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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 304371441
Report Date: 12/14/2022
Date Signed: 12/14/2022 11:52:45 AM

Substantiated


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
09/19/2022 and conducted by Evaluator Stacy Torrence
PUBLIC
COMPLAINT CONTROL NUMBER: 06-CC-20220919121249
FACILITY NAME:ACACIA MONTESSORI SCHOOLFACILITY NUMBER:
304371441
ADMINISTRATOR:CHUNG, SUNFACILITY TYPE:
850
ADDRESS:1701 EAST CHAPMAN AVENUETELEPHONE:
(336) 870-2176
CITY:FULLERTONSTATE: CAZIP CODE:
92831
CAPACITY:54CENSUS: 23DATE:
12/14/2022
UNANNOUNCEDTIME BEGAN:
10:30 AM
MET WITH:Sun Chung, LicenseeTIME COMPLETED:
11:50 AM
ALLEGATION(S):
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Staff handled daycare child in a rough manner
Staff did not keep indoor passageway free from obstruction
Staff yells at children in care
INVESTIGATION FINDINGS:
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On 12/14/2022, Licensing Program Analyst (LPA) Stacy Torrence conducted an in-person inspection to deliver the findings regarding the above complaint allegations. LPA Torrence met with Licensee Sun Chung. There was a total of 23 preschool children with three staff supervising. A review of staff criminal clearance 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.
On 09/19/2022, Licensing office received a complaint alleging the following: Staff handled daycare child in a rough manner, staff did not keep indoor passageway free from obstruction, and staff yell at day care children.

Reporting Party (RP) stated Staff 1(S1) dragged a child out of a jumper house. RP stated S1 block the exit door in the preschool classroom. RP stated S1 also talk to the children in an inappropriate tone.

Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Thuy Ho
LICENSING EVALUATOR NAME: Stacy Torrence
LICENSING EVALUATOR SIGNATURE:

DATE: 12/14/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/14/2022
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 5
Control Number 06-CC-20220919121249
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: ACACIA MONTESSORI SCHOOL
FACILITY NUMBER: 304371441
VISIT DATE: 12/14/2022
NARRATIVE
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Allegation: staff handled daycare child in a rough manner
During the course of the investigation, LPA Torrence interviewed seven staff members. Staff 6 (S6) stated witnessing S1 and Staff 4 (S4) grabbing the children when they are mad. Staff 7 (S7) stated looking out the infant’s classroom window, which faces the preschool’s playground, and seeing a mad expression on S1’s face, then witnessing S1 go inside the bouncer, grab the child’s arm and leg and dragged the child out of the bouncer. Licensee stated S1 was asked what happened and was told by S1 the child did not want to come out of the bouncer and was having trouble taking the child out, so S1 pulled the child out of the bouncer by child’s arm.

Allegation: staff did not keep indoor passageway free from obstruction
License stated staff was cleaning the classroom and children’s kitchen furniture was blocking the bathroom and one of the infant’s classroom door leading to the large classroom. Licensee stated S1 blocked the door and was asked to unblock the door and it was moved right away. Staff 2 (S2), Staff 3(S3), Staff 5(S5), S6, and S7 have witnessed an object blocking the door, leading from the infant’s classroom to the preschool classroom.

Allegation: staff yell at children in care
Licensee stated S1 does sometimes use inappropriate tone and communication with the children when S1 is feeling overwhelmed. S3, S5 and S7 stated witnessing S1, S2, and S4 yelling at the children. S6 stated witnessing S1 and S4 inappropriately talking to the children.

During the course of the investigation, LPA Torrence interviewed four qualified children. Child 1 (C1) stated S1 yell at C1 when C1 do not listen. Child 4 stated S1 yell at the kids for not listening.

LPA Torrence contacted eleven parents and was able to interview two parents; which had no issues or concerns.

