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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 197493268
Report Date: 02/10/2022
Date Signed: 02/10/2022 12:23:15 PM



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
11/19/2021 and conducted by Evaluator Laticia S Thompson
PUBLIC
COMPLAINT CONTROL NUMBER: 30-CC-20211119080607
FACILITY NAME:VALLEY MONTESSORI PRESCHOOLFACILITY NUMBER:
197493268
ADMINISTRATOR:GAYANI SENARATNEFACILITY TYPE:
850
ADDRESS:22103 VANOWEN STREETTELEPHONE:
(818) 578-6177
CITY:CANOGA PARKSTATE: CAZIP CODE:
91303
CAPACITY:76CENSUS: 63DATE:
02/10/2022
UNANNOUNCEDTIME BEGAN:
11:05 AM
MET WITH:Noesh HordagodaTIME COMPLETED:
12:43 PM
ALLEGATION(S):
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Facility have not provided a copy of records to authorized representative
INVESTIGATION FINDINGS:
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On at 02/10/2022 Licensing Program Analyst (LPA) Laticia Thompson conducted an unannounced visit to Valley Montessori Preschool. LPA met with Noesh Hordagoda (Administrator). LPA advised administrator the reason for the visit today is to deliver the findings of the complaint received on 11/19/2021 regarding the allegations referenced above. LPA observed 63 children and 8 adults

Based on LPA’s interview conducted and record review the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED. California code of Regulations (Title 22, Division chapter number are being cited on 9099D

Substantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Peter FloresTELEPHONE: (424) 301-3077
LICENSING EVALUATOR NAME: Laticia S ThompsonTELEPHONE: (424) 301-3048
LICENSING EVALUATOR SIGNATURE:

DATE: 02/10/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/10/2022
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 30-CC-20211119080607
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: VALLEY MONTESSORI PRESCHOOL
FACILITY NUMBER: 197493268
VISIT DATE: 02/10/2022
NARRATIVE
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The Licensee was advised that the Notice of Site Visit and a copy of this report must be posted at the entrance of the facility for a period of 30 days.

In addition; A copy of this report must be provided to the parent or authorized representatives of all currently enrolled children and any newly enrolled children for the following 12 months.
The ACKNOWLEDGEMENT OF RECEIPT OF LICENSING REPORTS (LIC9224) shall be signed and kept in each of the children’s records. The report shall be provided no later than the next business day or the next day the child is in care.
SUPERVISOR'S NAME: Peter FloresTELEPHONE: (424) 301-3077
LICENSING EVALUATOR NAME: Laticia S ThompsonTELEPHONE: (424) 301-3048
LICENSING EVALUATOR SIGNATURE:

DATE: 02/10/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/10/2022
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, 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
11/19/2021 and conducted by Evaluator Laticia S Thompson
COMPLAINT CONTROL NUMBER: 30-CC-20211119080607

FACILITY NAME:VALLEY MONTESSORI PRESCHOOLFACILITY NUMBER:
197493268
ADMINISTRATOR:GAYANI SENARATNEFACILITY TYPE:
850
ADDRESS:22103 VANOWEN STREETTELEPHONE:
(818) 578-6177
CITY:CANOGA PARKSTATE: CAZIP CODE:
91303
CAPACITY:76CENSUS: DATE:
02/10/2022
UNANNOUNCEDTIME BEGAN:
11:05 AM
MET WITH:Noesh HordagodaTIME COMPLETED:
12:43 PM
ALLEGATION(S):
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Children are forced to stay sleep.
INVESTIGATION FINDINGS:
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On at 02/10/2022 Licensing Program Analyst (LPA) Laticia Thompson conducted an unannounced visit to Valley Montessori Preschool. LPA met with Noesh Hordagoda (Adminstrator). LPA advised administrator the reason for the visit today is to deliver the findings of the complaint received on 11/19/2021 regarding the allegations referenced above. LPA observed 63 children and 8 staff members today.

Based on the evidence gathered throughout the investigation, there is not a preponderance of evidence to support or deny the allegation above . LPA conducted interviews with relevant parties and was unable to determine that children have been forced to stay sleep. Therefore, the allegations is unsubstantiated.

Unsubstantiated – A finding that the complaint is unsubstantiated means that although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged allegation occurred.
Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Peter FloresTELEPHONE: (424) 301-3077
LICENSING EVALUATOR NAME: Laticia S ThompsonTELEPHONE: (424) 301-3048
LICENSING EVALUATOR SIGNATURE:

DATE: 02/10/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/10/2022
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
Control Number 30-CC-20211119080607
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: VALLEY MONTESSORI PRESCHOOL
FACILITY NUMBER: 197493268
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/10/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
02/10/2022
Section Cited
CCR
101218.1(e)
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101218.1Admission Procedures and Parental and Authorized Representative's Rights (e)At the time of acceptance of each child into care and for all children... licensee shall give each parent... a copy of the Notification of Parents' Rights (LIC 995) ...This requirement was not met by
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Administrator has provided all parents or authorized representative with copies of LIC 995 Parental Rights. Administrator has updated the mailing address and phone number to the regional office on the documents. LPA reviewed files and confirmed documentation has been provided and updated.
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Based on record review and interveiw with Administrator a copy of the parents rights were not provided to parents or authorized representative. which poses a potential health and safety risk to children 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: Peter FloresTELEPHONE: (424) 301-3077
LICENSING EVALUATOR NAME: Laticia S ThompsonTELEPHONE: (424) 301-3048
LICENSING EVALUATOR SIGNATURE:

DATE: 02/10/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/10/2022
LIC9099 (FAS) - (06/04)
Page: 3 of 4