197416027-8-12-2021-30-CC-MRUZ-C5UKE5-20210813074947

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197416027
Report Date: 08/11/2021
Date Signed: 08/12/2021 09:48:54 AM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

This is an official report of an unannounced visit/investigation of a complaint received in our office on
06/17/2021 and conducted by Evaluator Lisa Rios

PUBLIC

COMPLAINT CONTROL NUMBER: 30-CC-20210617095327

FACILITY NAME:	WEST VALLEY MONTESSORI		FACILITY NUMBER:	197416027
ADMINISTRATOR:	JEWEL FERRER		FACILITY TYPE:	830
ADDRESS:	20211 SATICOY STREET		TELEPHONE:	(818) 341-5655
CITY:	WINNETKA	STATE: CA	ZIP CODE:	91304
CAPACITY:	7	CENSUS: 5	DATE:	08/11/2021
		UNANNOUNCED	TIME BEGAN:	09:30 AM
MET WITH:	Jewel Ferrer		TIME COMPLETED:	10:30 AM

ALLEGATION(S):

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7
8
9

LICENSE:
Facility staff is commingling infants with preschoolers.

NEGLECT/LACK OF SUPERVISION
Infant left in crib for extended period of time.

INVESTIGATION FINDINGS:

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13

Licensing Program Analyst (LPA) Lisa Rios made an unannounced visit to the West Valley Montessori on 8/12/21 for the purpose of concluding the investigation on the above allegations and to deliver the findings. LPA met with Administrator and together discussed the investigation details.

Based on the interviews conducted during the investigation process and statements obtained during the investigation process, the allegations cannot be substantiated. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is UNSUBSTANTIATED.

Exit interview was conducted with the facility administrator. Appeal Rights were issued, and a copy of this report was left at the facility.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Peter Flores	TELEPHONE: (424) 301-3077
LICENSING EVALUATOR NAME: Lisa Rios	TELEPHONE: (424) 301-3072
LICENSING EVALUATOR SIGNATURE:	DATE: 08/09/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/09/2021

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 3

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

This is an official report of an unannounced visit/investigation of a complaint received in our office on
06/17/2021 and conducted by Evaluator Lisa Rios

PUBLIC

COMPLAINT CONTROL NUMBER: 30-CC-20210617095327

FACILITY NAME:	WEST VALLEY MONTESSORI		FACILITY NUMBER:	197416027
ADMINISTRATOR:	JEWEL FERRER		FACILITY TYPE:	830
ADDRESS:	20211 SATICOY STREET		TELEPHONE:	(818) 341-5655
CITY:	WINNETKA	STATE: CA	ZIP CODE:	91304
CAPACITY:	7	CENSUS:	DATE:	08/11/2021
		UNANNOUNCED	TIME BEGAN:	09:30 AM
MET WITH:	Administrator Jewel Ferrer		TIME COMPLETED:	10:30 AM

ALLEGATION(S):

1
2
3
4
5
6
7
8
9

LICENSE
Facility is operating out of ratio.
Unqualified staff providing care and supervision to infants.

INVESTIGATION FINDINGS:

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

Licensing Program Analyst (LPA) Lisa Rios made an unannounced inspection to the West Valley Montessori on 8/12/21 for the purpose of concluding the investigation on the above allegations and to deliver the findings.
Based on the interviews conducted during the investigation process and statements from LPA Rios (see LIC812 dated 6/24/21) obtained during the investigation process, the above allegations have been substantiated.
The Department has concluded, based on the preponderance of the evidence obtained during this investigation, that the above allegations are SUBSTANTIATED.
The following 2 Type A 101416.5 (b) and 101416.3 (a)(b) deficiencies have been cited per California Code of Regulations, TITLE 22, DIVISION 12, CHAPTER 1 Articles 1-7.

Exit interview was conducted with the licensee. Appeal Rights were issued, and a copy of this report was left at the facility.

Substantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Peter Flores	TELEPHONE: (424) 301-3077
LICENSING EVALUATOR NAME: Lisa Rios	TELEPHONE: (424) 301-3072
LICENSING EVALUATOR SIGNATURE:	DATE: 08/11/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/11/2021

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 3

Control Number 30-CC-20210617095327

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME: WEST VALLEY MONTESSORI	FACILITY NUMBER: 197416027
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 08/11/2021

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type A 08/11/2021 Section Cited CCR 101416.5(b)	1 2 3 4 5 6 7	101416.5 (b) (b) There shall be a ratio of one teacher for every four infants in attendance. This requirement is not met as evidenced by: Based on observations by LPA Rios on 6/24/21, there was 1 teacher with 6 infants.	1 2 3 4 5 6 7	The Director shall ensure that either herself or another teacher fills in in the infant room when the children are awake and the teachers need their lunch break. A staff meeting discussing such and a declaration signed by Administartor shall be submitted to LPA Rios no later than 9/11/21.
Type A 08/11/2021 Section Cited CCR 101416.3(a)(b)	1 2 3 4 5 6 7	101416.3 Infant Care Aide Qualifications and Duties (a) In addition to Section 101216.2, the following shall apply: (b) An infant care aide shall work under the direct supervision of the director, the assistant director or a fully qualified teacher. This requirement was not met as evidenced by:	1 2 3 4 5 6 7	The Director has satified the Plan of Correction for this deficiency by enrolling the aide in the required infant course as of 7/28/21. LPA Rios has received the receipt.
	8 9 10 11 12 13 14	At the time of LPA Rios's visit to the facility on 6/24/21, there was an aid in the classroom by herself.	8 9 10 11 12 13 14
	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: Peter Flores	TELEPHONE: (424) 301-3077
LICENSING EVALUATOR NAME: Lisa Rios	TELEPHONE: (424) 301-3072
LICENSING EVALUATOR SIGNATURE:	DATE: 08/11/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/11/2021

LIC9099 (FAS) - (06/04)

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