334846059-7-1-2022-09-CC-AROS-CFWVUK-20220701164452

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 334846059
Report Date: 07/01/2022
Date Signed: 07/01/2022 11:52:00 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, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501

This is an official report of an unannounced visit/investigation of a complaint received in our office on
04/05/2022 and conducted by Evaluator Karrene Turner

COMPLAINT CONTROL NUMBER: 09-CC-20220405165220

FACILITY NAME:	COUNTRYSIDE MONTESSORI ACADEMY		FACILITY NUMBER:	334846059
ADMINISTRATOR:	JAFFERY, KANEEZ		FACILITY TYPE:	850
ADDRESS:	2266 GRIFFIN WAY		TELEPHONE:	(951) 340-2821
CITY:	CORONA	STATE: CA	ZIP CODE:	92879
CAPACITY:	78	CENSUS: 40	DATE:	07/01/2022
		UNANNOUNCED	TIME BEGAN:	11:27 AM
MET WITH:	Zainab Jaffery, Director		TIME COMPLETED:	12:05 PM

ALLEGATION(S):

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Lack of Care/Supervision – Daycare child sustained injuries while in care
Other – Staff did not report daycare child’s injuries to responsible party
Lack of Care/Supervision – Staff does not properly supervise daycare children

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Kay Turner arrived at the facility to provide investigation findings of the reported above allegations. LPA met with the director, Zainab Jaffery, and stated the purpose of today’s inspection. LPA Turner toured the facility and a census was taken.

The allegations state that while in care at the facility, a child sustained injuries and the injuries were not reported to the responsible party. The allegations further state staff do not properly supervise the daycare children.

Information obtained during the course of the investigation could not ascertain the child sustained injuries while in care at the facility. Staff at the facility noted there were no observed and/or documented instances of physical injuries nor acts of aggression towards the child. The child had documented incidents of biting, smacking and kicking other children at the facility, which the parent provided documentation of receiving. Staff at the facility explained incidents are documented both in writing via dailies and verbally with parents.

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Aaron Ross
LICENSING EVALUATOR NAME: Karrene Turner
LICENSING EVALUATOR SIGNATURE:	DATE: 07/01/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/01/2022

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 09-CC-20220405165220

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501

FACILITY NAME: COUNTRYSIDE MONTESSORI ACADEMY	FACILITY NUMBER: 334846059
	VISIT DATE: 07/01/2022

NARRATIVE

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The mother confirmed she did not receive written nor verbal notification of any injuries sustained by the child. Regarding the child’s injuries it was noted no medical attention was sought and there was also a delay in notifying the facility of noted injuries.

During the initial interview with the facility staff, it was noted the parents were not provided with the written discipline policy, to include biting, or how the facility address children’s challenging behaviors. To ensure clarity and consistency, the facility updated not only their biting policy but also the policy on handling children with continuous disruptive, challenging behaviors that continue to violate the school’s policies to ensure the safety of all children enrolled.

Based on the interviews conducted, the review of the pertinent documentation and conflicting information, the allegations are UNSUBSTANTIATED. A finding that the allegation is unsubstantiated means that although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the allegations occurred.

No deficiencies were found at this time.

The report was reviewed and an exit interview was conducted with the Director, Zainab Jaffery. A Notice of Site Visit was given and must remain posted on, or immediately adjacent to, the interior side of the main door for 30 days. A copy of this report was provided to the licensee.

SUPERVISORS NAME: Aaron Ross
LICENSING EVALUATOR NAME: Karrene Turner
LICENSING EVALUATOR SIGNATURE:	DATE: 07/01/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/01/2022

LIC9099 (FAS) - (06/04)

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