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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 197419681
Report Date: 02/01/2024
Date Signed: 02/01/2024 12:10:38 PM

Substantiated


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
01/26/2024 and conducted by Evaluator Miriam Cohen
COMPLAINT CONTROL NUMBER: 30-CC-20240126104246
FACILITY NAME:PALOS VERDES MONTESSORI ACADEMYFACILITY NUMBER:
197419681
ADMINISTRATOR:MARISSA MABINIFACILITY TYPE:
850
ADDRESS:28451 INDIAN PEAK ROADTELEPHONE:
(310) 541-2405
CITY:RANCHOS PALOS VERDESSTATE: CAZIP CODE:
90274
CAPACITY:98CENSUS: 52DATE:
02/01/2024
UNANNOUNCEDTIME BEGAN:
09:15 AM
MET WITH:Marissa Mabini, DirectorTIME COMPLETED:
12:30 PM
ALLEGATION(S):
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Day-care child was left on a playground unattended.
INVESTIGATION FINDINGS:
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On 02/01/2024 @ 9:15 AM, Licensing Program Analyst (LPA) Miriam Cohen conducted an unannounced complaint visit for the purpose of notifying the preschool director concerning the above-mentioned allegation and to perform an investigation. Upon arrival, LPA Cohen observed eight adults providing care for 52 children. LPA Cohen met and interviewed preschool director, Marissa Mabini.
LPA obtained the following written documentation:
1. Statement from preschool director (internal investigation)
2. Action Plan
3. Unusual Incident Report
4. Ouch Report with parent signature
During the interview, Ms. Mabini stated the following:
1. On 01/25/2024, @ 5:00 PM, Child #1 (C1) was found by his parent standing outside, (alone and without adult supervision) in the play yard. C1 was left outside alone and unattended for approximately 30 minutes.


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

DATE: 02/01/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/01/2024
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 30-CC-20240126104246
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: 02/01/2024
NARRATIVE
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2. An internal investigation was conducted immediately by the director and a written report of the incident was provided by the teacher in charge of the classroom, Staff #1 (S1).
3. A meeting with the parents of C1 was held to ensure the safety of the children.
4. Teacher’s reminder with memo protocol regarding supervision is reinforced with additional supervision by the director (verbal and written communication).
5. Three teachers on duty during the incident were written up (documentation in file).

LPA Cohen substantiated the allegation based on verbal interviews and written statements from RP, preschool director, and assistant preschool director. The facility was cited a Type A deficiency and a $500 Immediate Civil Penalty according to California Code of Regulations Title 22 (See LIC 9099D report for deficiency). The Licensee is to post notice of Site Visit for 30 Days, failure to do so will result in $100 immediate civil penalty. This report must be copied and given to all parents and to the parents of any child enrolling within the next 12 months (see LIC 9224).

An exit interview, a copy of the report, and Appeal Rights were provided to the preschool director.

SUBSTANTIATED - A finding that a complaint is substantiated means that the allegation is valid because the preponderance of the evidence standard has been met.

SUPERVISORS NAME: Maureen Neal
LICENSING EVALUATOR NAME: Miriam Cohen
LICENSING EVALUATOR SIGNATURE:

DATE: 02/01/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/01/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 30-CC-20240126104246
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
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/01/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
02/16/2024
Section Cited
CCR
101229(a)(1)
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Responsibility for Providing Care and Supervision a) The licensee shall provide care and supervision as necessary to meet the children's needs.
(1) No child(ren) shall be left without the supervision of a teacher at any time...
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*Director agrees to provide a written statement (LIC 855/Declaration Form) on intention to keep children safe at all times. Declaration to be submitted to LPA by 02/16/2024, end of business day.
*Director agrees provide an in-service to
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Supervision shall include visual observation. This requirement was not met as evidenced by (C1) standing outside alone, without adult supervision, in the play yard. This poses an immediate risk to the health, safety, or personal rights of children in care.
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all staff members to include watching the following CCL videos:
https://ccld.childcarevideos.org/child-care-center-operators/supervising-children-in-child-care-centers/
https://ccld.childcarevideos.org/child-care-center-operators/childrens-personal-rights-in-child-care/
*Director agrees to provide a written statement of completion, using LIC 855 (Declaration Form), from all staff members. Declaration from all staff members to be sent to LPA, via email, by 02/16/2024, end of business day.

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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: Maureen Neal
LICENSING EVALUATOR NAME: Miriam Cohen
LICENSING EVALUATOR SIGNATURE:

DATE: 02/01/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/01/2024
LIC9099 (FAS) - (06/04)
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