198020312-12-4-2020-33-CC-CGUA-BWRVWP-20201229154817

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198020312
Report Date: 12/03/2020
Date Signed: 12/04/2020 12:18:33 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
11/10/2020 and conducted by Evaluator Alanna Gontarek

PUBLIC

COMPLAINT CONTROL NUMBER: 33-CC-20201110142007

FACILITY NAME:	MONTESSORI ACADEMY OF LA PUENTE/W.COVINA		FACILITY NUMBER:	198020312
ADMINISTRATOR:	ISMAT ARASTU		FACILITY TYPE:	830
ADDRESS:	846 N. ORANGE AVE		TELEPHONE:	(626) 917-3638
CITY:	LA PUENTE	STATE: CA	ZIP CODE:	91744
CAPACITY:	29	CENSUS: 5	DATE:	12/03/2020
		UNANNOUNCED	TIME BEGAN:	02:30 PM
MET WITH:	Megha Sahni		TIME COMPLETED:	04:15 PM

ALLEGATION(S):

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Staff did not provide child in care with a clean drinking cup

INVESTIGATION FINDINGS:

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An unannounced Complaint tele inspection was conducted via the FaceTime application by Licensing Program Analyst (LPA) Alanna Gontarek. LPA met with Director Megha Sahni to discuss the above allegation. Census was taken. There were 5 children present with 3 staff.

On 11/13/2020, LPAs Alanna Gontarek and Michelle Sanchez conducted an investigation into the above allegation. LPAs obtained and reviewed a copy of the Parent Contract, Infant Needs and Services Plan, and Infant snack menu. During the walk through, at 9:28 a.m., LPAs observed unwashed “sippy” cups, containing milk and other liquids, stored in the refrigerator inside of a bin labeled “Dirty Dishes.” Pictures were taken. Per staff interviews, disclosures were made that “sippy” cups are being provided by the children’s authorized representative and being maintained at the facility. Staff disclosed dishes are being washed daily in the kitchen with soap and cold water. LPAs observed the water temperature in the kitchen to be cold. The facility is not sterilizing or sanitizing the dishes properly. This poses a potential risk to the health and safety of children in care. PAGE 1 of 2

Substantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Claudia Guangorena	TELEPHONE: (323) 981-8417
LICENSING EVALUATOR NAME: Alanna Gontarek	TELEPHONE: (323) 854-8644
LICENSING EVALUATOR SIGNATURE:	DATE: 12/03/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/03/2020

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-20201110142007

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/W.COVINA	FACILITY NUMBER: 198020312
	VISIT DATE: 12/03/2020

NARRATIVE

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The investigation regarding: staff did not provide child in care with a clean drinking cup, was completed. Based on LPA’s observations, interviews which were 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 12 Chapter 1 Subchapter 02.), are being cited on the attached LIC 9099D.

An exit interview was conducted with Director. A copy of the Complaint Investigation report (LIC 9099), Appeal Rights (LIC 9058), and the Notice of Site Visit (LIC 9213) were explained and sent via Email to Director. An electronic read receipt confirms receipt of the reports. The facility representative was provided with the mailing address to the Monterey Park Regional Office (1000 Corporate Center Drive, Suite 200B, Monterey Park, CA 91754) and agrees to send a copy of the signed LIC 9099 reports by email to LPA and mail originals forms to the office. 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.

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SUPERVISOR'S NAME: Claudia Guangorena	TELEPHONE: (323) 981-8417
LICENSING EVALUATOR NAME: Alanna Gontarek	TELEPHONE: (323) 854-8644
LICENSING EVALUATOR SIGNATURE:	DATE: 12/03/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/03/2020

LIC9099 (FAS) - (06/04)

Page: 4 of 5

Control Number 33-CC-20201110142007

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/W.COVINA	FACILITY NUMBER: 198020312
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 12/03/2020

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 12/23/2020 Section Cited CCR 101427(n)(2)	1 2 3 4 5 6 7	101427 Infant Care Food Service (n) Bottles and nipples maintained by the infant care center shall be sterilized using any of the following methods after each use: (2) Soaked for a minimum of one minute in a sterilizing solution using ½ cup of bleach and five gallons of water and air-dried This requirement was not met as evidenced by: LPAs observed unwashed “sippy” cups stored in the refrigerator in a “Dirty Dishes” bin. LPAs also observed no running hot water in the facility. The facility is not sterilizing or sanitizing the dishes properly. This poses a potential risk to the health and safety of children in care. he kitchen where dishes are washed. Interviews conducted and disclosures made that “sippy” cups are maintained at the facility and washed with soap and cold water. The facility is not sterilizing or sanitizing the dishes properly. This poses a potential risk to the health and safety of children in care	1 2 3 4 5 6 7	Per Director, a staff meeting will be provided to the staff about sterilizing and sanitizing dishes 12/4/20. Per director, she will send a copy of agenda, information, and all staff signatures. Per director, she will have staff immediately using a bleach-water sanitizing solution to clean dishes, and facility will have hot
	8 9 10 11 12 13 14		8 9 10 11 12 13 14	running water by POC due date. Per Director, she will have staff rinse and return both water and milk/ juice "sippy" cups home daily
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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: Claudia Guangorena	TELEPHONE: (323) 981-8417
LICENSING EVALUATOR NAME: Alanna Gontarek	TELEPHONE: (323) 854-8644
LICENSING EVALUATOR SIGNATURE:	DATE: 12/03/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/03/2020

LIC9099 (FAS) - (06/04)

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