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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 304270588
Report Date: 02/15/2024
Date Signed: 02/15/2024 12:46:10 PM

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
12/18/2023 and conducted by Evaluator Anna Francesca Chan
PUBLIC
COMPLAINT CONTROL NUMBER: 06-CC-20231218123433
FACILITY NAME:IVYCREST MONTESSORI PRIVATE SCHOOLFACILITY NUMBER:
304270588
ADMINISTRATOR:TAKEDA, CLAIREFACILITY TYPE:
830
ADDRESS:2025 E. CHAPMAN AVENUETELEPHONE:
(714) 879-6091
CITY:FULLERTONSTATE: CAZIP CODE:
92831
CAPACITY:32CENSUS: 19DATE:
02/15/2024
UNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Director Aida KingTIME COMPLETED:
01:15 PM
ALLEGATION(S):
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Facility staff handled a child in a rough manner.
Facility staff forced a child to eat.
INVESTIGATION FINDINGS:
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On 2/15/2024, at 9:00am Licensing Program Analyst (LPA) Anna Chan conducted an unannounced Complaint investigation inspection. This is to deliver findings of the investigation initiated on 12/22/2023. Upon arrival, the LPA met with Director Aida King. LPA informed director of the purpose of visit. LPA was led on a walk through of the facility and a census was taken. LPA observed 10 staff and 19 infant children.

The Department received a complaint on 12/18/2023 alleging (1) Facility staff handled a child in a rough manner. (2) Facility staff forced a child to eat.

LPA interviewed Reporting Party (RP). The RP stated that they received a call from the Fullerton Police Department pertaining to an on-campus investigation they are performing involving RP’s child. Fullerton PD visited the facility and while on the phone with RP, responders were describing what they were seeing on the video footage. RP stated they want to hold the facility accountable for not reporting the incident to child representative.
Page 1 of 1

Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Martha Malane
LICENSING EVALUATOR NAME: Anna Francesca Chan
LICENSING EVALUATOR SIGNATURE:

DATE: 02/15/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/15/2024
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 6
Control Number 06-CC-20231218123433
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: IVYCREST MONTESSORI PRIVATE SCHOOL
FACILITY NUMBER: 304270588
VISIT DATE: 02/15/2024
NARRATIVE
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LPA interviewed six (6) staff members. Two (2) staff confirmed they saw the video footage of the incident but did not personally witness the staff handle a child in a rough manner or force feeding a child. The other four (4) staff stated they did not witness staff handle child in a rough manner or force feeding a child.

LPA obtained a Police Report and video footage from Fullerton Police Department. The Police report states that the Fullerton PD obtained a video of the incident from the facility. Per the Fullerton PD, the video indicated that staff’s arm was placed diagonally on child’s body while feeding. According to the police report, it is not child abuse and minimal force was used.

LPA interviewed parents and only 2 out of the 6 parents responded to the department’s call. Both parents are satisfied with the care that their children receive.

LPA reviewed the video footage of the incident. The video shows that staff 1 (S1) is restraining the child’s body and arms using S1’s right arm in order to force feed child. LPA observed this behavior happened more than one time and the child is crying and leaning back.

Based on the LPA’s observations from the video footage and interviews conducted, the preponderance of evidence standard has been met, therefore the above allegations are found to be SUBSTANTIATED. A substantiated finding means that the complaint is substantiated, and the allegations are valid because the preponderance of the evidence standard has been met. See LIC9099D for Type A deficiency cited.

Also, LPA informed the Director Aida King to provide a copy of this licensing report dated 02/15/2024 that documents any Type A citation(s) 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.

Exit interview was conducted with Director, Aida King. Notice of Site Visit was posted during the visit. Director 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. The Director was provided with 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. Appeals must be submitted in writing within 15 business days.

Director refused to sign licensing report

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SUPERVISORS NAME: Martha Malane
LICENSING EVALUATOR NAME: Anna Francesca Chan
LICENSING EVALUATOR SIGNATURE:

DATE: 02/15/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/15/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 6
Control Number 06-CC-20231218123433
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: IVYCREST MONTESSORI PRIVATE SCHOOL
FACILITY NUMBER: 304270588
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/15/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Request Denied
Type A
02/16/2024
Section Cited
CCR
101223(a)(3)
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Personal Rights (a) The licensee shall ensure that each child is accorded the following personal rights:.. (3) To be free from corporal or unusual punishment, infliction of pain... actions of a punitive nature including but not limited to: interference with functions of daily living including eating... The requirement is not met as evidence by:
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The director stated that the facility conducted a staff training about personal rights, supervision, napping, feeding and etc. A copy of the training was given to LPA
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A staff restrained a child’s body and arms by using right arm in order to force feed child.

