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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 364841683
Report Date: 11/25/2025
Date Signed: 11/25/2025 04:30:27 PM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVERSIDE CC RO, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501
This is an official report of an unannounced visit/investigation of a complaint received in our office on
11/21/2025 and conducted by Evaluator Samuel Lopez
PUBLIC
COMPLAINT CONTROL NUMBER: 09-CC-20251121115015
FACILITY NAME:MONTESSORI SCHOOL OF CHINO HILLSFACILITY NUMBER:
364841683
ADMINISTRATOR:TONI ESPINOFACILITY TYPE:
850
ADDRESS:14635 PIPELINE AVENUETELEPHONE:
(909) 393-1982
CITY:CHINOSTATE: CAZIP CODE:
91710
CAPACITY:124CENSUS: 41DATE:
11/25/2025
UNANNOUNCEDTIME BEGAN:
08:09 AM
MET WITH:Keshini WijegoonaratnaTIME COMPLETED:
05:00 PM
ALLEGATION(S):
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Physical Plant - Staff do not keep the playground safe for children in care
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Samuel Lopez arrived at the facility to conduct an inspection regarding a complaint received concerning the above allegation. LPA entered the facility behind a parent due to not having access to a code to enter. LPA was met by staff and then LPA requested to speak with the Director and/or licensee but, neither was available. Minutes later, Keshini Wijegoonaratna arrived and stated that they were representing the licensee. LPA informed Keshini the purpose of the visit further discussed the complaint/allegations. Facility was toured and a census was taken. Interviews were conducted and facility documentation was obtained.

The following was alleged: a child fell down on the playground causing injury to there waistline. This was a result of the uneven padding/rubber tiles of the playground. Children continue to play outside knowing the playground needs to be fixed.

Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Aaron Ross
LICENSING EVALUATOR NAME: Samuel Lopez
LICENSING EVALUATOR SIGNATURE:

DATE: 11/25/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/25/2025
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 5
Control Number 09-CC-20251121115015
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVERSIDE CC RO, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501
FACILITY NAME: MONTESSORI SCHOOL OF CHINO HILLS
FACILITY NUMBER: 364841683
VISIT DATE: 11/25/2025
NARRATIVE
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The Licensing Program Analyst (LPA) Samuel Lopez investigated the above allegation and gathered the following information: A child was playing outside, running on the playground, tripped on the play structure flooring, and fell to the ground. The child suffered a gash on the right side of their waist line. Upon touring the playground and the area where the incident occurred, LPA observed several rubber tiles, which are used to cover partial area of the playground and underneath the play structures, were protruding and/or lifted on the corners. The observation made of the numerous tiles in this state constitute a tripping hazard for children at play. During the walk through of the playground, by the LPA, a child was observed tripping over one of the many protruding tiles however, the child did not fall. Additional information obtained during the visit and investigation was that there have been at least 7 other tripping incidents, which also involve staff, within the last month, this is all due to the rubber tiles/flooring of the playgrounds.

Based on LPA interviews conducted, documentation/reports obtained, and observations made during this visit, the preponderance of evidence standard has been met, therefore the above allegation is found to be Substantiated.

See LIC9099-D for cited deficiency.

A notice of site visit was given and must remain posted on, or immediately adjacent to, the interior side of the main door for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

Exit interview conducted and report was reviewed with the licensee representative Keshini Wijegoonaratna.
SUPERVISORS NAME: Aaron Ross
LICENSING EVALUATOR NAME: Samuel Lopez
LICENSING EVALUATOR SIGNATURE:

DATE: 11/25/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/25/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 5
Control Number 09-CC-20251121115015
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVERSIDE CC RO, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501

FACILITY NAME: MONTESSORI SCHOOL OF CHINO HILLS
FACILITY NUMBER: 364841683
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/25/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
12/05/2025
Section Cited
CCR
101238.2(d)(1)
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Outdoor Activity Space: (d)The surface of the outdoor activity space shall be maintained (1)In a safe condition for the activities planned. This requirement is not met as evidenced by observation of several rubber tiles on the playground floor that are protruding/lifted from the ground and having
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Licensee representative agrees to submit a two part written plan that will address the immediate steps that will be taken to assure the health and safety of children when at play outside. The second part will address the plan for permanent repairs to assure compliance going forward.
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children tripped as result. This poses/posed a potential health, safety or personal rights risk to persons in care.
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Plan is to be submitted to the Riverside Child Care Regional Office by 12/5/2025.
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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: Aaron Ross
LICENSING EVALUATOR NAME: Samuel Lopez
LICENSING EVALUATOR SIGNATURE:

DATE: 11/25/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/25/2025
LIC9099 (FAS) - (06/04)
Page: 5 of 5