313617640-1-18-2022-03-CC-KPES-CB7VD6-20220131152011

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 313617640
Report Date: 01/18/2022
Date Signed: 01/18/2022 11:21:17 AM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833

This is an official report of an unannounced visit/investigation of a complaint received in our office on
12/07/2021 and conducted by Evaluator Amanda Blesi

PUBLIC

COMPLAINT CONTROL NUMBER: 03-CC-20211207090401

FACILITY NAME:	MORNINGSTAR MONTESSORI		FACILITY NUMBER:	313617640
ADMINISTRATOR:	PERKINS, BRITTANY		FACILITY TYPE:	850
ADDRESS:	218 5TH STREET		TELEPHONE:	(916) 645-1324
CITY:	LINCOLN	STATE: CA	ZIP CODE:	95648
CAPACITY:	27	CENSUS: 17	DATE:	01/18/2022
		UNANNOUNCED	TIME BEGAN:	09:30 AM
MET WITH:	Serena Green		TIME COMPLETED:	11:45 AM

ALLEGATION(S):

1
2
3
4
5
6
7
8
9

Personal Rights - Staff member handled daycare child in a rough manner
Other - Facility staff have not been following the proper protocol for COVID-19

INVESTIGATION FINDINGS:

1
2
3
4
5
6
7
8
9
10
11
12
13

LPA Amanda Blesi met with teacher Serena Green who states Brittany Perkins is out of town and will return tomorrow. The purpose of today's inspection is to deliver findings for the complaint that was opened on 12.08.2022. During the investigation LPA interviewed the complainant, staff, and children. The allegation states a staff handled a child in a rough manner. Based on eyewitness testimony and interviews, it was determined a child was handled in a rough and aggressive manner which violated the child's Personal Rights. It was also alleged that the facility does not follow proper protocol for COVID-19 by not wearing a mask indoors. Staff were observed not wearing masks/face coverings while indoors. The preponderance of evidence standard was met and the allegations above are SUBSTANTIATED.

Title 22 Deficiency has been cited on the attached LIC 9099-D. LPA Amanda Blesi informed facility representative Serena Green that this report dated January 18, 2022 document(s) one Type A citation(s) which shall be posted for 30 consecutive days as there is/are immediate risk(s) to the health, safety, or personal rights of children in care. Report is continued on the following page (See LIC 9099-C....)

Substantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Keven Peters	TELEPHONE: (916) 263-5728
LICENSING EVALUATOR NAME: Amanda Blesi	TELEPHONE: (916) 208-3427
LICENSING EVALUATOR SIGNATURE:	DATE: 01/18/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/18/2022

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

Page: 1 of 3

Control Number 03-CC-20211207090401

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833

FACILITY NAME: MORNINGSTAR MONTESSORI	FACILITY NUMBER: 313617640
	VISIT DATE: 01/18/2022

NARRATIVE

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32

Also, LPA Amanda Blesi informed facility representative to provide a copy of this licensing report dated January 18, 2022 that documents any Type A citation(s) to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification. Appeal Rights given.

Exit interview conducted and report was reviewed with facility representative Serena Green.
A notice of site visit was given and must remain posted for 30 days.
Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

SUPERVISOR'S NAME: Keven Peters	TELEPHONE: (916) 263-5728
LICENSING EVALUATOR NAME: Amanda Blesi	TELEPHONE: (916) 208-3427
LICENSING EVALUATOR SIGNATURE:	DATE: 01/18/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/18/2022

LIC9099 (FAS) - (06/04)

Page: 2 of 3

Control Number 03-CC-20211207090401

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833

FACILITY NAME: MORNINGSTAR MONTESSORI	FACILITY NUMBER: 313617640
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 01/18/2022

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type A 01/19/2022 Section Cited CCR 101223(a)(3)	1 2 3 4 5 6 7	Personal Rights: The licensee shall ensure that each child is accorded the following personal rights: To be free from corporal or unusual punishment, infliction of pain, humiliation, intimidation, ridicule, coercion, threat, mental abuse or other actions of a punitive nature...This requirement is not met as	1 2 3 4 5 6 7	LIcensee shall conduct a staff training on children's personal rights. To correct the deficiency, licensee shall submit a summary of the training as well as employee signatures of who attended the training. Proof of correction can be mailed to the office or emailed to LPA @amanda.blesi@dss.ca.gov.
	8 9 10 11 12 13 14	evidenced: Evidence gathered revealed staff #1 grabbed a child by the arm and yanked the child to the ground by pulling on the child’s arm in a rough and aggressive manner.	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: Keven Peters	TELEPHONE: (916) 263-5728
LICENSING EVALUATOR NAME: Amanda Blesi	TELEPHONE: (916) 208-3427
LICENSING EVALUATOR SIGNATURE:	DATE: 01/18/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/18/2022

LIC9099 (FAS) - (06/04)

Page: 3 of 3