073402302-10-27-2022-02-CC-LDYN-CKUFP3-20221104043916

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 073402302
Report Date: 10/27/2022
Date Signed: 10/27/2022 03:42:44 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
10/24/2022 and conducted by Evaluator Tasha Hackett-Alexander

COMPLAINT CONTROL NUMBER: 02-CC-20221024162417

FACILITY NAME:	ANGELS MONTESSORI PRESCHOOL - CONCORD		FACILITY NUMBER:	073402302
ADMINISTRATOR:	KARAMPOUR, ANGEL		FACILITY TYPE:	850
ADDRESS:	1566 BAILEY ROAD		TELEPHONE:	(925) 686-5621
CITY:	CONCORD	STATE: CA	ZIP CODE:	94520
CAPACITY:	49	CENSUS: 8	DATE:	10/27/2022
		UNANNOUNCED	TIME BEGAN:	08:50 AM
MET WITH:	MARYAM KARAMPOUR		TIME COMPLETED:	04:00 PM

ALLEGATION(S):

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LACK OF SUPERVISION- STAFF DID NOT PROVIDE ADEQUATE SUPERVISION TO DAY CARE CHILDREN

PERSONAL RIGHTS- STAFF DID NOT PROVIDE DIAPER/UNDERWEAR TO DAY CARE CHILD

INVESTIGATION FINDINGS:

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LICENSING PROGRAM ANALYST TASHA ALEXANDER MET TODAY WITH CENTER DIRECTOR MARYAM KARAMPOUR IN REGARDS TO THE ABOVE COMPLAINT ALLEGATIONS.

UPON ARRIVAL, LPA RANG THE BELL SEVERAL TIMES AND CALLED THE CENTER'S PHONE NUMBER AND GOT NO ANSWER. LPA WALKED TO THE BACK GATE, SAW CHILDREN PLAYING BUT NO ADULT AT THAT TIME. FINALLY A STAFF MEMBER ANSWERED THE FRONT DOOR. THE CENTER DIRECTOR ARRIVED AT THE CENTER SHORTLY AFTER. UPON ARRIVAL INTO THE CENTER, THERE ARE 8 CHILDREN PRESENT ALONG WITH 1 STAFF MEMBER. TODAY LPA CONDUCTED AN INSPECTION OF THE FACILITY, INTERVIEWED STAFF AND REVIEWED RECORDS. ON 10/21/22 WHILE ON THE PLAYGROUND A CHILD WAS INJURED BY ANOTHER CHILD WHEN PLAYING WITH A BROKEN TOY. INTERVIEWS ALSO REVEALED THAT ON ANOTHER OCCASION A CHILD WAS SENT HOME WITHOUT A DIAPER ON.

BASED ON LPAs OBSERVATIONS AND INTERVIEWS WHICH WERE CONDUCTED AND RECORD REVIEWS, THE PREPONDERANCE OF EVIDENCE STANDARD HAS BEEN MET, THEREFORE THE ABOVE ALLEGATIONS ARE FOUND TO BE SUBSTANTIATED. California Code of Regulations, Title 22, Division 12 & Chapter number), ARE BEING CITED ON THE ATTACHED LIC 9099D

Substantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Loretta Dyson	TELEPHONE: (510) 695-0243
LICENSING EVALUATOR NAME: Tasha Hackett-Alexander	TELEPHONE: (510) 292-9724
LICENSING EVALUATOR SIGNATURE:	DATE: 10/27/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/27/2022

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 02-CC-20221024162417

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: ANGELS MONTESSORI PRESCHOOL - CONCORD	FACILITY NUMBER: 073402302
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 10/27/2022

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 11/10/2022 Section Cited CCR 101229(a)	1 2 3 4 5 6 7	101229 Responsibility for Providing Care and Supervision (a) The licensee shall provide care and supervision as necessary to meet the children's needs. THIS REQUIREMENT WAS NOT MET AS EVIDENCED BY: A CHILDREN WERE ALLOWED TO PLAY WITH A BROKEN TOY WHICH CAUSED INJURY TO ONE CHILD	1 2 3 4 5 6 7	LICENSEE WILL CONDUCT A STAFF TRAINING ON CHILD SUPERVISION AND SUBMIT A SUMMARY OF WHAT WAS COVERED AND A SIGN IN SHEET OF STAFF THAT ATTENDED. THERE ARE VIDEOS PROVIDED ON CCLD WEBSITE ON CHLD SUPERVISION AND REGULATIONS THAT MAY BE HELPFUL. LPA HAS ALSO DISCUSSED THE TSP PROGRAM WITH LICENSEE. PLEASE SUBMIT PROOF OF TRAINING BY 11/10/22
Type B 11/10/2022 Section Cited CCR 101223(a)(3)	1 2 3 4 5 6 7	101223 Personal Rights (a) The licensee shall ensure that each child is accorded the following personal rights: (2) To be accorded safe, healthful and comfortable accommodations, furnishings and equipment to meet his/her needs. THIS REQUIREMENT WAS NOT MET AS EVIDENCED BY: AS CHILD WAS SENT HOME FROM DAY CARE WITHOUT A DIAPER OR UNDERWEAR ON	1 2 3 4 5 6 7	LICENSEE WILL ENSURE THAT ALL STAFF MAKE SURE THAT ALL CHILDREN ARE CHANGED PROPERLY. LICENSEE WILL CONDUCT A STAFF TRAINING TO REFRESH STAFF ON CHILDREN'S PERSONAL RIGHTS. PLEASE REFER TO COMMUNITY CARE LICENSING'S WEBSITE FOR VIDEOS AND REGULATIONS ON PERSONAL RIGHTS. LICENSEE WILL ALSO SUBMIT A SUMMARY ON DETAILS OF THE TRAINING AND A SIGN IN SHEET OF STAFF THAT ATTENDED TRAINING. DBY 11/10/22
	1 2 3 4 5 6 7		1 2 3 4 5 6 7
	1 2 3 4 5 6 7		1 2 3 4 5 6 7

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: Loretta Dyson	TELEPHONE: (510) 695-0243
LICENSING EVALUATOR NAME: Tasha Hackett-Alexander	TELEPHONE: (510) 292-9724
LICENSING EVALUATOR SIGNATURE:	DATE: 10/27/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/27/2022

LIC9099 (FAS) - (06/04)

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