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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 013420947
Report Date: 04/05/2023
Date Signed: 04/07/2023 01:56:23 PM

Substantiated


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, SUITE 1102
OAKLAND, CA 94612
This is an official report of an unannounced visit/investigation of a complaint received in our office on
02/22/2023 and conducted by Evaluator Catherine Fernandes
PUBLIC
COMPLAINT CONTROL NUMBER: 02-CC-20230222105110
FACILITY NAME:CHILD UNIQUE MONTESSORI SCHOOL, THEFACILITY NUMBER:
013420947
ADMINISTRATOR:BATTLE, TIFFANIFACILITY TYPE:
850
ADDRESS:1400 - 6TH STTELEPHONE:
(510) 521-0595
CITY:ALAMEDASTATE: CAZIP CODE:
94501
CAPACITY:75CENSUS: 30DATE:
04/05/2023
UNANNOUNCEDTIME BEGAN:
10:21 AM
MET WITH:Cindy AckerTIME COMPLETED:
02:15 PM
ALLEGATION(S):
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Unqualified staff caring for daycare children
INVESTIGATION FINDINGS:
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Todays's daye is 4/7/23, this is an amended report for inspection day 4/5/23.
On 4/5/23, at 10:21AM, Licensing Program Analyst (LPA) Catherine Fernandes arrived unannounced to deliver the findings to the above allegation and met with owner Cindy Acker. Present in care were 30 preschoolers and an additional seven staff members. During the course of the investigation LPA Fernandes did a walk through of the center, reviewed center files and conducted interviews.
Interviews and records indicated that the center has had unqualified staff providing care to the children. Therefore, the allegation is SUBSTANTIATED, the preponderance of evidence standard has been met. LPA Fernandes informed the licensee to provide a copy of this licensing report dated 4/5/23 that document a Type A citation to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification. Title 22, California Code of Regulation is being cited on the attached LIC 9099D.
Notice of site visit was provided and must be posted for 30 days.
Exit interview conducted. Report, Appeal Rights and LIC9224 provided
Substantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Mayla MendozaTELEPHONE: (510) 873-6408
LICENSING EVALUATOR NAME: Catherine FernandesTELEPHONE: (510) 725-7002
LICENSING EVALUATOR SIGNATURE:

DATE: 04/07/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/07/2023
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 2
Control Number 02-CC-20230222105110
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612

FACILITY NAME: CHILD UNIQUE MONTESSORI SCHOOL, THE
FACILITY NUMBER: 013420947
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/05/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
04/06/2023
Section Cited
CCR
101229(a)(1)
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Responsibility for Providing Care and Supervision- No child(ren) shall be left without the supervision of a teacher at any time, except as specified in Sections 101216.2(e)(1) and 101230(c)(1). Supervision shall include visual observation. This requirement has not been met as evidenced by:
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The center will reassess all classrooms and come up with a plan to ensure compliance, then send the plan to CCLD by Proof of correction date.
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Based on interviews and reviewed evidence the center has had unqualified staff providing care to the children, which is an immediate risk to children in care.
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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.
SUPERVISOR'S NAME: Mayla MendozaTELEPHONE: (510) 873-6408
LICENSING EVALUATOR NAME: Catherine FernandesTELEPHONE: (510) 725-7002
LICENSING EVALUATOR SIGNATURE:

DATE: 04/05/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/05/2023
LIC9099 (FAS) - (06/04)
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