313619751-9-9-2019-03-CC-KPES-BG5N4D-20190918100745

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 313619751
Report Date: 09/09/2019
Date Signed: 09/09/2019 11:33:39 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
08/13/2019 and conducted by Evaluator Katrina Owens

COMPLAINT CONTROL NUMBER: 03-CC-20190813141231

FACILITY NAME:	AMERICAN MONTESSORI ACADEMY		FACILITY NUMBER:	313619751
ADMINISTRATOR:	WISE, MICHELLE		FACILITY TYPE:	850
ADDRESS:	1050 DOUGLAS BLVD		TELEPHONE:	(916) 786-3636
CITY:	ROSEVILLE	STATE: CA	ZIP CODE:	95678
CAPACITY:	128	CENSUS: 78	DATE:	09/09/2019
		UNANNOUNCED	TIME BEGAN:	10:45 AM
MET WITH:	Michelle Wise - Director		TIME COMPLETED:	11:45 AM

ALLEGATION(S):

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LACK OF SUPERVISION- Facility staff failed to provide adequate supervision resulting in child injuring self.

INVESTIGATION FINDINGS:

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An unannounced inspection was conducted today by Licensing Program Analyst (LPA) Owens. LPA Owens met with Director Michelle Wise. The purpose of the inspection is to close a complaint investigation that was originally opened on August 22, 2019. A census of children were taken during inspection.

Based on conflicting interviews, the allegation that the facility staff failed to provide adequate supervision resulting in child injuring self is unsubstantiated. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the allegation did or did not occur. The complaint is UNSUBSTANTIATED.

An exit interview was conducted. Appeal rights were given and explained to the licensee. A Notice of Site Visit was posted during this inspection. No citation issued.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Keven Peters	TELEPHONE: (916) 263-5728
LICENSING EVALUATOR NAME: Katrina Owens	TELEPHONE: 916-263-6280
LICENSING EVALUATOR SIGNATURE:	DATE: 09/09/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/09/2019

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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