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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 073402889
Report Date: 09/16/2022
Date Signed: 09/16/2022 11:22:45 AM

Unsubstantiated


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
08/19/2022 and conducted by Evaluator Michelle Sutton
PUBLIC
COMPLAINT CONTROL NUMBER: 02-CC-20220819154801

FACILITY NAME:MONTESSORI SCHOOL OF CONCORDFACILITY NUMBER:
073402889
ADMINISTRATOR:METROCK, ANAFACILITY TYPE:
850
ADDRESS:3039 WILLOW PASS ROADTELEPHONE:
(925) 682-8067
CITY:CONCORDSTATE: CAZIP CODE:
94519
CAPACITY:56CENSUS: DATE:
09/16/2022
UNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Ana MetrockTIME COMPLETED:
11:25 AM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Licensee falsified incident reports
Licensee left children unsupervised
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On 9/16/22 at 10:00 AM Licensing Program Analyst (LPA) Michelle Sutton conducted an Unannounced Complaint Investigation at Montessori School of Concord and met with Licensee Ana Metrock. The LPA inspected the facility, reviewed records, and conducted interviews. Based on LPA observations, interviews and information obtained throughout the investigation, the allegation is UNSUBSTANTIATED. 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. No Deficiencies have been cited for the allegation.

A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with the licensee Ana Metrock.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Sherelle Johnson
LICENSING EVALUATOR NAME: Michelle Sutton
LICENSING EVALUATOR SIGNATURE:

DATE: 09/16/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/16/2022
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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