090319030-11-3-2021-03-CC-MMAA-C8PMSU-20211112085228

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 090319030
Report Date: 11/01/2021
Date Signed: 11/03/2021 11:27:44 AM

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
10/13/2021 and conducted by Evaluator Michelle Pascual

PUBLIC

COMPLAINT CONTROL NUMBER: 03-CC-20211013085015

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:	DATE:	11/01/2021
		UNANNOUNCED	TIME BEGAN:	10:45 AM
MET WITH:	Leslie Dillon		TIME COMPLETED:	11:30 AM

ALLEGATION(S):

1
2
3
4
5
6
7
8
9

Personal Rights- Lack of supervision resulting in inappropriate interactions between daycare children.

INVESTIGATION FINDINGS:

1
2
3
4
5
6
7
8
9
10
11
12
13

Licensing Program Analyst (LPA) Pascual met with Director Leslie Dillon on 11/3/2021 approximately at 11:00 AM to deliver complaint findings for the allegation mentioned above.

It was alleged that “Lack of supervision resulting in inappropriate interactions between daycare children” occurred while children were in the play yard. During the course of the investigation LPA conducted interviews with the staff, Director, children, parents and reporting party. LPA obtained relevant medical documentation to assist in the investigation and also conducted observations while touring the inside and the outside of the facility.

An allegation was received stating children behaved inappropriately behind a rock due to a lack of supervision in the play yard. LPA observed the rock in the play yard and the strategic placement of teachers as they supervised children. LPA observed that there were no areas in and around the rock that provided privacy in which children would not be seen as the rock is centrally located within the play area. Further, LPA spoke to three (3) children and 4 (teachers), including the Director. LPA found that there were no children who could corroborate the allegation. Furthermore, the interviews conducted did not provide corroboration for the allegations presented.

Based on the information obtained the allegation is determined to be unsubstantiated, meaning that although the allegation may have happened or is valid, there is not a preponderance of evidence to prove it.
Notice of site visit was given and shall be posted for 30 days

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Roxana Saravia	TELEPHONE: (916) 263-5715
LICENSING EVALUATOR NAME: Michelle Pascual	TELEPHONE: (916) 704-7665
LICENSING EVALUATOR SIGNATURE:	DATE: 11/01/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/01/2021

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 2

Control Number 03-CC-20211013085015

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
	VISIT DATE: 11/01/2021

NARRATIVE

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32

Based on the information obtained, LPA was not able to corroborate the allegation, therefore the allegation is determined to be UNSUBSTANTIATED, meaning that although the allegation may have happened or is valid, there is not a preponderance of evidence to prove it.

Notice of site visit and appeal rights were also sent in the e-mail to Site Supervisor Simmons.
Notice of site visit shall remain posted for 30 days for parental review.

SUPERVISOR'S NAME: Roxana Saravia	TELEPHONE: (916) 263-5715
LICENSING EVALUATOR NAME: Michelle Pascual	TELEPHONE: (916) 704-7665
LICENSING EVALUATOR SIGNATURE:	DATE: 11/02/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/02/2021

LIC9099 (FAS) - (06/04)

Page: 2 of 2

Control Number 03-CC-20211013085015

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
	VISIT DATE: 11/01/2021

NARRATIVE

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32

SUPERVISOR'S NAME: Roxana Saravia	TELEPHONE: (916) 263-5715
LICENSING EVALUATOR NAME: Michelle Pascual	TELEPHONE: (916) 704-7665
LICENSING EVALUATOR SIGNATURE:	DATE: 11/02/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/02/2021

LIC9099 (FAS) - (06/04)

Page: 2 of 2