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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 304270699
Report Date: 10/27/2023
Date Signed: 10/27/2023 02:40:00 PM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE CO CHILD CARE, 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
09/25/2023 and conducted by Evaluator Giselle Lucero
PUBLIC
COMPLAINT CONTROL NUMBER: 06-CC-20230925120610
FACILITY NAME:CYPRESS MONTESSORI ACADEMYFACILITY NUMBER:
304270699
ADMINISTRATOR:DAVIS, DANAFACILITY TYPE:
850
ADDRESS:8622 LA SALLETELEPHONE:
(714) 826-0800
CITY:CYPRESSSTATE: CAZIP CODE:
90630
CAPACITY:33CENSUS: 20DATE:
10/27/2023
UNANNOUNCEDTIME BEGAN:
01:00 PM
MET WITH:Director Rebecca RuizTIME COMPLETED:
02:40 PM
ALLEGATION(S):
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Staff are not properly supervising day care children.
Facility gate is in disrepair.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Giselle Lucero conducted an unannounced complaint inspection to deliver the findings for the above allegations. This is a continuation of the investigation initiated on 10/02/2023. LPA met with Director Rebecca Ruiz. Director guided LPA on a tour of the facility. At 1:00 PM LPA observed a total of 20 preschool children with 3 staff.

A review of staff records on this date indicated that all facility staff or other individuals who required caregiver background checks have received criminal record and child abuse index clearances or exemptions.

The department received a complaint on 09/25/2023 alleging (1) Facility gate is in disrepair and (2) Staff are not properly supervising day care children. Reporting Party (RP) stated when RP went to pick up RP’s child, RP observed the facility entrance gate was broken and was not closing.

(continue to page 2)
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Judy Hanson
LICENSING EVALUATOR NAME: Giselle Lucero
LICENSING EVALUATOR SIGNATURE:

DATE: 10/27/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/27/2023
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 6
Control Number 06-CC-20230925120610
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE CO CHILD CARE, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
FACILITY NAME: CYPRESS MONTESSORI ACADEMY
FACILITY NUMBER: 304270699
VISIT DATE: 10/27/2023
NARRATIVE
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(page 2)
RP also disclosed observing a staff not properly supervising children on the playground by allowing the children to use the playground equipment incorrectly, children were observed walking up the slide.

During the investigation LPA Lucero interviewed 4 staff members, 5 parents, conducted a facility inspection, and reviewed the children’s roster.

During the investigation on 10/02/2023, LPA Lucero interviewed 4 staff. Staff #1 (S1) stated since the beginning of employment, they have been unaware of issues with the facility entrance gate, the gate is closed at all times and staff make sure of it. S1 disclosed staff are stationed at the corners of the playground and feels the supervision on the playground is good. Staff #2 (S2) stated there is no issue with the facility entrance gate, the only changes to the gate was the gate code. S2 disclosed staff are always watching the children on the playground and ensure children are not fighting with each other. Staff #3 (S3) stated there have been no issues with the gate. S3 disclosed the supervision on the playground is good and especially when children are near the swings. Staff #4 (S4) disclosed there was a slight issue with the gate not latching but was fixed and is now working properly. S4 stated the gate took some time to get repaired. S4 also disclosed with the change in staff, S4 noticed the children were walking up the slides. S4 stated no children have been hurt. Staff were reminded to give children reminders that they have to go up the stairs and down the slide.

On 10/02/2023, LPA Lucero inspected the facility entrance gate that is located between the children’s playground and facility parking lot and observed gate latching and in good repair.

On 10/23/2023 LPA attempted to interview 7 parents, however only 5 parents were available for interview. All of the parents interviewed are satisfied with the childcare facility and did not have any concerns.

Based on LPAs facility inspection, interviews conducted with 4 staff, 5 parents, it has been determined (1) Facility gate is in disrepair and (2) Staff are not properly supervising day care children. Therefore, the preponderance of evidence standard has been met, therefore the above allegations are found to be Substantiated. California Code of Regulations, Title 22, 101229 (a) Responsibility for Providing Care and Supervision and 101238(a) Buildings and Grounds are being cited on the attached LIC 9099D.
(continue to page 3)
SUPERVISORS NAME: Judy Hanson
LICENSING EVALUATOR NAME: Giselle Lucero
LICENSING EVALUATOR SIGNATURE:

DATE: 10/27/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/27/2023
LIC9099 (FAS) - (06/04)
Page: 2 of 6
Control Number 06-CC-20230925120610
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE CO CHILD CARE, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
FACILITY NAME: CYPRESS MONTESSORI ACADEMY
FACILITY NUMBER: 304270699
VISIT DATE: 10/27/2023
NARRATIVE
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(page 3)
Exit interview conducted and report was reviewed with the Director Rebecca Ruiz. A notice of site visit was given and must remain posted for 30 days.

Appeal Rights were explained. The Licensee was provided a copy of appeal rights (LIC 9058 01/16) and their signature on this form acknowledges receipt of these rights. All appeals must be in writing and received by the Regional Office within 15 business days. First level appeals should be sent to the regional manager to the address listed above.


