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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 197419681
Report Date: 12/07/2022
Date Signed: 12/07/2022 05:01:06 PM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 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
10/17/2022 and conducted by Evaluator Miriam Cohen
COMPLAINT CONTROL NUMBER: 30-CC-20221017105128
FACILITY NAME:PALOS VERDES MONTESSORI ACADEMYFACILITY NUMBER:
197419681
ADMINISTRATOR:OFELIA WATANABEFACILITY TYPE:
850
ADDRESS:28451 INDIAN PEAK ROADTELEPHONE:
(310) 541-2405
CITY:RANCHOS PALOS VERDESSTATE: CAZIP CODE:
90274
CAPACITY:98CENSUS: 68DATE:
12/07/2022
UNANNOUNCEDTIME BEGAN:
03:00 PM
MET WITH:Eliza Byrd, DirectorTIME COMPLETED:
05:20 PM
ALLEGATION(S):
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Staff did not prevent child's access to unsafe objects that caused injury to child in care
Child sustained an unexplained injury while in care
Staff did not ensure that water was accessible to child while in care
INVESTIGATION FINDINGS:
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On 12/07/2022 @ 3:00 PM, LPA Cohen conducted an unannounced visit for the purpose of delivering the finding against alleged complaint reported concerning the above preschool. Upon arrival, LPA Cohen observed nine adults providing care for 68 children. LPA Cohen met with the preschool director.
After conducting interviews with six staff members (written declaration obtained) and three parents of children currently enrolled in the above preschool, visual observation, and consultation with management, the following conclusion has been reached: Unsubstantiated - A finding that the complaint is unsubstantiated means that although the allegations may have happened or are valid, there is not a preponderance of the evidence to prove that the alleged violations occurred. There shall be no deficiency cited during today’s visit.

An exit interview was conducted with the above items discussed with preschool director.
A copy of this report and Appeal Rights were provided.

Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Maureen Neal
LICENSING EVALUATOR NAME: Miriam Cohen
LICENSING EVALUATOR SIGNATURE:

DATE: 12/07/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/07/2022
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 30-CC-20221017105128
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: PALOS VERDES MONTESSORI ACADEMY
FACILITY NUMBER: 197419681
VISIT DATE: 12/07/2022
NARRATIVE
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On 10/19/2022 @ 12:45 PM, Licensing Program Analyst (LPA) Miriam Cohen conducted an unannounced complaint visit for the purpose of notifying the preschool director concerning the above-mentioned allegations and to perform an investigation. Upon arrival, LPA Cohen observed nine adults providing care for 77 children. LPA Cohen met with preschool director, Eliza Byrd and acquired acquired the following documentation:
*Children Roster for Pre-Primary classroom
*Emergency ID with parent contact information for Pre-Primary classroom

LPA interviewed and obtained written declaration from three staff members assigned in Pre-Primary classroom. Further witnesses and documentation will be needed to conclude the investigation. An exit interview was conducted with the above items discussed with preschool director. A copy of this report was provided.
SUPERVISORS NAME: Maureen Neal
LICENSING EVALUATOR NAME: Miriam Cohen
LICENSING EVALUATOR SIGNATURE:

DATE: 12/07/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/07/2022
LIC9099 (FAS) - (06/04)
Page: 2 of 2