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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 070213379
Report Date: 12/21/2022
Date Signed: 12/21/2022 01:28:10 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
12/20/2022 and conducted by Evaluator Christina Watts
PUBLIC
COMPLAINT CONTROL NUMBER: 02-CC-20221220082103

FACILITY NAME:DIABLO VALLEY MONTESSORI SCHOOL, INC. #2FACILITY NUMBER:
070213379
ADMINISTRATOR:SMITH, SUZETTEFACILITY TYPE:
830
ADDRESS:3408 DEERHILL ROADTELEPHONE:
(925) 283-6036
CITY:LAFAYETTESTATE: CAZIP CODE:
94549
CAPACITY:40CENSUS: DATE:
12/21/2022
UNANNOUNCEDTIME BEGAN:
08:30 AM
MET WITH:Jayne MartinTIME COMPLETED:
12:00 PM
ALLEGATION(S):
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Daycare children has access to hazardous materials.
INVESTIGATION FINDINGS:
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On 12/21/2022 at 8:30 AM, Licensing Program Analysts (LPAs) Christina Watts and Monica Mathur conducted an Unannounced Intial Complaint Investigation at Diablo Valley Montessori School, Inc #2. LPAs met with Director, Jayne Martin and explained purpose of today's investigation. Finding for the above allegation was delivered during the inspection.

Complainant alleges daycare children has access to hazardous materials. During the course of the investigation, LPAs inspected the facility, reviewed records and conducted interviews. It was determined that children had access to screws and hazardous construction material that staff had to pick up on multiple occasions during construction of facility. No incidents or injuries occured and staff was proactive in removing the material immediately. Based on the interviews and information obtained throughout the investigation, the preponderance of evidence standard has been met. Therefore, the allegation is SUBSTANTIATED. California Code of Regulations, Title 22, Division 12 is being cited on 9099-D page.

Exit interview was conducted with Director Jayne Martin. Appeal rights were provided. A NOTICE OF SITE VISIT WAS ISSUED, AND MUST BE POSTED FOR 30 CONSECTIVE DAYS.
Substantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Sherelle JohnsonTELEPHONE: (510) 421-3587
LICENSING EVALUATOR NAME: Christina WattsTELEPHONE: (510) 246-1797
LICENSING EVALUATOR SIGNATURE:

DATE: 12/21/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/21/2022
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 3 of 4
Control Number 02-CC-20221220082103
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: DIABLO VALLEY MONTESSORI SCHOOL, INC. #2
FACILITY NUMBER: 070213379
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/21/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
01/12/2023
Section Cited
CCR
101238(g)
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101238 Buildings and Grounds (g) Disinfectants, cleaning solutions, poisons and other items that could pose a danger if readily available to children shall be stored where inaccessible to children. This requirement is has not been met as evidenced by:
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By COB 12/28/2022, submit a written plan of operation that ensures compliance with this regulation to CCLD. By COB 01/12/2023, Conduct Staff training on implentation of plan of operation and submit verification.
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Per LPA investigation, it was determined screws and random construction tools were in accessible areas. Staff did remove material immediately and no incident or injuires occured. This posed a potiental risk to the health and safety of 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: Sherelle JohnsonTELEPHONE: (510) 421-3587
LICENSING EVALUATOR NAME: Christina WattsTELEPHONE: (510) 246-1797
LICENSING EVALUATOR SIGNATURE:

DATE: 12/21/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/21/2022
LIC9099 (FAS) - (06/04)
Page: 4 of 4