198021233-7-28-2026-33-CC-BVON-DWNT4W-20260805142435

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198021233
Report Date: 07/28/2026
Date Signed: 07/28/2026 11:00:26 AM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

This is an official report of an unannounced visit/investigation of a complaint received in our office on
04/30/2026 and conducted by Evaluator Diana Ortiz

PUBLIC

COMPLAINT CONTROL NUMBER: 33-CC-20260430092519

FACILITY NAME:	AZUSA MONTESSORI ACADEMY		FACILITY NUMBER:	198021233
ADMINISTRATOR:	ZILI WANG		FACILITY TYPE:	850
ADDRESS:	325 S AZUSA AVENUE		TELEPHONE:	(909) 620-5100
CITY:	AZUSA	STATE: CA	ZIP CODE:	91702
CAPACITY:	46	CENSUS: 24	DATE:	07/28/2026
		UNANNOUNCED	TIME BEGAN:	08:30 AM
MET WITH:	Adriana Hermosillo, Site Supervisor		TIME COMPLETED:	11:15 AM

ALLEGATION(S):

1
2
3
4
5
6
7
8
9

Child sustained injury due lack of supervision

INVESTIGATION FINDINGS:

1
2
3
4
5
6
7
8
9
10
11
12
13

On 07/28/26 at 8:30am, Licensing Program Analyst (LPA) Diana Ortiz conducted an unannounced site inspection to deliver the findings regarding the above complaint allegation. LPA met with Assistant Program Director, Kit Del Rosario and Site Supervisor Adriana Hermosillo, who were informed of the purpose of the visit. LPA was guided on a tour of the facility, and a census was taken, during which 24 children and three (3) staff were observed present. Per site supervisor there are currently 27 children enrolled.

The allegation stated that child sustained injury due lack of supervision.

As part of the investigation, LPA interviewed the Site Supervisor, four (4) staff members, four (4) preschool children, and three (3) daycare parents. LPA obtained and reviewed facility records, including the Personnel Report, Facility Roster, Parent Handbook, staff timesheets for April 29 and 30, 2026, photographs related to the April 29, 2026 incident, and the associated Ouch Report.
Page 1 of 3

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Brandi VanOosten
LICENSING EVALUATOR NAME: Diana Ortiz
LICENSING EVALUATOR SIGNATURE:	DATE: 07/28/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/28/2026

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 33-CC-20260430092519

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: AZUSA MONTESSORI ACADEMY	FACILITY NUMBER: 198021233
	VISIT DATE: 07/28/2026

NARRATIVE

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32

LPA also reviewed video footage of the incident. According to the Program Director, copies of the footage could not be released without authorization from legal counsel. As a result, LPA reviewed the footage on the Site Supervisor's phone. Additionally, LPA conducted a random sample review of children's and staff files. LPA was unable to interview the Reporting Party.

The Reporting party (RP) stated that on 04/29/26, they were notified by the facility's site supervisor that another child had hit the RP's 4-year-old child (child #1, C#1) and was asked to pick C#1 up early. RP stated they took C#1 to urgent care, where a bruise was observed beneath the child's eye. The RP took photographs of the injury and was referred for further evaluation, including X-rays. Medical staff advised that the child remain home for a few days to allow the injury to heal.

Staff #1 (S#1) and Staff #2 (S#2) reported that they did not witness the incident but were present at the facility at the time the incident occurred. S#1 stated that Staff #3 (S#3) requested an ice pack after a child was struck in the face with a rubber stool by another child. S#1 responded, observed swelling around the injured child’s left eye, provided an ice pack, photographed the injury, and notified the parent by phone and text message, after which the child was picked up for medical evaluation. S#1 and S#2 reported that S#3 stated the incident occurred after the injured child took another child’s toy, resulting in the other child striking the injured child with the stool and attempting to strike the child again before S#3 intervened and removed the stool.

Staff #3 (S#3) reported that on 04/29/26, they were supervising five children on the playground when they observed one child take a toy from another child and run beneath the play structure. S#3 approached to intervene, they witnessed the other child strike the first child once in the stomach and then in the face with a plastic stool. S#3 stated that they immediately removed the stool, redirected the child, and observed bruising beneath the injured child's eye. An ice pack was applied, and S#1-S#2 responded to assist. S#3 stated that incident reports were completed for both children's parents and that both parents were informed of the incident.

Staff #4 (S#4) and Staff #5 (S#5) stated that neither staff member witnessed the incident, as both were inside supervising other children at the time. S#4-S#5 reported that S#3 was supervising approximately four to five children outside when the incident occurred.
Page 2 of 3

SUPERVISORS NAME: Brandi VanOosten
LICENSING EVALUATOR NAME: Diana Ortiz
LICENSING EVALUATOR SIGNATURE:	DATE: 07/28/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/28/2026

LIC9099 (FAS) - (06/04)

Page: 2 of 3

Control Number 33-CC-20260430092519

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: AZUSA MONTESSORI ACADEMY	FACILITY NUMBER: 198021233
	VISIT DATE: 07/28/2026

NARRATIVE

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32

Child #1 (C#1) reported that another child hit them with a green plastic stool. When asked why the other child hit them, C#1 stated they did not know. When asked which teacher was outside at the time of the incident, the child stated they did not know.

Child #2 (C#2) and Child #4 (C#4) reported that C#1 was struck with a stool by another child. Both children identified S#3 as the staff member who was supervising the children outside at the time of the incident and stated that S#3 intervened and stopped the other child.

Parents interviewed stated that they do not have any concerns regarding the facility or staff and reported satisfaction with the care provided.

During the course of the investigation, LPA reviewed staff timesheets for April 29 and 30, 2026, and video footage of the incident. The video footage from April 29, 2026, showed two preschool-aged children playing near the play structure. LPA observed one child pick up a step stool and strike the other child once in the stomach area and a second time in the facial area. At the time of the incident, a staff member was observed standing a few feet away from the children. The staff member then immediately approached the children, intervened, and escorted them to the classroom.

Based on interviews conducted, documentation reviewed, and LPA’s video footage observations, there was no indication or evidence to support the allegation that child sustained injury due lack of supervision. Based upon the evidence as presented above, the allegation has been determined to be UNSUBSTANTIATED. A finding of Unsubstantiated means that although the allegation may have happened or is valid, there is not a preponderance of evidence to prove alleged violation(s) did or did not occur, therefore at this time the above allegation is unsubstantiated.

A notice of site visit was given and must remain posted 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 Assistant Program Director, Kit Del Rosario and Site Supervisor Adriana Hermosillo.

Page 3 of 3

SUPERVISORS NAME: Brandi VanOosten
LICENSING EVALUATOR NAME: Diana Ortiz
LICENSING EVALUATOR SIGNATURE:	DATE: 07/28/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/28/2026

LIC9099 (FAS) - (06/04)

Page: 3 of 3