NORTHWOOD MONTESSORI SCHOOL OF IRVINE

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25Page One Licensing Program Analyst (LPA) Castro conducted a case management inspection to follow up on a self-reported unusual incident that was submitted to CCL Regional Licensing Office on 02/18/2025. It was reported by Cheryll Ruszat, Executive Director and Lisa Fukunaga, Director. According to director, Parent/Caretaker of Child 1 (C1) stated that Staff 1 (S1) allegedly dragged C1 to the bathroom and forced them to go potty. During today's inspection a tour of the facility was conducted and census was taken: LPA observed 25 children in the classroom with 3 teachers. During today's inspection, the facility was observed operating within its licensed capacity and within compliance of staff to child ratios. A review of staff records on this date indicates that all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances. Five (5) staff were interviewed. Five (5) children were also interviewed. All interviewed staff provided consistent statements about the following facility’s toileting, guidance and discipline policies. All interviewed staff also denied witnessing the alleged incident between C1 and S1. Five (5) children were interviewed. The five (5) interviewed children did not disclose any information to confirm the incident did occur. Director provided LPA with a facility children's roster, personnel report, and other pertinent documents. Continue to Page Two SUPERVISORS NAME: Nguyen K Tran LICENSING EVALUATOR NAME: Alma Castro LICENSING EVALUATOR SIGNATURE: DATE: 03/11/2025 I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/11/2025 This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC809 (FAS) - (06/04)Page: 1 of 2 FACILITY NAME: NORTHWOOD MONTESSORI SCHOOL OF IRVINEFACILITY NUMBER: 304270294 VISIT DATE: 03/11/2025 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 32Page Two LPA was informed that C1 is no longer enrolled at the facility. According to director, a reminder on guidance and discipline policies will be conducted and mentioned during an upcoming staff meeting on Friday, March 14th, 2025. In the areas that were evaluated, no deficiencies were observed of the California Code of Regulations, Title 22, Division 12 at the time of the visit. Appeal Rights and deficiency were discussed. The facility representative was provided a copy of their appeal rights (LIC 9058) and their signature on this form acknowledges receipt of these rights. All appeals must be in writing and received by the Regional Office within 15 business days. A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with the Director, Lisa Fukunaga, Cheryll Ruszat and associate director, Rayann Palazzolo. Appeal Rights and deficiency were discussed. The facility representative was provided a copy of their appeal rights (LIC 9058) and their signature on this form acknowledges receipt of these rights. All appeals must be in writing and received by the Regional Office within 15 business days. A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with the Director, Lisa Fukunaga End of Report SUPERVISORS NAME: Nguyen K Tran LICENSING EVALUATOR NAME: Alma Castro LICENSING EVALUATOR SIGNATURE: DATE: 03/11/2025 I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/11/2025

Type B citation - potential risk if not corrected

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25Page One Licensing Program Analyst (LPA) Castro conducted a case management inspection to follow up on a self-reported unusual incident that was submitted to CCL Regional Licensing Office on 02/18/2025. It was reported by Cheryll Ruszat, Executive Director and Lisa Fukunaga, Director. According to director, Parent/Caretaker of Child 1 (C1) stated that Staff 1 (S1) allegedly dragged C1 to the bathroom and forced them to go potty. During today's inspection a tour of the facility was conducted and census was taken: LPA observed 25 children in the classroom with 3 teachers. During today's inspection, the facility was observed operating within its licensed capacity and within compliance of staff to child ratios. A review of staff records on this date indicates that all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances. Five (5) staff were interviewed. Five (5) children were also interviewed. All interviewed staff provided consistent statements about the following facility’s toileting, guidance and discipline policies. All interviewed staff also denied witnessing the alleged incident between C1 and S1. Five (5) children were interviewed. The five (5) interviewed children did not disclose any information to confirm the incident did occur. Director provided LPA with a facility children's roster, personnel report, and other pertinent documents. Continue to Page Two SUPERVISORS NAME: Nguyen K Tran LICENSING EVALUATOR NAME: Alma Castro LICENSING EVALUATOR SIGNATURE: DATE: 03/11/2025 I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/11/2025 This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC809 (FAS) - (06/04)Page: 1 of 2 FACILITY NAME: NORTHWOOD MONTESSORI SCHOOL OF IRVINEFACILITY NUMBER: 304270294 VISIT DATE: 03/11/2025 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 32Page Two LPA was informed that C1 is no longer enrolled at the facility. According to director, a reminder on guidance and discipline policies will be conducted and mentioned during an upcoming staff meeting on Friday, March 14th, 2025. In the areas that were evaluated, no deficiencies were observed of the California Code of Regulations, Title 22, Division 12 at the time of the visit. Appeal Rights and deficiency were discussed. The facility representative was provided a copy of their appeal rights (LIC 9058) and their signature on this form acknowledges receipt of these rights. All appeals must be in writing and received by the Regional Office within 15 business days. A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with the Director, Lisa Fukunaga, Cheryll Ruszat and associate director, Rayann Palazzolo. Appeal Rights and deficiency were discussed. The facility representative was provided a copy of their appeal rights (LIC 9058) and their signature on this form acknowledges receipt of these rights. All appeals must be in writing and received by the Regional Office within 15 business days. A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with the Director, Lisa Fukunaga End of Report SUPERVISORS NAME: Nguyen K Tran LICENSING EVALUATOR NAME: Alma Castro LICENSING EVALUATOR SIGNATURE: DATE: 03/11/2025 I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/11/2025