198013166-11-18-2020-33-CC-CGUA-BW75UT-20201210191628

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198013166
Report Date: 11/18/2020
Date Signed: 11/18/2020 05:54:31 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

This is an official report of an unannounced visit/investigation of a complaint received in our office on
09/16/2020 and conducted by Evaluator Mireya Garcia

PUBLIC

COMPLAINT CONTROL NUMBER: 33-CC-20200916154541

FACILITY NAME:	MONTESSORI ACADEMY OF LA PUENTE		FACILITY NUMBER:	198013166
ADMINISTRATOR:	JACQUELINE MADRIGAL		FACILITY TYPE:	850
ADDRESS:	846 N. ORANGE AVENUE		TELEPHONE:	(626) 917-3638
CITY:	LA PUENTE	STATE: CA	ZIP CODE:	91744
CAPACITY:	138	CENSUS: 36	DATE:	11/18/2020
		ANNOUNCED	TIME BEGAN:	03:01 PM
MET WITH:	Director, Megha Sahni		TIME COMPLETED:	03:23 PM

ALLEGATION(S):

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Staff scratched daycare child

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Mireya García contacted the facility on November 18, 2020, via telephone due to COVID-19 and precautionary measures in order to provide the findings of the Complaint investigation. This inspection was conducted with Director, Megha Sahni via a tele-inspection by use of Facetime. During this tele-inspection the Director took this LPA on a virtual tour of the facility. There were 36 children present at the facility during this tele-inspection.

Allegation states that Staff scratched daycare child. Reporting Party (RP) reported on September 14, 2020 observing injuries; scratches on a child in care and believes a staff member scratched child. Per RP, no disclosures were made by child.

Report continues on next page 1 of 3.

Substantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Valarie Cook	TELEPHONE: (323) 981-3362
LICENSING EVALUATOR NAME: Mireya Garcia	TELEPHONE: (323) 558-2192
LICENSING EVALUATOR SIGNATURE:	DATE: 11/18/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/18/2020

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 33-CC-20200916154541

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: MONTESSORI ACADEMY OF LA PUENTE	FACILITY NUMBER: 198013166
	VISIT DATE: 11/18/2020

NARRATIVE

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During this investigation, LPA García obtained; copies of Children's roster dated 09/25/20, Children’s Classroom Schedule dated September 2020, LIC 500 Personnel Report dated 09/24/20, Roses classroom’s Daily Physical Check for the month of September 2020, Roses Classroom Time In/Out Sheet for the month of September, Roses classroom’s Child Supervision Record for month of September 2020, a Blank copy of Potty Training and Diaper Changing Chart, Staff Meeting Agenda dated 09/16/20, Roses classroom's Student/Teacher Ratios Staffing Pattern for the week of 09/14-09/18, Employee memo for Staff #1, Declaration from Director, ouch report dated 09/14/20 for child in question and pictures of child’s injuries.

Based on observations made on 09/25/20, LPA García observed the physical check station inside the outdoor patio area of the facility being used by staff to conduct health checks upon children’s arrival to the facility. The staff was observed documenting the daily physical checks of children.

In review of records Director provided a copy to LPA of the Daily Physical Check document dated September 14, 2020 for review, although each entry identifies a section for; cough/cold, bruise/scratch, bumps, rash, open wound, eye sore, fever, clear, teacher initial, temperature, the Daily Physical Check document indicates child in question was cleared. Director also provided LPA a copy of the Employee Memo; First warning dated September 16, 2020 for Staff #1 given for lack of supervision of the classroom resulting to scratches on the child’s body signed by both Staff #1 and Director.

LPA García conducted interviews with Director, three (3) Staff, four (4) parents of currently enrolled children who attend facility and attempted to interview child in question.

Although all interviews conducted with staff determined staff denied observing or having knowledge of any child being scratched while in care. During interviews with Director and Staff statements, they concur that Staff received first warning for lack of supervision of the classroom as a result of incident involving child in question. Staff disclosed child in question was clear of any scratches during daily physical check conducted on September 14, 2020 by Staff. All four (4) parents interviewed disclosed in the time attending day care all families have not had any issues or concerns with staff or day care services. In addition, all four (4) families denied their child being scratched by staff.

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SUPERVISOR'S NAME: Valarie Cook	TELEPHONE: (323) 981-3362
LICENSING EVALUATOR NAME: Mireya Garcia	TELEPHONE: (323) 558-2192
LICENSING EVALUATOR SIGNATURE:	DATE: 11/18/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/18/2020

LIC9099 (FAS) - (06/04)

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Control Number 33-CC-20200916154541

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: MONTESSORI ACADEMY OF LA PUENTE	FACILITY NUMBER: 198013166
	VISIT DATE: 11/18/2020

NARRATIVE

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Based on LPAs interviews which were conducted, and record reviews, the preponderance of evidence standard has been met, therefore the above allegation is found to be substantiated. California Code of Regulations, Title 22, Division 12, Chapter 1, the following deficiency is being cited (see attached 9099D).

A copy of this report must be provided to the authorized representatives of all currently enrolled children and must also be provided to newly enrolled children for the next 12 months. The report shall be provided no later than the next business day or the next day the child is in care.

The ACKNOWLEDGEMENT OF RECEIPT OF LICENSING REPORTS (LIC9224) shall be signed and kept in each of the children’s records. Web site address to obtain forms, review quarterly updates, review Title 22 & Health & Safety Codes is: www.ccld.ca.gov.

A Notice of Site Visit was not provided to Director, Megha Sahni since a physical inspection was not conducted.

Exit interview was conducted with Director, Megha Sahni via tele-inspection, during which Appeal Rights were verbally explained to Director. A copy of this report has been signed by LPA García. This report, along with a copy of the Appeal Rights (LIC 9058) will be scanned via e-mail to Director Megha, who understands that an electronic “Read Receipt” and/or confirmation of receipt of the e-mail confirms receipt of the report and constitutes an electronic signature.

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SUPERVISOR'S NAME: Valarie Cook	TELEPHONE: (323) 981-3362
LICENSING EVALUATOR NAME: Mireya Garcia	TELEPHONE: (323) 558-2192
LICENSING EVALUATOR SIGNATURE:	DATE: 11/18/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/18/2020

LIC9099 (FAS) - (06/04)

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Control Number 33-CC-20200916154541

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: MONTESSORI ACADEMY OF LA PUENTE	FACILITY NUMBER: 198013166
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 11/18/2020

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Request Denied Type A 11/25/2020 Section Cited CCR 101223(a)(1)(2)	1 2 3 4 5 6 7	101223 Personal Rights : (a) The licensee shall ensure that each child is accorded the following personal rights:(1) To be accorded dignity in his/her personal relationships with staff and other persons. (2) To be accorded safe, healthful and comfortable accommodations, furnishings and equipment to meet his/her needs.	1 2 3 4 5 6 7	Per Director Megha, she will conduct an all staff training regarding; personal rights, visual and sound supervision and health check procedures and will provide LPA Garcia via email staff agenda and staff sign in sheet by POC due date of 11/25/2020.
	8 9 10 11 12 13 14	This requirement is not met as evidenced by LPA's investigation findings of records review and staff disclosures reveal Staff #1 was written up for lack of supervision of the classroom resulting to scratches on the child's body. This poses and immediate health and safety 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
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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: Valarie Cook	TELEPHONE: (323) 981-3362
LICENSING EVALUATOR NAME: Mireya Garcia	TELEPHONE: (323) 558-2192
LICENSING EVALUATOR SIGNATURE:	DATE: 11/18/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/18/2020

LIC9099 (FAS) - (06/04)

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