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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 304371247
Report Date: 01/10/2025
Date Signed: 01/10/2025 10:44:08 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
01/09/2025 and conducted by Evaluator Soo Jin Jung
PUBLIC
COMPLAINT CONTROL NUMBER: 06-CC-20250109113635
FACILITY NAME:MILESTONES MONTESSORI OF LAKE FORESTFACILITY NUMBER:
304371247
ADMINISTRATOR:PATOPOFF, JAMIEFACILITY TYPE:
850
ADDRESS:23222 LAKE CENTER DRIVETELEPHONE:
(949) 830-9999
CITY:LAKE FORESTSTATE: CAZIP CODE:
92630
CAPACITY:189CENSUS: 41DATE:
01/10/2025
UNANNOUNCEDTIME BEGAN:
08:45 AM
MET WITH:Director Jamie PatopoffTIME COMPLETED:
11:00 AM
ALLEGATION(S):
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Staff did not properly report an incident involving a daycare child
INVESTIGATION FINDINGS:
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On 1/10/2025, Licensing Program Analyst (LPA), Christine Jung, conducted an unannounced initial complaint investigation and delivered findings for the above allegation. At 8:45AM, LPA met with Director, Jamie Patopoff, who guided LPA on a tour of the facility. Census was taken and observed were five (5) staff and 41 preschoolers.

On 1/9/2025, the Orange County Regional Child Care Licensing Office received a complaint with one allegation listed above: Reporting Party (RP) alleged that staff did not properly report an incident involving a daycare child.

On 1/10/2025, LPA made an unannounced visit to the facility to investigate the above allegation. LPA interviewed staff, conducted record reviews, and obtained documents pertinent to the investigation which were provided by the Director.
(Go to Page 2)
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Nguyen K Tran
LICENSING EVALUATOR NAME: Soo Jin Jung
LICENSING EVALUATOR SIGNATURE:

DATE: 01/10/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/10/2025
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-20250109113635
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: MILESTONES MONTESSORI OF LAKE FOREST
FACILITY NUMBER: 304371247
VISIT DATE: 01/10/2025
NARRATIVE
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(Page 2)

During investigation, LPA interviewed three (3) staff and four (4) parents. Facility confirmed that an incident involving a daycare child was not reported to the Department as required by Title 22 Reporting Requirements.
LPA could not interview children due to their age and not being developmentally qualified for interview. Parents interviewed did not provide any concerns regarding the allegation.

The Orange County Regional Child Care Licensing Office has investigated the complaint alleging staff did not properly report an incident involving a daycare child. Based on information gathered from LPA’s interviews and record reviews, the preponderance of evidence standard has been met, therefore the allegation is substantiated. California Code of Regulations, Title 22, Division 12 & Chapter 1, Section 101212(d)(1)(B) Reporting Requirements is being cited; see LIC 9099D.

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

Exit interview conducted and report was reviewed with the Director, Jamie Patopoff.

End of report.
SUPERVISORS NAME: Nguyen K Tran
LICENSING EVALUATOR NAME: Soo Jin Jung
LICENSING EVALUATOR SIGNATURE:

DATE: 01/10/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/10/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 06-CC-20250109113635
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: MILESTONES MONTESSORI OF LAKE FOREST
FACILITY NUMBER: 304371247
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/10/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
01/17/2025
Section Cited
CCR
101212(d)(1)(B)
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101212(d)(1)(B) Reporting Requirements: Any injury to any child that requires medical treatment. This requirement was not met as evidenced by:
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Director stated that facility will report all incidents which need medical attention to the Department going forward regardless of severity. Director will submit a statement detailing their incident policy and reporting procedures to the department to LPA via email by due date.
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Based on interviews and record reviews, the licensee did not comply with the section cited above in that, facility did not report to the Department an injury which required medical attention, which poses a potential health, safety or personal rights risk to persons 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: Nguyen K Tran
LICENSING EVALUATOR NAME: Soo Jin Jung
LICENSING EVALUATOR SIGNATURE:

DATE: 01/10/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/10/2025
LIC9099 (FAS) - (06/04)
Page: 3 of 3