197750015-8-26-2021-12-CC-CBEL-C6UVR9-20210914163934

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197750015
Report Date: 08/26/2021
Date Signed: 08/26/2021 04:32:10 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
06/23/2021 and conducted by Evaluator Brigitte Tsutaoka

PUBLIC

COMPLAINT CONTROL NUMBER: 12-CC-20210623140438

FACILITY NAME:	LANCASTER MONTESSORI PRESCHOOL		FACILITY NUMBER:	197750015
ADMINISTRATOR:	KARINA ESPANA		FACILITY TYPE:	850
ADDRESS:	933 NEWGROVE AVE		TELEPHONE:	(661) 723-0026
CITY:	LANCASTER	STATE: CA	ZIP CODE:	93534
CAPACITY:	63	CENSUS: 18	DATE:	08/26/2021
		UNANNOUNCED	TIME BEGAN:	01:50 PM
MET WITH:	Assistant Director Karen Jones		TIME COMPLETED:	04:45 PM

ALLEGATION(S):

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Allegation: Ratio

INVESTIGATION FINDINGS:

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On August 26, 2021 at 1:50 PM, Licensing Program Analyst (LPA) Brigitte Tsutaoka conducted an unannounced complaint inspection on the above allegation. LPA disclosed the purpose of inspection and was granted entry by Assistant Director Karen Jones. Upon entry, LPA counted 18 napping children with 1 staff on association list. Assistant Director is also present at facility and is part of the ratios.

During the investigation, LPA interviewed staff, children, parents, and other relvant complaint parties. LPA also obtained facility roster, faciity sign in sheets, and staff time sheets. During staff interviews, it was determined that Staff 2 comes in earlier than her scheduled shifts and assists Assistant Director with supervision. Staff also disclosed the most children they tend to at once is 14. Child sign in sheets for June 10, 2021 and June 11, 2021, identified the facility was out of the required ratio of 1 staff for 12 children. On June 10, 2021 from 10:20AM until 12:28PM, 2 staff were present with 29 children. On June 11, 2021, from 10:15AM until 12:21PM, 2 staff were present with 27 children.

Substantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Carissa Bell	TELEPHONE: (661) 202-3359
LICENSING EVALUATOR NAME: Brigitte Tsutaoka	TELEPHONE: (661) 202-3786
LICENSING EVALUATOR SIGNATURE:	DATE: 08/26/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/26/2021

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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Control Number 12-CC-20210623140438

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: LANCASTER MONTESSORI PRESCHOOL	FACILITY NUMBER: 197750015
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 08/26/2021

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type A 08/27/2021 Section Cited CCR 101216.3(a)	1 2 3 4 5 6 7	101216.3 Teacher-Child Ratio (a) There shall be a ratio of one teacher visually observing and supervising no more than 12 children in attendance, except as specified in (b) and (c) below.This requirement was not met as evidence by:	1 2 3 4 5 6 7	Director will submit a schedule to the Department identifying coverage for the facility along with a plan to appoint substitute teachers should a staffing shortage occur. Schedule and plan shall be submitted no later than 8/27/2021.
	8 9 10 11 12 13 14	Based on interview and record review, it was determined the facility was out of ratio 6/10/2021 and 6/11/2021, which poses an immediate risk to children in care.	8 9 10 11 12 13 14
	1 2 3 4 5 6 7		1 2 3 4 5 6 7
	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: Carissa Bell	TELEPHONE: (661) 202-3359
LICENSING EVALUATOR NAME: Brigitte Tsutaoka	TELEPHONE: (661) 202-3786
LICENSING EVALUATOR SIGNATURE:	DATE: 08/26/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/26/2021

LIC9099 (FAS) - (06/04)

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Control Number 12-CC-20210623140438

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: LANCASTER MONTESSORI PRESCHOOL	FACILITY NUMBER: 197750015
	VISIT DATE: 08/26/2021

NARRATIVE

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Based on LPA's observations, interview, and record review, the preponderance of evidence standard has been met, therefore the above allegation is deemed Substantiated. California Code of Regulations, Title 22, Division 12 Chapter 1 101216.3 (a) Teacher-Child Ratio Type A violation is being cited. See LIC9099D for deficiency details.

Assistant Director was advised that the Notice of Site Visit must be posted at the entrance of the facility for a period of 30 days. A copy of this licensing report (LIC9099) must also be posted for 30 days. If these requirements are not met, civil penalties in the amount of $100 per violation will be assessed. Copies of the reports must also be provided to each parent. A copy of the Acknowledgment of receipt of licensing report (LIC9224) was
provided and must be kept in each child's file. In addition, any child enrolled within the following 12 months must also receive a copy of the Type A Citation.

An exit interview was conducted, a copy of this Report, Appeal Rights, and Notice of Site Visit was provided to Assistant Director.

SUPERVISOR'S NAME: Carissa Bell	TELEPHONE: (661) 202-3359
LICENSING EVALUATOR NAME: Brigitte Tsutaoka	TELEPHONE: (661) 202-3786
LICENSING EVALUATOR SIGNATURE:	DATE: 08/26/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/26/2021

LIC9099 (FAS) - (06/04)

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