This poses an immediate risk to the safety of 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: Martha Malane
LICENSING EVALUATOR NAME: Anna Francesca Chan
LICENSING EVALUATOR SIGNATURE:

DATE: 02/15/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/15/2024
LIC9099 (FAS) - (06/04)
Page: 3 of 6
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
12/18/2023 and conducted by Evaluator Anna Francesca Chan
PUBLIC
COMPLAINT CONTROL NUMBER: 06-CC-20231218123433

FACILITY NAME:IVYCREST MONTESSORI PRIVATE SCHOOLFACILITY NUMBER:
304270588
ADMINISTRATOR:TAKEDA, CLAIREFACILITY TYPE:
830
ADDRESS:2025 E. CHAPMAN AVENUETELEPHONE:
(714) 879-6091
CITY:FULLERTONSTATE: CAZIP CODE:
92831
CAPACITY:32CENSUS: 19DATE:
02/15/2024
UNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Director Aida KingTIME COMPLETED:
01:15 PM
ALLEGATION(S):
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 Facility staff did not properly report an incident to parents.
INVESTIGATION FINDINGS:
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On 2/15/2024, at 9:00am Licensing Program Analyst (LPA) Anna Chan conducted an unannounced Complaint investigation inspection. This is a continuation of the investigation initiated on 12/22/2023. Upon arrival, the LPA met with Director Aida King. LPA informed director of the purpose of visit. LPA was led on walk through of the facility by the staff and a census was taken. LPA observed 10 staff and 19 infants.

The Department received a complaint on 12/18/2023 alleging that facility staff did not properly report an incident to parents.

LPA interviewed Reporting Party (RP). RP stated they want to hold the facility accountable for not reporting the incident.

LPA interviewed staff, Staff 1 (S1) stated that the facility did not report the incident to the parents or licensing as the facility focused on the behavior of the staff in violation of their code of conduct.

Page 1 of 2
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Martha Malane
LICENSING EVALUATOR NAME: Anna Francesca Chan
LICENSING EVALUATOR SIGNATURE:

DATE: 02/15/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/15/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 4 of 6
Control Number 06-CC-20231218123433
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: IVYCREST MONTESSORI PRIVATE SCHOOL
FACILITY NUMBER: 304270588
VISIT DATE: 02/15/2024
NARRATIVE
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LPA interviewed parents and only 2 out of the 6 parents responded to the department’s call. Both parents are satisfied with the care that their children receive.

Based on the LPA’s record review and interviews conducted, the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED. A substantiated finding means that the complaint is substantiated, and the allegation is valid because the preponderance of the evidence standard has been met. See LIC9099D for Type B deficiency cited.

Exit interview was conducted with Director, Aida King. Notice of Site Visit was posted during the visit. Director 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. The Director was provided with 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.

Director refused to sign licensing report

page 2 of 2
SUPERVISORS NAME: Martha Malane
LICENSING EVALUATOR NAME: Anna Francesca Chan
LICENSING EVALUATOR SIGNATURE:

DATE: 02/15/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/15/2024
LIC9099 (FAS) - (06/04)
Page: 5 of 6
Control Number 06-CC-20231218123433
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: IVYCREST MONTESSORI PRIVATE SCHOOL
FACILITY NUMBER: 304270588
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/15/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Request Denied
Type B
03/08/2024
Section Cited
CCR
10121(f)
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Reporting Requirements
(f) The items specified in (d)(1)(A) through (H) above shall also be reported to the child's authorized representative.

This evidence was met by:
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The facility stated that a statement stating a meeting and communication with the preschool director Ms Bongcayao and school director Ms King on 9/14/23 and 9/15/23 respectively was conducted.
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Based on interview, there is no document showing that the child's representative were notified about the incident between the staff and the child during feeding.

This posses as a potential right to saftey of 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: Martha Malane
LICENSING EVALUATOR NAME: Anna Francesca Chan
LICENSING EVALUATOR SIGNATURE:

DATE: 02/15/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/15/2024
LIC9099 (FAS) - (06/04)
Page: 6 of 6