198013166-5-11-2020-33-CC-CGAN-BPRTZU-20200519151056

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198013166
Report Date: 05/11/2020
Date Signed: 05/11/2020 01:41:49 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
02/21/2020 and conducted by Evaluator Lissete Gonzalez

PUBLIC

COMPLAINT CONTROL NUMBER: 33-CC-20200221145618

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: 7	DATE:	05/11/2020
		UNANNOUNCED	TIME BEGAN:	10:30 AM
MET WITH:	Jacqueline Madrigal		TIME COMPLETED:	10:54 AM

ALLEGATION(S):

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Facility staff handled daycare child in a rough manner.

INVESTIGATION FINDINGS:

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At 10:30a.m. on May 11, 2020, Licensing Program Analyst (LPA) Lissete Gonzalez conducted a Tele-Visit Complaint Inspection due to COVID-19 and precautionary measures. The purpose of the Tele-Visit was to conclude the investigation regarding the above complaint allegation. LPA met with Director, Jacqueline Madrigal, who guided LPA on a virtual tour of the facility. Census was taken.

During the course of the investigation, interviews were conducted with five (5) day-care staff, five (5) day-care children, the reporting party and witness. Based on the evidence obtained during the investigation through interviews with staff and children, observation, and record review, the evidence does not support the above allegation. Although the allegation may have happened or is valid there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is Unsubstantiated.

Per California Code of Regulations Title 22, Division 12, no deficiency cited during today's visit. Exit interview
REPORT CONTINUES ON NEXT PAGE: 1 OF 2

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Christina Gabelman	TELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Lissete Gonzalez	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:	DATE: 05/11/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/11/2020

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-20200221145618

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: 05/11/2020

NARRATIVE

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conducted with Director, Jacqueline Madrigal. A copy of the report (LIC 9099), Appeal Rights (LIC 9058), and the Notice of Site Visit (LIC 9213) were sent via Email and an electronic read receipt confirms receipt of the reports. The facility representative was provided with the mailing address for the Monterey Park Regional Office (1000 Corporate Center Drive, Suite 200B, Monterey Park, CA 91754) and agrees to send the original report by email.

The Notice of Site Visit (LIC 9213) shall be posted for 30 consecutive days. Failure to maintain posting as required will result in a $100.00 civil penalty.

END OF REPORT: PAGE 2 OF 2

SUPERVISOR'S NAME: Christina Gabelman	TELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Lissete Gonzalez	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:	DATE: 05/11/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/11/2020

LIC9099 (FAS) - (06/04)

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