090319030-11-18-2021-03-CC-MMAA-C99NS4-20211130094232

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 090319030
Report Date: 11/18/2021
Date Signed: 11/18/2021 10:38:25 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
10/01/2021 and conducted by Evaluator Tanya Washington

PUBLIC

COMPLAINT CONTROL NUMBER: 03-CC-20211001151230

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: 52	DATE:	11/18/2021
		UNANNOUNCED	TIME BEGAN:	09:00 AM
MET WITH:	Leslie Dillon		TIME COMPLETED:	11:00 AM

ALLEGATION(S):

1
2
3
4
5
6
7
8
9

No masks are being worn at the day care

INVESTIGATION FINDINGS:

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

On Thursday, November 18, 2021 at 9:30 AM, Licensing Program Analysts (LPAs) Tanya Washington and Mikah Martinez met with Facility Representative Leslie Dillon to deliver complaint finding for the allegation mentioned above. Upon arrival Licensing Staff observed fifty two children supervised by five staff in two classrooms.
Reporting Party alleged that staff and children do not wear face masks. During today's tour of the facility all staff and a total of eight children were wearing a face mask. Facility representative stated that they provide single use masks and some chidlren come wearing a face mask in the morning, however within 15-20 minutes the mask comes off and the children refuse to wear it. During the inspection LPAs did not observe staff encouraging children to wear a mask, however the children's activity areas were separated to small cohorts.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Roxana Saravia	TELEPHONE: (916) 263-5744
LICENSING EVALUATOR NAME: Tanya Washington	TELEPHONE: 916-879-1209
LICENSING EVALUATOR SIGNATURE:	DATE: 11/18/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/18/2021

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-20211001151230

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: 11/18/2021

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

Facility Representative is encouraged to review Guidance for Child Care Providers and Programs dated 06/29/2021 and also provide a copy of this document to all parents of currently enrolled children. LPA also provided a poster regarding "Face Covering Required" which should be posted near the entrance. Facility is being issued a Technical Violation. Notice of site visit posted and appeal rights provided.

SUPERVISOR'S NAME: Roxana Saravia	TELEPHONE: (916) 263-5744
LICENSING EVALUATOR NAME: Tanya Washington	TELEPHONE: 916-879-1209
LICENSING EVALUATOR SIGNATURE:	DATE: 11/18/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/18/2021

LIC9099 (FAS) - (06/04)

Page: 2 of 2