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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 197407586
Report Date: 08/29/2024
Date Signed: 08/29/2024 12:30:28 PM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
This is an official report of an unannounced visit/investigation of a complaint received in our office on
06/06/2024 and conducted by Evaluator Elicia Calvillo
COMPLAINT CONTROL NUMBER: 58-CC-20240606095049
FACILITY NAME:MONTESSORI OF CHATSWORTHFACILITY NUMBER:
197407586
ADMINISTRATOR:ERBE, ANNEROSEFACILITY TYPE:
850
ADDRESS:10616 ANDORA AVE.TELEPHONE:
(818) 709-2980
CITY:CHATSWORTHSTATE: CAZIP CODE:
91311
CAPACITY:110CENSUS: 31DATE:
08/29/2024
UNANNOUNCEDTIME BEGAN:
08:30 AM
MET WITH:Annerose Erbe, DirectorTIME COMPLETED:
11:30 AM
ALLEGATION(S):
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Staff handled day care child in a rough manner
INVESTIGATION FINDINGS:
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On 08/29/2024 at 08:30 AM, Licensing Program Analysts (LPAs) Elicia Calvillo and Amelia Morales conducted a complaint visit to deliver findings on the above allegation. LPAs identified self and met with Sabrina Mundel, Assistant Director, who allowed entry into the facility and provided LPAs a guided tour of the inside and outside of the facility Upon arrival there were 31 children and 6 staff present, Annerose Erbe, Director arrived shortly after.

During today’s visit, LPA addressed the allegation that Staff handled day care child in a rough manner. Throughout the course of the investigation, LPA obtained the LIC 9040 Child Care Facility Roster, interviewed Director, interviewed parents, interviewed children, interviewed staff and personnel record review.

Information provided by the Reporting Party (RP) indicates that they observed Staff #4, handled child in a rough manner by aggressively slamming Child #7 on the chair while asking them to sit down.
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Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Rita Ramos
LICENSING EVALUATOR NAME: Elicia Calvillo
LICENSING EVALUATOR SIGNATURE:

DATE: 08/29/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/29/2024
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 3
Control Number 58-CC-20240606095049
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: MONTESSORI OF CHATSWORTH
FACILITY NUMBER: 197407586
VISIT DATE: 08/29/2024
NARRATIVE
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Director disclosed that they heard Staff #4 yelling “line up” at a child and when the child did not listen right away, Staff #4 went to child and took their hand and strongly pulled them into the line. Director stated that they immediately addressed the concern with Staff #4 and as a result, Staff #4 received a disciplinary warning for this incident.

When interviewing staff, parents, and children there were no disclosures made regarding the allegation.

When LPA conducted a personnel record review for the facility staff, LPA reviewed a written disciplinary notice for Staff #4. This disciplinary notice indicated that Staff #4 is too rough with children in their class by pulling hands and yelling.

Based on LPA’s observations and interviews which were conducted and record review, 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 3, Section number 101223(a)(3) Personal Rights, is being cited on the attached deficiencies page.

The Notice of Site Visit (LIC 9213) must remain posted for 30 days during the hours of operation after each site visit by a licensing representative. Failure to maintain posting as required will result in a civil penalty of $100.00.

Exit interview was conducted with Annerose Erbe, Director, including, but not limited to Provider Rights, Appeal Procedures and Agencies Consultative Role.

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SUPERVISORS NAME: Rita Ramos
LICENSING EVALUATOR NAME: Elicia Calvillo
LICENSING EVALUATOR SIGNATURE:

DATE: 08/29/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/29/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 58-CC-20240606095049
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME: MONTESSORI OF CHATSWORTH
FACILITY NUMBER: 197407586
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/29/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
09/26/2024
Section Cited
CCR
101223(a)(3)
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Personal Rights (a) The licensee shall ensure that each child is accorded the following personal rights: (3) To be free from corporal or unusual punishment, infliction of pain, humiliation, intimidation, ridicule, coercion, threat, mental abuse or other actions of a punitive nature… This requirement is not met
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Per Director, at the next staff meeting they will reviiew personnal rights of children and provide LPA a copy of the meeting agenda and sign in sheet. By the plan of correction due date of 09/26/2024.
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 as evidenced by: Observation, record review, and interviews conducted in that Staff #4 handled child in a rough manner and Director address the concern and gave Staff #4 a displinary warning, which poses an which poses a potential health, safety or personal rights risk to persons 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: Rita Ramos
LICENSING EVALUATOR NAME: Elicia Calvillo
LICENSING EVALUATOR SIGNATURE:

DATE: 08/29/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/29/2024
LIC9099 (FAS) - (06/04)
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