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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 376700059
Report Date: 03/23/2022
Date Signed: 03/23/2022 10:34:36 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 STREET, STE 700
RIVERSIDE, CA 92501
This is an official report of an unannounced visit/investigation of a complaint received in our office on
02/11/2022 and conducted by Evaluator Otsanya Cameron
PUBLIC
COMPLAINT CONTROL NUMBER: 10-CC-20220211101142
FACILITY NAME:MONTESSORI SCHOOL OF OCEANSIDE #2FACILITY NUMBER:
376700059
ADMINISTRATOR:MENDOZA, SYLVIAFACILITY TYPE:
850
ADDRESS:4760 OCEANSIDE BLVD., #B10TELEPHONE:
(760) 724-8955
CITY:OCEANSIDESTATE: CAZIP CODE:
92056
CAPACITY:43CENSUS: 33DATE:
03/23/2022
UNANNOUNCEDTIME BEGAN:
09:36 AM
MET WITH: Director Sylvia MendozaTIME COMPLETED:
10:46 AM
ALLEGATION(S):
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A staff pushed a daycare child causing child to fall to the ground
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Otsanya Cameron Conducted an unannounced visit to deliver findings on a complaint investigation that was initiated February 11th 2022.

It was alleged: staff pushed a daycare child causing child to fall to the ground.

During the investigation, staff were interviewed, LPA reviewed a staff and a child’s file, and the LPA obtained a copy of: Sign In/Out sheet. All staff interviewed stated they have never witnessed any staff member push a day-care child. Additionally, during the investigation, there was not any documentation provided to LPA from facility staff indicating that a child was pushed or any incidents eluding to a child falling.

Due to conflicting information gathered, there isn’t enough evidence to corroborate the reported allegations.

Continued on LIC 9099-c
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Pauline Beschorner
LICENSING EVALUATOR NAME: Otsanya Cameron
LICENSING EVALUATOR SIGNATURE:

DATE: 03/23/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/23/2022
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 2
Control Number 10-CC-20220211101142
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 STREET, STE 700
RIVERSIDE, CA 92501
FACILITY NAME: MONTESSORI SCHOOL OF OCEANSIDE #2
FACILITY NUMBER: 376700059
VISIT DATE: 03/23/2022
NARRATIVE
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Therefore, based on interviews with pertinent parties and records reviewed, the allegations that a staff pushed a daycare child causing child to fall to the ground is unsubstantiated, at this time. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur.


An exit interview was conducted, and a copy of this report was issued to Director Sylvia Mendoza.

A copy of this report must be made available to the public for 3 years.
SUPERVISORS NAME: Pauline Beschorner
LICENSING EVALUATOR NAME: Otsanya Cameron
LICENSING EVALUATOR SIGNATURE:

DATE: 03/23/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/23/2022
LIC9099 (FAS) - (06/04)
Page: 2 of 2