304371140-4-17-2024-06-CC-JHAN-D4GSNS-20240419140158

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 304371140
Report Date: 04/17/2024
Date Signed: 04/17/2024 01:17:50 PM

Unsubstantiated

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
03/19/2024 and conducted by Evaluator Carmen Odom

PUBLIC

COMPLAINT CONTROL NUMBER: 06-CC-20240319085109

FACILITY NAME:	LA HABRA MONTESSORI PRESCHOOL		FACILITY NUMBER:	304371140
ADMINISTRATOR:	WEERAKON, MANOJA		FACILITY TYPE:	830
ADDRESS:	230 S IDAHO ST		TELEPHONE:	(562) 691-6450
CITY:	LA HABRA	STATE: CA	ZIP CODE:	90631
CAPACITY:	8	CENSUS: 5	DATE:	04/17/2024
		UNANNOUNCED	TIME BEGAN:	12:00 PM
MET WITH:	Manoja Weerakon - Director		TIME COMPLETED:	01:30 PM

ALLEGATION(S):

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Child sustained an unexplained injury while in care.
Staff did not ensure reporting requirements were followed.
Staff do not ensure adequate care and supervision is provided to children in care.

INVESTIGATION FINDINGS:

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Licensing Program Analysts (LPA) Odom conducted an unannounced complaint investigation. This is a continuation of the investigation initiated on 03/21/2024. Upon arrival LPA met with Director Manoja Weerakon, to deliver complaint findings. Director took LPA on a tour of the facility and census was taken. LPA observed a total of 5 infants and 1 staff, infants were napping. During the inspection it was determined the facility is operating within its licensed capacity and within compliance with staffing ratios.

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.

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Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Judy Hanson
LICENSING EVALUATOR NAME: Carmen Odom
LICENSING EVALUATOR SIGNATURE:	DATE: 04/17/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/17/2024

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 06-CC-20240319085109

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: LA HABRA MONTESSORI PRESCHOOL	FACILITY NUMBER: 304371140
	VISIT DATE: 04/17/2024

NARRATIVE

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The Department received a complaint on 03/19/2024 alleging 1) Child #1(C1) sustained an unexplained injury while in care, 2) Staff did not ensure reporting requirements were followed, 3) Staff do not ensure adequate care and supervision is provided to children in care. Reporting party (RP) disclosed they were concerned the staff are not properly supervising the children in care due to the multiple injuries C1 sustained while in care.

During the investigation LPA Odom interviewed the reporting party, and 3 staff members. LPA reviewed the children’s roster, personnel records, ouch reports, text messages, and pictures taken. LPA did not interview children; children had limited vocabulary did not qualify for interview.

During an interview on 03/27/2024, Staff #3 (S3) stated on 02/05/2024 Staff #1 (S1) notified S3 that C1 was bit by another child, in which, it left a bit mark on C1. S1 took a picture of the bite mark and sent it to S3. At 9:59am S3 sent the picture of C1’s bite mark along with a statement of the incident to RP. S3 addressed the incident with both children’s authorized representatives. S3 stated on 03/18/2024 they were on a vacation, and they left S1 all the children’s emergency contact information in case of an incident to communicate with the authorized representative. That evening RP called S3 and told S3 that they were going to report the incident to police department. S3 spoke with staff regarding C1’s injury. S1 told S3 that C1 was running outside on the playground, tripped and fell face forward, C1 had a bloody lip, S1 cleaned the wound, took a picture of the wound, and wrote the incident on C1’s daily report that was provided to RP at the end of the day. RP decided to remove C1 from care on 03/18/24, so S3 was not aware C1 received medical attention to report the incident to licensing. S3 stated staff are trained to give children activities to keep the infant busy.

LPA Odom interviewed 2 staff members on 03/21/2024 and 03/27/2024. S1 stated on 03/18/2024 the children went outside for outdoor play, S1 observed C1 running around when C1 fell on the synthetic grass face forward and hit their bottom lip. Staff #2 (S2) immediately cleaned the wound, placed an ice pack, gave C1 a hug to comfort child and S1 took a picture of the injury. S1 stated they wrote the incident on the daily report to give to RP at the end of the day.

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SUPERVISORS NAME: Judy Hanson
LICENSING EVALUATOR NAME: Carmen Odom
LICENSING EVALUATOR SIGNATURE:	DATE: 04/17/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/17/2024

LIC9099 (FAS) - (06/04)

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Control Number 06-CC-20240319085109

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: LA HABRA MONTESSORI PRESCHOOL	FACILITY NUMBER: 304371140
	VISIT DATE: 04/17/2024

NARRATIVE

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S1 stated they do recall the incident on 02/05/2024, staff observed when another child bit C1, staff separated the children, S1 took a picture of the injury and sent it to S3 because S3 will immediately send the picture along with a written incident report of the injury to parents. Staff #2 (S2) stated on 03/19/2024 they recall C1 was running on the synthetic grass when C1 fell and hit their bottom lip. S2 stated when they picked up C1 they observed C1’s lip was bleeding a little bit. S2 cleaned the wound, placed an ice pack on lip, but C1 cried for a moment but C1 was fine the rest of the day during meals times, nap time, C1 did not show signs of pain. Staff monitored the wound throughout the day and C1 did not complain. S2 stated S1 wrote the incident report. All the staff disclosed they do receive training on supervision.

Based on LPA’s facility inspection, observations, interviews conducted with reporting party, 3 staff and records reviewed it was determined there was insufficient evidence that Staff were not supervising C1 when child sustained the injuries. Although the allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegations are Unsubstantiated.

Exit interview was conducted with Director Manoja Weerakon. 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. 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: Judy Hanson
LICENSING EVALUATOR NAME: Carmen Odom
LICENSING EVALUATOR SIGNATURE:	DATE: 04/17/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/17/2024

LIC9099 (FAS) - (06/04)

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