213004841-3-18-2021-05-CC-GLEG-BZ92G6-20210318172237

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 213004841
Report Date: 03/18/2021
Date Signed: 03/18/2021 12:44:51 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

This is an official report of an unannounced visit/investigation of a complaint received in our office on
12/21/2020 and conducted by Evaluator Farhan Bashir-Tariq

PUBLIC

COMPLAINT CONTROL NUMBER: 05-CC-20201221091603

FACILITY NAME:	ABBEY MONTESSORI CHILDREN'S CENTER - INFANT		FACILITY NUMBER:	213004841
ADMINISTRATOR:	COSTELO, ELIZABETH		FACILITY TYPE:	830
ADDRESS:	138 N. SAN PEDRO ROAD		TELEPHONE:	(415) 479-8865
CITY:	SAN RAFAEL	STATE: CA	ZIP CODE:	94903
CAPACITY:	12	CENSUS: 6	DATE:	03/18/2021
		UNANNOUNCED	TIME BEGAN:	12:08 PM
MET WITH:	Lourdes Anca		TIME COMPLETED:	12:18 PM

ALLEGATION(S):

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Staff left day-care child in wet clothing.
Staff do not maintain a comfortable temperature in classroom.

INVESTIGATION FINDINGS:

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***** This report was prepared in CCLD Regional Office, San Bruno on 3/18/21. This inspection was conducted via phone call due to COVID-19 restrictions. Lourdes was informed that a copy of today’s report will be emailed to her *****

Licensing Program Analyst (LPA), Farhan Bashir-Tariq called and spoke to co-director, Lourdes Anca to deliver the findings of this complaint investigation on 3/18/21. Purpose of inspection was explained. During the course of investigation, interviews were conducted with RP, Lourdes and Parents. As part of this investigation, Facility Roster, Techers Schedule, Personnel Report and Copies of email communications between facility staff and parents, were collected.

This agency has investigated the complaint alleging that day care staff left a child in wet clothing and failed to maintain a comfortable temperature in classroom. Based on the information obtained, although the allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is UNSUBSTANTIATED.

No citations were issued on this report. This report must be available in the facility for public review. Facility was advised to call office for any additional questions, M-F, 8AM-5PM at 650-266-8800. Website: www.cdss.ca.gov

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Garfield Leung	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Farhan Bashir-Tariq	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 03/18/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/18/2021

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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