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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 073406649
Report Date: 07/23/2019
Date Signed: 07/23/2019 10:00:19 AM



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
05/20/2019 and conducted by Evaluator Dayna Collier
PUBLIC
COMPLAINT CONTROL NUMBER: 02-CC-20190520164059
FACILITY NAME:A LITTLE WORLD MONTESSORI SCHOOLFACILITY NUMBER:
073406649
ADMINISTRATOR:ELAINE SALDIVARFACILITY TYPE:
850
ADDRESS:324 37TH STTELEPHONE:
(510) 412-2244
CITY:RICHMONDSTATE: CAZIP CODE:
94805
CAPACITY:55CENSUS: 3DATE:
07/23/2019
UNANNOUNCEDTIME BEGAN:
08:50 AM
MET WITH:Hiikkaduwa DeAlwisTIME COMPLETED:
10:15 AM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
PERSONAL RIGHTS: Facility staff caused injury to child
INVESTIGATION FINDINGS:
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2
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5
6
7
8
9
10
11
12
13
LPA Dayna Collier met with Acting Center Director Hiikkaduwa DeAlwis for a complaint investigation regarding the above allegation. Present for the investigation were the Director, a staff member and 3 children in care. During the course of the investigation, interviews were conducted. It was alleged that a staff member's interaction with a child in care resulted in an injury. Although there was an incident that occurred between the child and the staff member, the staff member denied any physical interaction with the child. There was no evidence that anyone else observed the incident. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation(s) did or did not occur. Therefore, the allegation is unsubstantiated.

A SITE VISIT NOTICE WAS POSTED BY DIRECTOR.
Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Diane PerezTELEPHONE: (510) 622-2593
LICENSING EVALUATOR NAME: Dayna CollierTELEPHONE: (510) 725-7021
LICENSING EVALUATOR SIGNATURE:

DATE: 07/23/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/23/2019
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 7
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
05/20/2019 and conducted by Evaluator Dayna Collier
PUBLIC
COMPLAINT CONTROL NUMBER: 02-CC-20190520164059

FACILITY NAME:A LITTLE WORLD MONTESSORI SCHOOLFACILITY NUMBER:
073406649
ADMINISTRATOR:ELAINE SALDIVARFACILITY TYPE:
850
ADDRESS:324 37TH STTELEPHONE:
(510) 412-2244
CITY:RICHMONDSTATE: CAZIP CODE:
94805
CAPACITY:55CENSUS: 3DATE:
07/23/2019
UNANNOUNCEDTIME BEGAN:
08:50 AM
MET WITH:Hiikkaduwa DeAlwisTIME COMPLETED:
10:15 AM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
PERSONAL RIGHTS: Facility staff handled child in a rough manner
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
LPA Dayna Collier met with Acting Center Director Hiikkaduwa DeAlwis for a complaint investigation regarding the above allegation. Present for the investigation were the Director, one staff member and 3 children in care. During the course of the investigation, interviews were conducted. It was alleged that a staff member has grabbed a child's arm in a rough manner. The facility's discipline policy was discussed. One staff member stated that time out is used as a form of discipline. The staff member admitted that she would take the child by the arm and take the child to the time out chair. The staff member stated that time out will last as long as child needs to understand; sometimes 5-10 minutes long. Based on information gathered, the staff member's form of discipline violates children's personal rights. Based on the LPA's observations and interviews which were conducted and record review(s), the preponderance of evidence standard has been met. Therefore, the above allegation is found to be SUBSTANTIATED. California Code of Regulations, (Title 22, Division & Chapter # 1012223), are being cited on the attached LIC 9099D.
See LIC 9099C attached.
A SITE VISIT NOTICE WAS POSTED BY DIRECTOR.
Substantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Diane PerezTELEPHONE: (510) 622-2593
LICENSING EVALUATOR NAME: Dayna CollierTELEPHONE: (510) 725-7021
LICENSING EVALUATOR SIGNATURE:

DATE: 07/23/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/23/2019
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 2 of 7
Control Number 02-CC-20190520164059
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: A LITTLE WORLD MONTESSORI SCHOOL
FACILITY NUMBER: 073406649
VISIT DATE: 07/23/2019
NARRATIVE
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The attached type B deficiency is cited today and must be corrected by the due date. This report must be available for public review for 3 years. An exit interview was conducted and the report was discussed. Licensee was provided a copy of their appeal rights (LIC 9058 12/15) and the signature on this form acknowledges receipt of these rights.
SUPERVISOR'S NAME: Diane PerezTELEPHONE: (510) 622-2593
LICENSING EVALUATOR NAME: Dayna CollierTELEPHONE: (510) 725-7021
LICENSING EVALUATOR SIGNATURE:

DATE: 07/23/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/23/2019
LIC9099 (FAS) - (06/04)
Page: 3 of 7
Control Number 02-CC-20190520164059
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: A LITTLE WORLD MONTESSORI SCHOOL
FACILITY NUMBER: 073406649
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/23/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
07/30/2019
Section Cited
CCR
101223(a)(3)
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2
3
4
5
6
7
101223 Personal Rights
(a) The licensee shall ensure that each child is accorded the following personal rights:
(3) To be free from corporal or unusual punishment, infliction of pain, humiliation, intimidation, ridicule, coercion, threat, mental abuse or other actions of a punitive nature
1
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POC: By 7/30/19, a written plan of action will be submitted to Licensing detailing the facility's discipline policy and steps the Director will take to ensure this is the policy followed by staff.
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14
This requirement was not met as evidenced by interviews conducted. This poses a potential risk to the health and safety of children in care.
A STAFF MEMBER'S DISCIPLINE TECHNIQUES VIOLATE CHILDREN'S PERSONAL RIGHTS.
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14
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7
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7
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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: Diane PerezTELEPHONE: (510) 622-2593
LICENSING EVALUATOR NAME: Dayna CollierTELEPHONE: (510) 725-7021
LICENSING EVALUATOR SIGNATURE:

