<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 197492787
Report Date: 10/15/2021
Date Signed: 10/15/2021 12:35:10 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 Lady King
COMPLAINT CONTROL NUMBER: 12-CC-20210809085157
FACILITY NAME:MONTESSORI OF SANTA CLARITAFACILITY NUMBER:
197492787
ADMINISTRATOR:BRANDY BLACK-PEREAFACILITY TYPE:
850
ADDRESS:27757 BOUQUET CANYON ROADTELEPHONE:
(661) 296-0175
CITY:SANTA CLARITASTATE: CAZIP CODE:
91350
CAPACITY:90CENSUS: 25DATE:
10/15/2021
UNANNOUNCEDTIME BEGAN:
11:45 AM
MET WITH:Brandy Black-PereaTIME COMPLETED:
12:45 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
Licensing Program Analyst (LPA) Lady King-Lewis and Liana Stepanyan conducted a subsequent investigation inspection for the purpose of delivering the finding on the above allegation. Upon arrival, LPA was greeted by director Brandy Black-Perea. The Preschool census at the at the time of this inspection is 25 children with 3 staff providing care and supervision.

The investigation concerning the above allegation consisted of interviews with staff, other pertinent parties including LPA observation during inspections conducted on 08/17/21 and 10/15/21.

Based on the interviews conducted and LPA’s observation, all staff providing supervision to children were wearing a facial covering. LPA was informed the facility have a supply of additional facial coverings available for staff and children. LPA was informed staff are encouraging children to wear their facial coverings throughout the day. LPA observed posters concerning facial coverings to remind and encourage
Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Mariela RamonTELEPHONE: (661) 202-3798
LICENSING EVALUATOR NAME: Lady KingTELEPHONE: (661) 568-8933
LICENSING EVALUATOR SIGNATURE:

DATE: 10/15/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/15/2021
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 2
Control Number 12-CC-20210809085157
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: MONTESSORI OF SANTA CLARITA
FACILITY NUMBER: 197492787
VISIT DATE: 10/15/2021
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
children to wear facial covering. From the evidence obtained during the investigation, the facility is following the mask mandate by the Department of Public Health.

This complaint is being deemed unsubstantiated.

An exit interview was conducted with Brandy Black-Perea director, a copy of this report was provided along with the appeal rights and Notice of Site Visit.
SUPERVISOR'S NAME: Mariela RamonTELEPHONE: (661) 202-3798
LICENSING EVALUATOR NAME: Lady KingTELEPHONE: (661) 568-8933
LICENSING EVALUATOR SIGNATURE:

DATE: 10/15/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/15/2021
LIC9099 (FAS) - (06/04)
Page: 2 of 2