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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 100403062
Report Date: 04/15/2021
Date Signed: 04/15/2021 11:01:17 AM



STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1310 E. SHAW AVE,
FRESNO, CA 93710
This is an official report of an unannounced visit/investigation of a complaint received in our office on
01/28/2021 and conducted by Evaluator Kari McWilliams
PUBLIC
COMPLAINT CONTROL NUMBER: 04-CC-20210128113643
FACILITY NAME:FRESNO MONTESSORI SCHOOLFACILITY NUMBER:
100403062
ADMINISTRATOR:FUSSELMAN, JANETFACILITY TYPE:
850
ADDRESS:1572 E. BARSTOWTELEPHONE:
(559) 432-3669
CITY:FRESNOSTATE: CAZIP CODE:
93710
CAPACITY:80CENSUS: 28DATE:
04/15/2021
UNANNOUNCEDTIME BEGAN:
10:15 AM
MET WITH:Jan FusselmanTIME COMPLETED:
11:30 AM
ALLEGATION(S):
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Staff spoke inappropriately to child in care.
INVESTIGATION FINDINGS:
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On April 15, 2021, Licensing Program Analysts (LPAs) Kari McWilliams and Robert Gutierrez conducted an unannounced inspection to provide findings with regard to the above-listed allegation. LPAs met with Director Jan Fusselman.

During the course of the investigation, LPA McWilliams reviewed records and conducted interviews with staff and parents. Based on the investigation, it has been determined that Staff #1 has spoke inappropriately to child(ren) in care by speaking in a harsh tone and/or manner. The preponderance of the evidence standard has been met, therefore, the above allegation is found to be SUBSTANTIATED. Per California Code of Regulations, Title 22, Division 12, a deficiency is being cited (see next page 9099D).

Exit interview conducted with Director Jan Fusselman. Facility was provided with a copy of this report, appeal rights and a LIC 9213 - Notice of Site Visit Form is required to be posted to parent's board and must remain posted for 30 days.
Substantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Susie FanningTELEPHONE: (559) 650-7980
LICENSING EVALUATOR NAME: Kari McWilliamsTELEPHONE: (559) 341-4724
LICENSING EVALUATOR SIGNATURE:

DATE: 04/15/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/15/2021
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 4
Control Number 04-CC-20210128113643
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1310 E. SHAW AVE,
FRESNO, CA 93710

FACILITY NAME: FRESNO MONTESSORI SCHOOL
FACILITY NUMBER: 100403062
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/15/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
05/03/2021
Section Cited
CCR
101223(a)(3)
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Personal Rights 101223(a)(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 including but not limited to: interference with functions of daily living including eating, sleepingor toileting; or withholding
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Director would review children's personal rights with staff, discuss each point, make plan on how to improve on each point.
Director will provide written plan and signature of staff attendance to LPA by May 3, 2021.
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of shelter, clothing, medication or aids to physical functioning. Based on interviews, this was not met by Staff #1 speaking in a harsh tone/manner to children in care. This poses as a potential risk to the health, safety and/or personal rights of cihldren in care.
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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: Susie FanningTELEPHONE: (559) 650-7980
LICENSING EVALUATOR NAME: Kari McWilliamsTELEPHONE: (559) 341-4724
LICENSING EVALUATOR SIGNATURE:

DATE: 04/15/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/15/2021
LIC9099 (FAS) - (06/04)
Page: 2 of 4
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1310 E. SHAW AVE,
FRESNO, CA 93710
This is an official report of an unannounced visit/investigation of a complaint received in our office on
01/28/2021 and conducted by Evaluator Kari McWilliams
PUBLIC
COMPLAINT CONTROL NUMBER: 04-CC-20210128113643

FACILITY NAME:FRESNO MONTESSORI SCHOOLFACILITY NUMBER:
100403062
ADMINISTRATOR:FUSSELMAN, JANETFACILITY TYPE:
850
ADDRESS:1572 E. BARSTOWTELEPHONE:
(559) 432-3669
CITY:FRESNOSTATE: CAZIP CODE:
93710
CAPACITY:80CENSUS: DATE:
04/15/2021
UNANNOUNCEDTIME BEGAN:
10:15 AM
MET WITH:Jan FusselmanTIME COMPLETED:
11:30 AM
ALLEGATION(S):
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2
3
4
5
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7
8
9
Staff handled child in a rough manner while in care.
INVESTIGATION FINDINGS:
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On April 15, 2021, Licensing Program Analysts (LPAs) Kari McWilliams and Robert Gutierrez conducted an unannounced inspection to provide findings with regard to the above-listed allegation. LPAs met with Director Jan Fusselman.

During the course of the investigation, LPA McWilliams reviewed records and conducted interviews with staff and parents. Based on the investigation, there is not a preponderance of the evidence to prove that staff physically handled child(ren) in a rough manner. Although the allegation may have happened or is valid, the preponderance of the evidence standard has not been met, therefore, the allegation is UNSUBSTANTIATED.

Exit interview conducted with Director Jan Fusselman. Facility was provided with a copy of this report, appeal rights and a LIC 9213 - Notice of Site Visit Form is required to be posted to parent's board and must remain posted for 30 days.
Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Susie FanningTELEPHONE: (559) 650-7980
LICENSING EVALUATOR NAME: Kari McWilliamsTELEPHONE: (559) 341-4724
LICENSING EVALUATOR SIGNATURE:

DATE: 04/15/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/15/2021
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 4 of 4