197750070-11-29-2023-58-CC-RNAO-CZMVGW-20240119152613

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197750070
Report Date: 11/29/2023
Date Signed: 11/29/2023 03:43:02 PM

Unsubstantiated

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
10/12/2023 and conducted by Evaluator Joe Katrdzhyan

PUBLIC

COMPLAINT CONTROL NUMBER: 58-CC-20231012124533

FACILITY NAME:	GRANADA HILLS MONTESSORI PRESCHOOL		FACILITY NUMBER:	197750070
ADMINISTRATOR:	VILLALOBOS, GLADYS		FACILITY TYPE:	850
ADDRESS:	11451 WOODLEY AVE		TELEPHONE:	(818) 360-7448
CITY:	GRANADA HILLS	STATE: CA	ZIP CODE:	91344
CAPACITY:	75	CENSUS: 57	DATE:	11/29/2023
		UNANNOUNCED	TIME BEGAN:	02:15 PM
MET WITH:	Staff / Noresha Jayasundara Director / Gladys Villalobos		TIME COMPLETED:	04:00 PM

ALLEGATION(S):

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Child sustained unexplained injury while in care.

INVESTIGATION FINDINGS:

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On 11/29/23, at 2:15PM, Licensing Program Analyst (LPA) Joe Katrdzhyan conducted an unannounced visit to this facility to deliver findings on the above-mentioned allegation of “Child sustained unexplained injury while in care”. Upon arrival, LPA met with Staff / Noresha Jayasundara and shortly after Director / Gladys Villalobos arrived and assisted with the visit. Ms. Villalobos guided LPA on a tour of the facility. There were 57 children with 8 staff observed present. LPA explained the purpose of today’s visit.

During the course of the investigation, interviews were conducted, pictures were obtained and a copy of the Children’s Roster was obtained and reviewed.

Per Reporting Party, on 10/11/23, Child 1 woke up from a nap with a cut over the left eye and staff did not know how it occurred.

(Please see LIC 9099C for additional information)

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Rita Ramos
LICENSING EVALUATOR NAME: Joe Katrdzhyan
LICENSING EVALUATOR SIGNATURE:	DATE: 11/29/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/29/2023

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

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Control Number 58-CC-20231012124533

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: GRANADA HILLS MONTESSORI PRESCHOOL	FACILITY NUMBER: 197750070
	VISIT DATE: 11/29/2023

NARRATIVE

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Pg. 2

During the interview with the Director, it was disclosed that on 10/11/23, at approximately 2:30PM - 2:40PM, Child 1 woke up from a nap and Staff 1 observed a cut on the left eye of Child 1. Staff 1 immediately notified the Director and at which time the Director notified the mother of Child 1. Per the Director, the cut on the left eye must have happened on the cot as Child 1 was observed lifting its head up and while putting the head down possibly hitting the left eye on the plastic part of the cot. Prior to taking a nap, Child 1 was observed to be fine with no injuries. Child 1 was picked up by the mother and taken to the E.R., where Child 1 received medical attention and released back to school on 10/12/23, with no restrictions. Child 1 returned to school on 10/12/23.

The statements obtained from staff were consistent and corroborated with the statement obtained from the Director. During the interview of Staff 1, Staff 1 disclosed that on 10/11/23, at approximately 2:30PM, Staff 1 observed Child 1 lift its head up and put it back down. Staff 1 thought Child 1 had a bad dream and went to check on Child 1 and at which time observed a cut on the left eye of Child 1. There was very little blood observed on the sheet covering the cot. The Director was notified and shortly after the mother arrived and took Child 1 to the E.R. Per Staff 1, they did not observe the actual incident but Staff 1 believes the cut on the left eye happened as a result of Child 1 hitting the eye on the plastic part of the cot, while putting its head down. Prior to taking a nap, the entire class, including Child 1 were sitting and listening to classical music and no injury was observed on Child 1. After the incident, Staff 1 questioned Child 1 to see how the injury happened and Child 1 pointed at the bed/cot. Child 1 returned to school the following day with no restrictions.

Parents interviewed did not present concerns and were pleased with the services and care being provided to their children.

During the interview of Child 1, it was disclosed that the injury to the left eye was as a result of Child 1 bumping its head on the bed/cot, during nap time.

Although Child 1 sustained an injury while in care, staff provided first aid and also contacted the parent of Child 1. The injury was not a result of neglect or lack of care/supervision on part of facility staff.

SUPERVISORS NAME: Rita Ramos
LICENSING EVALUATOR NAME: Joe Katrdzhyan
LICENSING EVALUATOR SIGNATURE:	DATE: 11/29/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/29/2023

LIC9099 (FAS) - (06/04)

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Control Number 58-CC-20231012124533

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: GRANADA HILLS MONTESSORI PRESCHOOL	FACILITY NUMBER: 197750070
	VISIT DATE: 11/29/2023

NARRATIVE

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Based on the investigation conducted, there is insufficient evidence to support the above-mentioned allegation to be true. Therefore, 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, therefore the allegation is Unsubstantiated.

The Notice of Site Visit was provided and 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 Gladys Villalobos and Appeals Rights provided.

SUPERVISORS NAME: Rita Ramos
LICENSING EVALUATOR NAME: Joe Katrdzhyan
LICENSING EVALUATOR SIGNATURE:	DATE: 11/29/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/29/2023

LIC9099 (FAS) - (06/04)

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