via incident report and verbally on 4/13/26. S2 and Staff 3 (S3) confirmed that the incident on 4/13/2026 with C1 occurred in the preschool outdoor area. S2 stated another incident occurred on 4/17/26 where C1 and another child were playing at the base of the slide in the infant room and C1 hit the slide with their head on the same spot. S2 stated S3 provided an ice pack and washed the wounded area. S2 stated parents were notified via incident report and verbally on 4/17/26.

LPA reviewed April incident reports and facility reported on 4/13/26 at 7:30am, C1 fell down trying to ride a bike in the morning. S2 provided an ice pack and cleaned the wounded area. On 4/17/26 at 9:30am, C1 and another child were fighting over a set of toys and C1 hit their head on the same spot.
(continue to page 3)

SUPERVISORS NAME: Tina Nguyen
LICENSING EVALUATOR NAME: Sarah Garcia
LICENSING EVALUATOR SIGNATURE:	DATE: 05/08/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/08/2026

LIC9099 (FAS) - (06/04)

Page: 2 of 7

Control Number 06-CC-20260421101053

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: SMILES MONTESSORI CHILDCARE	FACILITY NUMBER: 304371465
	VISIT DATE: 05/08/2026

NARRATIVE

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(Page 3)
Throughout the investigation, LPA interviewed children’s authorized representatives. Representatives interviewed provided feedback regarding their enrollment experience but not enough evidence to corroborate the allegation.

Based on record review and interviews, it has been determined that the allegation that the facility failed to provide an infant outdoor activity space physically separate from space used by preschool children is found to be substantiated. California Code of Regulations, Title 22, Division 12, Chapter 1 Section 101438.2(b) Outdoor Activity Space for Infants are being cited on the attached LIC 9099D. LPA provided facility representative with the Title 22 regulations Section 101438.2(b) for reference.

LPA Sarah Garcia informed facility representative Sung Ja Ahn, that this report dated 05/08/2026 documents (1) Type A citation which shall be posted for 30 consecutive days as there is immediate risk to the health, safety, or personal rights of children in care. Also, LPA Sarah Garcia informed facility representative Sung Ja Ahn, to provide a copy of this licensing report dated 05/08/2026 that documents any Type A citation 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.

Exit interview conducted and report was reviewed with the facility representative, Sung Ja Ahn. A notice of site visit was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

End of Report.

SUPERVISORS NAME: Tina Nguyen
LICENSING EVALUATOR NAME: Sarah Garcia
LICENSING EVALUATOR SIGNATURE:	DATE: 05/08/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/08/2026

LIC9099 (FAS) - (06/04)

Page: 3 of 7

Control Number 06-CC-20260421101053

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: SMILES MONTESSORI CHILDCARE	FACILITY NUMBER: 304371465
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 05/08/2026

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type A 05/11/2026 Section Cited CCR 101438.2(b)	1 2 3 4 5 6 7	101438.2 Outdoor Activity Space for Infants (b) Outdoor activity space shall be physically separate from space used by children in the child care center and school-age child care center components. This requirement was not met as evidenced by:	1 2 3 4 5 6 7	Facility representative will submit a declaration stating they understand that infants must have an outdoor activity space separate from preschool center and submit to LPA via email by 5pm on 5/11/2026.
	8 9 10 11 12 13 14	Based on interview and record review, Staff 2 (S2) and Staff 3 (S3) confirmed that the incident on 4/13/2026 with Child 1 (C1) occurred in the preschool outdoor area which poses an immediate risk to the health, safety, and personal rights of 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.

SUPERVISORS NAME: Tina Nguyen
LICENSING EVALUATOR NAME: Sarah Garcia
LICENSING EVALUATOR SIGNATURE:	DATE: 05/08/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/08/2026

LIC9099 (FAS) - (06/04)

Page: 4 of 7

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
04/21/2026 and conducted by Evaluator Sarah Garcia

PUBLIC

COMPLAINT CONTROL NUMBER: 06-CC-20260421101053

FACILITY NAME:	SMILES MONTESSORI CHILDCARE		FACILITY NUMBER:	304371465
ADMINISTRATOR:	AHN, SUNG JA		FACILITY TYPE:	830
ADDRESS:	2261 NORTH ORANGE OLIVE ROAD		TELEPHONE:	(714) 283-2857
CITY:	ORANGE	STATE: CA	ZIP CODE:	92865
CAPACITY:	20	CENSUS: 2	DATE:	05/08/2026
		UNANNOUNCED	TIME BEGAN:	08:48 AM
MET WITH:	Facility representative, Sung Ja "Annie" Ahn		TIME COMPLETED:	11:00 AM

ALLEGATION(S):

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Neglect/Lack of Supervision-Staff did not provide adequate supervision, resulting in day care child sustaining injuries.
Reporting Requirements-Staff did not properly report incidents involving day care child.