End of Report.
SUPERVISORS NAME: Judy Hanson
LICENSING EVALUATOR NAME: Giselle Lucero
LICENSING EVALUATOR SIGNATURE:

DATE: 10/27/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/27/2023
LIC9099 (FAS) - (06/04)
Page: 3 of 6
Control Number 06-CC-20230925120610
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

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

FACILITY NAME: CYPRESS MONTESSORI ACADEMY
FACILITY NUMBER: 304270699
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/27/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
10/27/2023
Section Cited
CCR
101229(a)
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101229 Responsibility for Providing Care and Supervision (a)The licensee shall provide care and supervision as necessary to meet the children's needs. This requirement is not met as evidence by:
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Director stated a staff meeting was held on 10/05/2023 to go over classroom management. Director provided a copy of sign ins with staff in attendance of meeting.
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Based on interviews conducted. It has been determined that staff were not supervising children on the playground by allowing children to walk up the slide. This poses potential Health and Safety risk to children in care.
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LPA will email the Director with link to the website to CCLD video on Supervision to provide to staff.
Type B
10/27/2023
Section Cited
CCR
101238(a)
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101238 Buildings and Grounds (a) the child care center shall be clean, safe, sanitary and in good repair at all times to ensure the safety and well-being of children, employees, and visitors. This requirement is not met as evidence by:
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LPA observed facility entrance gate in good repair during visit. Director stated she will ensure facility gate is always in good repair.
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Based on interviews conducted. It has been determined that the facility gate that is located between the children’s playground and the facility parking lot was in disrepair. This poses potential Health and Safety risk to 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: Judy Hanson
LICENSING EVALUATOR NAME: Giselle Lucero
LICENSING EVALUATOR SIGNATURE:

DATE: 10/27/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/27/2023
LIC9099 (FAS) - (06/04)
Page: 4 of 6
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE CO CHILD CARE, 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
09/25/2023 and conducted by Evaluator Giselle Lucero
COMPLAINT CONTROL NUMBER: 06-CC-20230925120610

FACILITY NAME:CYPRESS MONTESSORI ACADEMYFACILITY NUMBER:
304270699
ADMINISTRATOR:DAVIS, DANAFACILITY TYPE:
850
ADDRESS:8622 LA SALLETELEPHONE:
(714) 826-0800
CITY:CYPRESSSTATE: CAZIP CODE:
90630
CAPACITY:33CENSUS: 20DATE:
10/27/2023
UNANNOUNCEDTIME BEGAN:
01:00 PM
MET WITH:Director Rebecca RuizTIME COMPLETED:
02:40 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Staff are not effectively communicating with day care children's parents
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analyst (LPA) Giselle Lucero conducted an unannounced complaint inspection to deliver the findings for the above allegation. This is a continuation of the investigation initiated on 10/02/2023. Upon arrival LPA met with Director Rebecca Ruiz. Director guided LPA on a tour of the facility. At 1:00 PM LPA observed a total of 20 preschool children with 3 staff.

A review of staff records on this date indicated that all facility staff or other individuals who required caregiver background checks have received criminal record and child abuse index clearances or exemptions.

The department received a complaint on 09/25/2023 alleging staff are not effectively communicating with day care children's parents. Reporting Party (RP) disclosed the facility had a COVID-19 outbreak and parents were not notified regarding the outbreak.
(continue to page 2)
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Judy Hanson
LICENSING EVALUATOR NAME: Giselle Lucero
LICENSING EVALUATOR SIGNATURE:

DATE: 10/27/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/27/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 5 of 6
Control Number 06-CC-20230925120610
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE CO CHILD CARE, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
FACILITY NAME: CYPRESS MONTESSORI ACADEMY
FACILITY NUMBER: 304270699
VISIT DATE: 10/27/2023
NARRATIVE
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(page 2)
During the investigation LPA Lucero interviewed 4 staff members, 5 parents and reviewed the children’s roster.

During the investigation on 10/02/2023, LPA Lucero interviewed 4 staff. 4 out of 4 staff interviewed stated they are unaware of any COVID-19 exposures that occurred in the facility. The Department didn’t receive any notice from the facility about COVID-19 as is required.

On 10/23/2023 LPA attempted to interview 7 parents, however only 5 parents were available for interview. All of the parents interviewed are satisfied with the childcare facility and did not have any concerns.

Based on LPAs interviews conducted with 4 staff, 5 parents, it has been determined there was insufficient evidence that staff are not effectively communicating with day care children's parents. 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.

Exit interview conducted and report was reviewed with the Director Rebecca Ruiz. A notice of site visit was given and must remain posted for 30 days.

Appeal Rights were explained. The Licensee was provided a copy of appeal rights (LIC 9058 01/16) and their signature on this form acknowledges receipt of these rights. All appeals must be in writing and received by the Regional Office within 15 business days. First level appeals should be sent to the regional manager to the address listed above.

End of Report.
SUPERVISORS NAME: Judy Hanson
LICENSING EVALUATOR NAME: Giselle Lucero
LICENSING EVALUATOR SIGNATURE:

DATE: 10/27/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/27/2023
LIC9099 (FAS) - (06/04)
Page: 6 of 6