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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 304270519
Report Date: 09/06/2024
Date Signed: 09/06/2024 11:31:15 AM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE COUNTY CC RO, 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
06/26/2024 and conducted by Evaluator Soo Jin Jung
PUBLIC
COMPLAINT CONTROL NUMBER: 06-CC-20240626132515
FACILITY NAME:MONTESSORI ON THE LAKE INFANT CENTERFACILITY NUMBER:
304270519
ADMINISTRATOR:EVEREST, JULIEFACILITY TYPE:
830
ADDRESS:24291 MUIRLANDS, SUITE 4TELEPHONE:
(949) 855-5630
CITY:LAKE FORESTSTATE: CAZIP CODE:
92630
CAPACITY:32CENSUS: 44DATE:
09/06/2024
UNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Director Julie EverestTIME COMPLETED:
10:30 AM
ALLEGATION(S):
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Lack of supervision resulted in child wandering away unattended
INVESTIGATION FINDINGS:
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On 9/6/2024, Licensing Program Analyst (LPA), Christine Jung conducted an unannounced visit to the facility to deliver findings for a complaint that was received at the Orange County Regional Child Care Licensing Office. LPA met with Director, Julie Everest, and explained the reason for the visit. LPA was led on a tour of the facility and observed a total of 11 children and 6 staff.

On 6/21/2024, the Orange County Regional Child Care Licensing Office received a complaint with the allegation listed above: Reporting Party (RP) alleged lack of supervision resulted in child wandering away unattended.

On 7/1/2024, LPA made an unannounced visit to the facility. LPA interviewed staff and conducted record reviews. Facility representative provided LPA video footage which showed child wandering away unattended. LPA reviewed the footage with Staff 2 (S2) who was present during the incident. S2 confirmed they did not see C1 exit the infant play yard gate and walk into another play yard without their supervision.
(Go to Page 2)
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Martha Malane
LICENSING EVALUATOR NAME: Soo Jin Jung
LICENSING EVALUATOR SIGNATURE:

DATE: 09/06/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/06/2024
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 06-CC-20240626132515
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE COUNTY CC RO, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
FACILITY NAME: MONTESSORI ON THE LAKE INFANT CENTER
FACILITY NUMBER: 304270519
VISIT DATE: 09/06/2024
NARRATIVE
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The Orange County Regional Child Care Licensing Office has investigated the complaint alleging lack of supervision resulted in child wandering away unattended. Based on information gathered from LPA’s interviews and record review, the preponderance of evidence standard has been met, therefore the allegation is substantiated. California Code of Regulations, Title 22, Division 12 & Chapter 1, Section 101229 Responsibility for Providing Care and Supervision; see LIC 9099D for Type A deficiency.

LPA Jung informed Director, Julie Everest, that this report dated 9/6/2024 documents 1 Type A citation. Type A citations shall be posted for 30 consecutive days as there is an immediate risk to the health, safety, or personal rights of children in care. Also, LPA informed the Director, Julie Everest, to provide a copy of this licensing report dated 9/6/2024 that documents any Type A citation to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification. In addition, the licensee shall immediately post upon receipt the Proof of Correction for 30 consecutive days. Failure to post Type A reports for 30 days will result in a Civil Penalty of $100.00.

Due to technical difficulties, LPA emailed the report to the director.

A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with the Director, Julie Everest.
SUPERVISORS NAME: Martha Malane
LICENSING EVALUATOR NAME: Soo Jin Jung
LICENSING EVALUATOR SIGNATURE:

DATE: 09/06/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/06/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 06-CC-20240626132515
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

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

FACILITY NAME: MONTESSORI ON THE LAKE INFANT CENTER
FACILITY NUMBER: 304270519
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/06/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
09/13/2024
Section Cited
CCR
101429(a)(1)
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101429(a)(1) Responsibility for Providing Care and Supervision: No child(ren) shall be left without the supervision of a teacher at any time,... Supervision shall include visual observation. This requirement was not met as evidenced by:
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Facility painted the gates different colors and reminded parents and staff to close all gates behind them. Facility posted signs on the gates as reminders to close the gates. LPA observed the corrections during visit.
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*This is an amended version of an original report dated 9/6/24.* licensee did not ensure visual supervision was provided at all times, which poses an immediate risk to the health, safety, and pBased on interviews and record reviews, the ersonal rights of the clients 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: Martha Malane
LICENSING EVALUATOR NAME: Soo Jin Jung
LICENSING EVALUATOR SIGNATURE:

DATE: 09/06/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/06/2024
LIC9099 (FAS) - (06/04)
Page: 3 of 3