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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 197495140
Report Date: 04/16/2024
Date Signed: 04/16/2024 11:01:09 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, 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
03/15/2024 and conducted by Evaluator Miriam Cohen
COMPLAINT CONTROL NUMBER: 30-CC-20240315122908
FACILITY NAME:PACIFIC COAST MONTESSORI ACADEMYFACILITY NUMBER:
197495140
ADMINISTRATOR:CHRISTINE ROMEROFACILITY TYPE:
850
ADDRESS:2342 PACIFIC COAST HIGHWAYTELEPHONE:
(424) 263-5362
CITY:LOMITASTATE: CAZIP CODE:
90717
CAPACITY:120CENSUS: 45DATE:
04/16/2024
UNANNOUNCEDTIME BEGAN:
10:34 AM
MET WITH:Eliana Carbajal, DirectorTIME COMPLETED:
10:35 AM
ALLEGATION(S):
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Staff did not provide care as necessary to meet day care child’s needs.
Staff left day care child in soiled clothing.
INVESTIGATION FINDINGS:
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On 04/16/2024 @ 9:30 AM, LPA Cohen conducted an unannounced visit for the purpose of delivering the findings against alleged complaint reported concerning the above preschool. Upon arrival, LPA Cohen observed 12 adults providing care for 45 children. LPA Cohen met with preschool director, Eliana Carbajal.
After conducting verbal interviews with staff members (written declarations obtained) and parents of children currently enrolled in the above preschool, and record reviews, 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.

The investigation regarding the above allegations has been completed. No deficiencies will be issued.
An exit interview was conducted, and the above items discussed with preschool director. A copy of this report was provided.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Maureen Neal
LICENSING EVALUATOR NAME: Miriam Cohen
LICENSING EVALUATOR SIGNATURE:

DATE: 04/16/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/16/2024
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 2
Control Number 30-CC-20240315122908
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: PACIFIC COAST MONTESSORI ACADEMY
FACILITY NUMBER: 197495140
VISIT DATE: 04/16/2024
NARRATIVE
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On 03/21/2024 @ 12:30 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 13 adults providing care for 42 children. LPA Cohen met with preschool director, Eliana Carbajal.
LPA acquired the following documentation:
*Children Roster with Emergency ID and parent contact information
*Written declaration from staff members
*ProCare daily Reports for diapering and meals and naps
LPA interviewed and obtained written declaration from staff members including preschool director, assistant director, and owner; however, 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: 04/16/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/16/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 2