304270541-7-16-2026-06-CC-THOO-DW7LJ9-20260721084733

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 304270541
Report Date: 07/16/2026
Date Signed: 07/16/2026 11:46:50 AM

Unsubstantiated

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
04/24/2026 and conducted by Evaluator Susan Deschampe

COMPLAINT CONTROL NUMBER: 06-CC-20260424142031

FACILITY NAME:	BACK BAY MONTESSORI		FACILITY NUMBER:	304270541
ADMINISTRATOR:	PRIYA EDIRIWIRA		FACILITY TYPE:	850
ADDRESS:	398 UNIVERSITY DRIVE		TELEPHONE:	(949) 548-3771
CITY:	COSTA MESA	STATE: CA	ZIP CODE:	92627
CAPACITY:	67	CENSUS: 41	DATE:	07/16/2026
		UNANNOUNCED	TIME BEGAN:	09:32 AM
MET WITH:	Facility Representative, Priyangani Ediriwira		TIME COMPLETED:	11:30 AM

ALLEGATION(S):

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Staff handled children in an inappropriate manner.

INVESTIGATION FINDINGS:

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On 07/16/2026, Licensing Program Analyst (LPA) Deschampe conducted an unannounced follow up complaint investigation, which was initiated on 05/01/2026, for the purpose of delivering findings for the above allegation. LPA arrived at the facility at 9:32AM and was met by the facility representative, Priyangani Ediriwira who provided access to the facility. The total enrollment is 58 children. Due to varying schedules, the census taken at the time of the visit was 41 children and 7 staff present.

A review of staff criminal record clearances was conducted on 07/16/2026. All facility staff and individuals requiring caregiver background checks were confirmed to have criminal record and child abuse index clearances or approved exemptions.

On 04/24/2026, the Orange County Regional Office (OCRO) received a complaint alleging that Staff 1 (S1) handled Child 1 (C1) in an inappropriate manner during a diaper change. Reporting Party (RP) stated they heard a child screaming from outside classroom 1 and, upon entering, observed S1

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Thuy Ho
LICENSING EVALUATOR NAME: Susan Deschampe
LICENSING EVALUATOR SIGNATURE:	DATE: 07/16/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/16/2026

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-20260424142031

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: BACK BAY MONTESSORI	FACILITY NUMBER: 304270541
	VISIT DATE: 07/16/2026

NARRATIVE

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Page 2 (Deliver Findings)

physically holding C1 down on the changing pad while attempting to change C1’s diaper.

During the investigation, LPA interviewed six (6) staff members, reviewed facility records (Personnel Report LIC 500, School Roster, Progress Report for C1, Parent Handbook, Staff Timesheets, Parent/Authorized Representative Sign In/Out), and conducted observations on 05/01/2026 and 05/26/2026. LPA attempted interviews with children; however, the children did not meet criteria under the required Ten Step Investigative Interview process. LPA contacted five (5) parents/authorized representatives, and four (4) responded.

Staff interviewed denied handling any child in an inappropriate manner. Three (3) staff reported that C1’s diaper changes were typically conducted while C1 was standing, while C1 resisted getting their diaper changed. One staff reported C1’s diaper was changed in a supine position. These statements were inconsistent and did not provide corroboration to support the allegation. LPA did not observe injuries, marks, or behavioral indicators consistent with inappropriate handling. Record review did not reveal documentation indicating that staff engaged in improper actions.

LPA interviewed S1, who stated they have never held a child down and do not routinely conduct diaper changes. S1 reported only performing diaper changes when no other staff are available. S1 stated they did not change C1’s diaper. S1 reported witnessing an attempted diaper change conducted by Staff 5 (S5), during which C1 was kicking and resisting. S1 stated S5 appeared reluctant to continue to change C1’s diaper due to being kicked.

LPA interviewed S5, who did not recall being kicked. S5 stated they discontinued diaper changing attempts because C1 consistently refused and removed their diaper during attempts. S5 reported asking C1 daily for several months, but C1 always refused.

Based on LPA observations, interviews, and records review, the preponderance of evidence standard has not been met. Although the allegation may have occurred or could be valid, there is not a preponderance of evidence to prove that staff handled a child in an inappropriate manner. Therefore, the allegation is UNSUBSTANTIATED.

SUPERVISORS NAME: Thuy Ho
LICENSING EVALUATOR NAME: Susan Deschampe
LICENSING EVALUATOR SIGNATURE:	DATE: 07/16/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/16/2026

LIC9099 (FAS) - (06/04)

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Control Number 06-CC-20260424142031

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: BACK BAY MONTESSORI	FACILITY NUMBER: 304270541
	VISIT DATE: 07/16/2026

NARRATIVE

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Page 3 (Deliver of Findings)

Exit interview conducted and report was reviewed with the facility representative, Priyangani Ediriwira. The Notice of Site Visit was posted during the visit. The facility representative was reminded that the Notice of Site Visit must remain posted for 30 consecutive days. The Notice of Site Visit must be posted on, or immediately adjacent to, the interior side of the main door of the facility.

Appeal Rights were discussed and provided. The facility representative’s signature acknowledges receipt of these rights. The facility representative may submit an appeal in writing to the Regional Manager within 15 business days from the date of receiving the penalty assessment or notice of deficiency. First level appeals must be sent to the Regional Manager at the address listed above.

End of report

SUPERVISORS NAME: Thuy Ho
LICENSING EVALUATOR NAME: Susan Deschampe
LICENSING EVALUATOR SIGNATURE:	DATE: 07/16/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/16/2026

LIC9099 (FAS) - (06/04)

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