090319030-9-24-2019-03-CC-BENN-BH6PRY-20191021113327

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 090319030
Report Date: 09/24/2019
Date Signed: 09/24/2019 05:55:46 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833

This is an official report of an unannounced visit/investigation of a complaint received in our office on
09/19/2019 and conducted by Evaluator Katrina Owens

COMPLAINT CONTROL NUMBER: 03-CC-20190919165655

FACILITY NAME:	MONTESSORI MANOR		FACILITY NUMBER:	090319030
ADMINISTRATOR:	DILLON, LESLIE		FACILITY TYPE:	850
ADDRESS:	2222 FRANCISCO DR., STE. 400		TELEPHONE:	(916) 933-2420
CITY:	EL DORADO HILLS	STATE: CA	ZIP CODE:	95762
CAPACITY:	58	CENSUS: 48	DATE:	09/24/2019
		UNANNOUNCED	TIME BEGAN:	12:20 PM
MET WITH:	Leslie Dillon		TIME COMPLETED:	02:30 PM

ALLEGATION(S):

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LACK OF SUPERVISION: Staff failed to provide adequately supervision resulting in a child walking away from the facility.

INVESTIGATION FINDINGS:

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An unannounced inspection was conducted today by Licensing Program Analyst Owens and Blesi. LPA's met with Director Leslie Dillon. The purpose of the inspection is to open and closed a complaint investigation. A census of children were taken and interviews were conducted.
Based on interviews on Thursday, September 19, 2019 a child wandered away from the facility and missing for approximately 5 to 10 minutes. The child was found by another neighboring school that is located up the hill, 800 ft away from the facility.

The preponderance of evidence standard has been met during this investigation, therefore the above allegation is found to be SUBSTANTIATED. Violations of the California Code of Regulations, Title 22, Division 12 & Chapter 3 are being cited on the attached LIC9099D. Civil Penalty is assessed,
Exit interview was conducted. Appeal rights provided. AB633 provided/explained. Notice of site visit posted.
REPORT MUST BE POSTED FOR 30 DAYS & PROVIDED TO PARENTS OF CURRENTLY ENROLLED PRESCHOOL CHILDREN AND PARENTS OF THE NEW ENROLLEES FOR THE NEXT 12 MONTHS.

Substantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Keven Peters	TELEPHONE: (916) 263-5728
LICENSING EVALUATOR NAME: Katrina Owens	TELEPHONE: 916-263-6280
LICENSING EVALUATOR SIGNATURE:	DATE: 09/24/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/24/2019

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 03-CC-20190919165655

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833

FACILITY NAME: MONTESSORI MANOR	FACILITY NUMBER: 090319030
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 09/24/2019

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type A 09/24/2019 Section Cited CCR 101229(a)(1)	1 2 3 4 5 6 7	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.	1 2 3 4 5 6 7	Director stated she has removed the ability for parents enter the gate without being let in by staff. Parent have to ring a bell. She has assigned a designated staff member to be in charge of opening the gate for parents.
	8 9 10 11 12 13 14	This requirement is not met as evidence by on Thursday, September 19, 2019 a child wandered away from the facility and missing for approximately 5 to 10 minutes. The child was found by another neighboring school that is located up the hill, 800 ft away from this facility. This is an immediate risk to a child. Zero Tolerance civil penalty assessed at time of inspection.	8 9 10 11 12 13 14	She has discontinued the 12:30 pm dismissal. All parents have to pick up child at 11:30 am thru the main door of the school. Children arriving at facility have to come thru main door of school. She will also be putting up an additional fence.
	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: Keven Peters	TELEPHONE: (916) 263-5728
LICENSING EVALUATOR NAME: Katrina Owens	TELEPHONE: 916-263-6280
LICENSING EVALUATOR SIGNATURE:	DATE: 09/24/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/24/2019

LIC9099 (FAS) - (06/04)

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