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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 197492785
Report Date: 11/01/2021
Date Signed: 11/01/2021 03:26:05 PM



STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
This is an official report of an unannounced visit/investigation of a complaint received in our office on
08/09/2021 and conducted by Evaluator Justin Dorsey
COMPLAINT CONTROL NUMBER: 12-CC-20210809083003
FACILITY NAME:MONTESSORI OF SANTA CLARITAFACILITY NUMBER:
197492785
ADMINISTRATOR:BRANDY BLACK-PEREAFACILITY TYPE:
840
ADDRESS:27757 BOUQUET CANYON ROADTELEPHONE:
(661) 296-0175
CITY:SANTA CLARITASTATE: CAZIP CODE:
91350
CAPACITY:20CENSUS: 3DATE:
11/01/2021
UNANNOUNCEDTIME BEGAN:
02:30 PM
MET WITH:Brandy Black-PereaTIME COMPLETED:
03:40 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Facility is not requiring children to wear masks.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On 11/01/21 Licensing Program Analyst (LPA) Justin Dorsey and Liana Stepanyan conducted a complaint investigation at the facility to deliver complaint investigation findings. LPA met with director Brandy Black-Perea, who guided LPA on a tour of the facility. Upon arrival LPA observed 3 children in care with 1 staff.

The investigation consisted of interviews with the director, staff, children and parents of the program. During the visit on 11/01/21 LPA's observed all children and staff wearing masks. According to director Brandy Black-Perea the facility sent a memo throuh class dojo to parents of the program that children ages 2 and up will be required to wear facemasks. Per director children of the program are encoraged to wear their masks. Based on the evidence obtained and LPAs observation the above allegation is deemed unsubstantiated. Although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the facility is not providing a safe and healthful environment, Therefore the above allegations are Unsubstantiated.

An exit interview was conducted, and a copy of this report was provided to director Brandy Black-Perea along with Notice of Site Visit and Appeal Rights.
Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Claretta YatesTELEPHONE: (661) 202-3318
LICENSING EVALUATOR NAME: Justin DorseyTELEPHONE: (661) 305-3012
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)
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