INVESTIGATION FINDINGS:

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On 5/8/26 at 8:48am, Licensing Program Analyst (LPA), Sarah Garcia and Licensing Program Manager (LPM) Tina Nguyen conducted an unannounced complaint inspection to deliver the findings for the above allegations. This is a continuation of the investigation initiated on 04/29/26. Upon arrival, LPA met with facility representative, Sung Ja Ahn. Director guided LPA on a walkthrough of the facility and conducted a census. Total census is 2 children with 1 staff. LPA utilized Korean translation interpreter ID #56229864 to conduct visit. LPA Soo Jin Jung assisted with Korean translation interpretation via telephone.

A review of Facility Report Summary on this date indicated that all facility staff or other individuals who required caregiver background checks have received criminal record and child abuse index clearances or exemptions.

(continue to page 2)

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Tina Nguyen
LICENSING EVALUATOR NAME: Sarah Garcia
LICENSING EVALUATOR SIGNATURE:	DATE: 05/08/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/08/2026

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

LIC9099 (FAS) - (06/04)

Page: 5 of 7

Control Number 06-CC-20260421101053

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: SMILES MONTESSORI CHILDCARE	FACILITY NUMBER: 304371465
	VISIT DATE: 05/08/2026

NARRATIVE

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(Page 2)
The Department received a complaint on 04/21/2026 alleging staff did not provide adequate supervision, resulting in day care child sustaining injuries and staff did not properly report incidents involving day care child.

LPA interviewed the Reporting Party (RP) for further information. RP stated C1 was on a tricycle used for preschool children and the C1 fell and hit their head on the concrete. Rp states a few days later C1 was fighting with another child and C1 fell and hit head in the same exact spot. Rp stated the child was in the main outdoor area which is for the big kids.

During today's visit, LPA interviewed 2 staff. LPA utilized Korean translation services ID #98477919 and #39214402.

During the investigation, LPA Garcia interviewed 3 staff, authorized representatives, and reviewed the facility roster and April incidents.

During staff interviews on 4/29/2026, Staff 1 (S1) stated they provide visual supervision to the children at all times and report incidents in a timely manner. Staff 2 (S2) stated on 4/13/26 they were watching C1 by themselves at approximately 7am in the preschool yard and as C1 grabbed the bicycle handle, it went sideways and C1 fell and bumped head. S2 applied an ice pack, completed an incident report, and notified parents via incident report and verbally on 4/14/26. S2 and Staff 3 (S3) confirmed that the incident on 4/13/2026 with C1 occurred in the preschool outdoor area. S2 stated another incident occurred on 4/17/26 where C1 and another child were playing at the base of the slide in the infant room and C1 hit the slide with their head on the same spot. S2 stated S3 provided an ice pack and washed the wounded area. S2 stated parents were notified via incident report and verbally on 4/17/26.

LPA reviewed April incident reports and facility reported on 4/13/26 at 7:30am, C1 fell down trying to ride a bike in the morning. S2 provided an ice pack and cleaned the wounded area. On 4/17/26 at 9:30am, C1 and another child were fighting over a set of toys and C1 hit their head on the same spot.

(Continue to page 3)

SUPERVISORS NAME: Tina Nguyen
LICENSING EVALUATOR NAME: Sarah Garcia
LICENSING EVALUATOR SIGNATURE:	DATE: 05/08/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/08/2026

LIC9099 (FAS) - (06/04)

Page: 6 of 7

Control Number 06-CC-20260421101053

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: SMILES MONTESSORI CHILDCARE	FACILITY NUMBER: 304371465
	VISIT DATE: 05/08/2026

NARRATIVE

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SUPERVISORS NAME: Tina Nguyen
LICENSING EVALUATOR NAME: Sarah Garcia
LICENSING EVALUATOR SIGNATURE:	DATE: 05/08/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/08/2026

LIC9099 (FAS) - (06/04)

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