DATE: 07/23/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/23/2019
LIC9099 (FAS) - (06/04)
Page: 4 of 7
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
05/20/2019 and conducted by Evaluator Dayna Collier
COMPLAINT CONTROL NUMBER: 02-CC-20190520164059

FACILITY NAME:A LITTLE WORLD MONTESSORI SCHOOLFACILITY NUMBER:
073406649
ADMINISTRATOR:ELAINE SALDIVARFACILITY TYPE:
850
ADDRESS:324 37TH STTELEPHONE:
(510) 412-2244
CITY:RICHMONDSTATE: CAZIP CODE:
94805
CAPACITY:55CENSUS: 3DATE:
07/23/2019
UNANNOUNCEDTIME BEGAN:
08:50 AM
MET WITH:Hiikkaduwa DeAlwisTIME COMPLETED:
10:15 AM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
PERSONAL RIGHTS: Facility staff yelled at child
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
LPA Dayna Collier met with Acting Center Director Hiikkaduwa DeAlwis for a complaint investigation regarding the above allegation. Present for the investigation were the Director, one staff member and 3 children in care. During the course of the investigation, interviews were conducted. An incident occurred when a child alleged that a staff member caused an injury. The staff member admitted to raising her voice at the child and calling the child a derogatory name in the presence of the child's parent. Per staff, none of the other children were aware of the incident.
Based on the LPA's observations and interviews which were conducted and record review(s), the preponderance of evidence standard has been met. Therefore, the above allegation is found to be SUBSTANTIATED. California Code of Regulations, (Title 22, Division & Chapter Number 101223), are being cited on the attached LIC 9099D.
An exit interview was conducted and the report was discussed. Licensee was provided a copy of their appeal rights (LIC 9058 12/15) and the signature on this form acknowledges receipt of these rights.
A SITE VISIT NOTICE WAS POSTED BY DIRECTOR.
Substantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Diane PerezTELEPHONE: (510) 622-2593
LICENSING EVALUATOR NAME: Dayna CollierTELEPHONE: (510) 725-7021
LICENSING EVALUATOR SIGNATURE:

DATE: 07/23/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/23/2019
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 5 of 7
Control Number 02-CC-20190520164059
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: A LITTLE WORLD MONTESSORI SCHOOL
FACILITY NUMBER: 073406649
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/23/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
07/30/2019
Section Cited
CCR
101223(a)(1)
1
2
3
4
5
6
7
101223 Personal Rights
(a) The licensee shall ensure that each child is accorded the following personal rights:
(1) To be accorded dignity in his/her personal relationships with staff and other persons.
This requirement was not met as evidenced by interviews conducted.
1
2
3
4
5
6
7
POC: By 7/30/19, a written plan of action will be sent to Licensing detailing the steps the Director will take to ensure staff do not violate children's personal rights.
8
9
10
11
12
13
14
This poses a potential risk to the health and safety of children in care.
A STAFF MEMBER VIOLATED A CHILD'S PERSONAL RIGHTS BY THE TONE AND WORDS SHE USED IN TALKING TO THE CHILD.
8
9
10
11
12
13
14
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: Diane PerezTELEPHONE: (510) 622-2593
LICENSING EVALUATOR NAME: Dayna CollierTELEPHONE: (510) 725-7021
LICENSING EVALUATOR SIGNATURE:

DATE: 07/23/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/23/2019
LIC9099 (FAS) - (06/04)
Page: 6 of 7
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
05/20/2019 and conducted by Evaluator Dayna Collier
PUBLIC
COMPLAINT CONTROL NUMBER: 02-CC-20190520164059

FACILITY NAME:A LITTLE WORLD MONTESSORI SCHOOLFACILITY NUMBER:
073406649
ADMINISTRATOR:ELAINE SALDIVARFACILITY TYPE:
850
ADDRESS:324 37TH STTELEPHONE:
(510) 412-2244
CITY:RICHMONDSTATE: CAZIP CODE:
94805
CAPACITY:55CENSUS: 3DATE:
07/23/2019
UNANNOUNCEDTIME BEGAN:
08:50 AM
MET WITH:Hiikkaduwa DeAlwisTIME COMPLETED:
10:15 AM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
OTHER: Facility staff gave food to children that belonged to another child
INVESTIGATION FINDINGS:
1
2
3
4
5
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7
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10
11
12
13
LPA Dayna Collier met with Acting Center Director Hiikkaduwa DeAlwis for a complaint investigation regarding the above allegation. Present for the investigation were the Director, one staff member and 3 children in care. During the course of the investigation, interviews were conducted and disclosed that parents provide meals for their children. Based on interviews, it could not be determined whether or not a child was instructed by staff to share his/her food. It also could not be determined whether or not a child throws away his/her leftovers instead of returning home with uneaten food.
Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation(s) did or did not occur. Therefore, the allegation is unsubstantiated.
Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Diane PerezTELEPHONE: (510) 622-2593
LICENSING EVALUATOR NAME: Dayna CollierTELEPHONE: (510) 725-7021
LICENSING EVALUATOR SIGNATURE:

DATE: 07/23/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/23/2019
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 7 of 7