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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 300610669
Report Date: 10/12/2023
Date Signed: 10/12/2023 09:48:54 AM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
This is an official report of an unannounced visit/investigation of a complaint received in our office on
08/24/2023 and conducted by Evaluator Cindy Nguyen
PUBLIC
COMPLAINT CONTROL NUMBER: 06-CC-20230824161029
FACILITY NAME:IVYCREST MONTESSORI PRIVATE SCHOOLFACILITY NUMBER:
300610669
ADMINISTRATOR:AIDA KINGFACILITY TYPE:
850
ADDRESS:2025 E. CHAPMAN AVENUETELEPHONE:
(714) 879-6091
CITY:FULLERTONSTATE: CAZIP CODE:
92831
CAPACITY:214CENSUS: 107DATE:
10/12/2023
UNANNOUNCEDTIME BEGAN:
08:30 AM
MET WITH:Directors, Aida King & Dominique Bongcayao TIME COMPLETED:
10:30 AM
ALLEGATION(S):
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Facility staff handled child in a rough manner resulting in injury.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Cindy Nguyen conducted an unannounced complaint investigation. This is a continuation of the investigation initiated on 08/31/2023. Upon arrival LPA met with Aida King, Director who accompanied LPA on a tour of the facility. Census was taken as follows: 18 toddlers, 89 preschool children with 19 staff members. A review of staff criminal records indicates all facility staff or individuals who require caregiver background checks have received a criminal record clearance or exemption and a child abuse index clearance.

On 08/24/2023 a complaint was filed with the Department alleging that facility staff handled a child in a rough manner resulting in injury. During the investigation, LPA Nguyen conducted 2 physical plant inspections, interviewed 8 staff members, reviewed a child file, obtained parent and staff handbooks, classroom’s roster, and a copy of the children's roster.

Continued on 9099C

Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Patricia Magana
LICENSING EVALUATOR NAME: Cindy Nguyen
LICENSING EVALUATOR SIGNATURE:

DATE: 10/12/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/12/2023
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 06-CC-20230824161029
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
FACILITY NAME: IVYCREST MONTESSORI PRIVATE SCHOOL
FACILITY NUMBER: 300610669
VISIT DATE: 10/12/2023
NARRATIVE
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Page 9099C

Complainant alleged that a child was grabbed by a staff member, which left bruising to the child arms and armpits.

During the staff interviews, two out of the eight staff disclosed that they observed Staff #8 (S8) being a little rough with the Child #1 (C1) who had a hard day at school on that day. Staff #6 (S6) stated S6 observed S8 grabbed C1 by the arm to bring C1 back to C1's seat to finished C1 snack. It happened quick, and S6 believed S8 didn’t intend to hurt the C1. S6 don’t know if that may have left the marks, but it was the only incident S6 could recall. All 8 out of 8 staff interviewed denied violating children’s personal rights.

LPA Nguyen attempted to interview the children in care and C1, but none were qualified for the interview.

LPA contacted the C1’s parent (P1). P1 stated school was cooperative and showed the video where it appeared S8 grabbed C1 a little hard. P1 stated it appeared to be an accident. P1 wanted to document the incident so Fullerton Police Department was contacted. P1 stated C1 has returned to school.

LPA obtained Fullerton Police Report which indicated the closing of the case as inactive.

LPA reviewed physician note and it indicates that bruising that appears like fingerprints based on the appearance and pattern on the child upper arms.

Based on the information gathered from LPA's interviews with 8 staff members, one parent, and reviewing records of the facility, Fullerton Police Report, and the physician note, it has been determined that facility staff S8 handled child in a rough manner resulting in injury. The preponderance of evidence standard has been met; therefore, the above allegation is found to be SUBSTANTIATED. California Code of Regulations, Title 22 101223(a)(2) Personal Rights are being cited on the attached LIC9099D.

Exit interview was conducted with Directors, Aida King & Dominique Bongcayao. Notice of Site Visit was posted during the visit. Directors was informed that the notice of site visit must be posted for 30 consecutive days. Failure to post will result in civil penalties of $100. Director was provided a copy of their appeal rights (LIC 9058 01/16) and their signature on this form acknowledges receipt of these rights. First level appeals should be sent to the regional manager to the address listed above.
SUPERVISORS NAME: Patricia Magana
LICENSING EVALUATOR NAME: Cindy Nguyen
LICENSING EVALUATOR SIGNATURE:

DATE: 10/12/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/12/2023
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 06-CC-20230824161029
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME: IVYCREST MONTESSORI PRIVATE SCHOOL
FACILITY NUMBER: 300610669
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/12/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
10/13/2023
Section Cited
CCR
101223(a)(2)
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101223(a)(2) Personal Rights (a) The licensee shall ensure that each child is accorded the following personal rights: (2) To be accorded safe, healthful, and comfortable accommodations, furnishings, and equipment to meet his/her needs. This requirement was not met evidence by:
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Director stated she already had one on one meetings to refresh personal right and will also hold a all staff training on 10/21/23.
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Based on interviews conducted by LPA, it was determined that the facility handled child in a rough manner resulting in injury. This is a potential Health and Safety risk to the children 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: Patricia Magana
LICENSING EVALUATOR NAME: Cindy Nguyen
LICENSING EVALUATOR SIGNATURE:

DATE: 10/12/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/12/2023
LIC9099 (FAS) - (06/04)
Page: 3 of 3