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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 013416606
Report Date: 05/18/2020
Date Signed: 05/18/2020 12:13:43 PM



STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
This is an official report of an unannounced visit/investigation of a complaint received in our office on
02/20/2020 and conducted by Evaluator Briana Plumboy
COMPLAINT CONTROL NUMBER: 52-CC-20200220145934
FACILITY NAME:MONTESSORI SCHOOL AT FIVE CANYONSFACILITY NUMBER:
013416606
ADMINISTRATOR:VAN GROENOU, MEHERFACILITY TYPE:
850
ADDRESS:22781 CANYON COURTTELEPHONE:
(510) 581-3729
CITY:CASTRO VALLEYSTATE: CAZIP CODE:
94552
CAPACITY:120CENSUS: 9DATE:
05/18/2020
UNANNOUNCEDTIME BEGAN:
12:00 PM
MET WITH:MEHER VAN GROENOUTIME COMPLETED:
12:45 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Personal Rights- Daycare staff hit child while in care
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On 05/18/20 at 12:09pm, Licensing Program Analyst (LPA) Briana Plumboy spoke with with Director Meher Van Groenou to deliver the finding of a Complaint filed against Montessori School at Five Canyons regarding the allegation of a daycare staff hitting child while in care.
Based on interviews conducted, there is not enough evidence to prove if the allegation is true or false. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore, the allegation is UNSUBSTANTIATED.
A notice of site visit was given and must remain posted for 30 days.
Appeal Rights were given and discussed. An exit interview was conducted.
Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Wynn NoronaTELEPHONE: (510) 421-1324
LICENSING EVALUATOR NAME: Briana PlumboyTELEPHONE: (510) 725-7005
LICENSING EVALUATOR SIGNATURE:

DATE: 05/18/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/18/2020
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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