Based on LPA’s interviews the preponderance of evidence standard has been met, therefore the above allegations are found to be SUBSTANTIATED. California Code of Regulations, Title 22, Division 12 & Chapter 1, 101223(a)(3) Personal Rights, 101238(a) Building and Grounds, and 101223(a)(3) Personal Rights are being cited on the attached LIC9099D.
SUPERVISORS NAME: Thuy Ho
LICENSING EVALUATOR NAME: Stacy Torrence
LICENSING EVALUATOR SIGNATURE:

DATE: 12/14/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/14/2022
LIC9099 (FAS) - (06/04)
Page: 4 of 5
Control Number 06-CC-20220919121249
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: ACACIA MONTESSORI SCHOOL
FACILITY NUMBER: 304371441
VISIT DATE: 12/14/2022
NARRATIVE
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End of Report

If the facility receives a Type A violation, the licensee shall post and provide copies of the report to parents/guardians of the children in care at the facility by the next business day and shall provide to the parents/guardians of children newly enrolled at the facility during the next 12 months. In addition, the licensee shall immediately post upon receipt the Proof of Correction for 30 consecutive days and provide a copy to current and enrolling parents. The licensee is to keep Acknowledgement Receipt (LIC 9224) signed by parents in each child’s file. In addition, the licensee shall immediately post upon receipt the Proof of Correction for 30 consecutive days.

Exit interview was conducted. The Notice of Site Visit was posted. Appeal Rights was explained. A copy of appeal rights (LIC 9058 1/16) will be provided through email and their signatures on this form acknowledges receipt of these rights. First level appeal is to Regional Manager, address is above on the report.
SUPERVISORS NAME: Thuy Ho
LICENSING EVALUATOR NAME: Stacy Torrence
LICENSING EVALUATOR SIGNATURE:

DATE: 12/14/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/14/2022
LIC9099 (FAS) - (06/04)
Page: 5 of 5
Control Number 06-CC-20220919121249
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: ACACIA MONTESSORI SCHOOL
FACILITY NUMBER: 304371441
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/14/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
12/15/2022
Section Cited
CCR
101223(a)(3)
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101223(a)(3) 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, humiliation…..
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Per licensee, will enrolled preschool teachers in classes on how to handle children's challenging. Per licensee, will have a staff meeting/training on Personal Rights with staff and submit agenda and staff signatures who attended.
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This requirement is not met as evidence by: Based on LPA’s interviews, it was discovered S6 witnessed S1 and S4 grabbing the children. S7 witnessed S1 grabbing child’s arm and leg and dragging child out of the bouncer.
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 During today's visit, licensee presented LPA with a Employee Warning Notice for Personal Rights violations for S1.
Type A
12/15/2022
Section Cited
CCR
101223(a)(3)
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101223(a)(3) 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, humiliation…..
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Per licensee, will enrolled preschool teachers in classes on how to handle children's challenging. Per licensee, will have a staff meeting/training on Personal Rights with staff and submit agenda and staff signatures who attended.
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This requirement is not met as evidence by: Based on LPA’s interviews, Licensee stated S1 sometimes use inappropriate tone and communication with the children. S3, S5, S6, and S7 stated witnessing S1, S2, and S4 yelling at the children.
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 During today's visit, licensee presented LPA with a Employee Warning Notice for Personal Rights violations for S1.
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: Thuy Ho
LICENSING EVALUATOR NAME: Stacy Torrence
LICENSING EVALUATOR SIGNATURE:

DATE: 12/14/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/14/2022
LIC9099 (FAS) - (06/04)
Page: 3 of 5
Control Number 06-CC-20220919121249
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: ACACIA MONTESSORI SCHOOL
FACILITY NUMBER: 304371441
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/14/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
12/16/2022
Section Cited
CCR
101238(c)
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101238(c) Building and Grounds. (c) All outdoor and indoor passageways……. shall be kept free of obstruction.

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Per licensee, will have meeting with staff regarding no blocking passageways at any time. Per licensee, will submit copy of agenda with staff signature of attendance.
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This requirement is not met as evidence by: Based on LPA’s interviews, Licensee stated S1 blocked the door. S2, S3, S5, S6, and S7 have witnessed an object blocking the door, leading from the infant’s classroom to the preschool classroom.
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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: Thuy Ho
LICENSING EVALUATOR NAME: Stacy Torrence
LICENSING EVALUATOR SIGNATURE:

DATE: 12/14/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/14/2022
LIC9099 (FAS) - (06/04)
Page: 2 of 5