<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 313619751
Report Date: 10/18/2022
Date Signed: 10/18/2022 01:14:31 PM

Substantiated


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
10/14/2022 and conducted by Evaluator Katrina Owens
COMPLAINT CONTROL NUMBER: 03-CC-20221014081715
FACILITY NAME:AMERICAN MONTESSORI ACADEMYFACILITY NUMBER:
313619751
ADMINISTRATOR:WISE, MICHELLEFACILITY TYPE:
850
ADDRESS:1050 DOUGLAS BLVDTELEPHONE:
(916) 786-3636
CITY:ROSEVILLESTATE: CAZIP CODE:
95678
CAPACITY:128CENSUS: 31DATE:
10/18/2022
UNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Michelle Wise - DirectorTIME COMPLETED:
01:30 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
PHYSICAL PLANT: Facility outdoor equipment is in disrepair.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
An unannounced inspection was conducted today by Licensing Program Analyst Owens and Gallo. LPA's met with Director, Michelle Wise. The purpose of the inspection is to open a complaint investigation. Present at time of inspection were 31 preschool children and 6 staff. Interviews were conducted and a tour of the classrooms and playground were conducted at time of inspection.

Based on observation and interviews the center playground does have a piece of play equipment that is is disrepair. The play equipment is a square box with a plastic doom on top of it that has a crack it in, the plastic is split separating from each other that can be a risk to a child. The play structure is technically called a Tube Junction Cube. There is also a self made wooden house / box on the play ground that has rusted nails that are coming out of the splinter wood / the roof part of the house - box.

The preponderance of evidence standard has been met during this investigation, therefore the above allegation is found to be SUBSTANTIATED. Violations of the California Code of Regulations, Title 22, Division 12 & Chapter 3 are being cited on the attached LIC 9099 D.

LPA Owens informed Director, Michelle Wise, that this report dated 10/18/2022
Type A citation which shall be posted for 30 consecutive days as there is immediate
risk to the health, safety, or personal rights of children in care. Also, LPA Owens informed the Director to provide a copy of this licensing report dated 10/18/2022 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. LIC 9224 was given to Director at time of inspection. Appeal Rights and Notice of Site visit given at time of inspection.
.
Substantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Keven PetersTELEPHONE: (916) 263-5728
LICENSING EVALUATOR NAME: Katrina OwensTELEPHONE: 916-263-6280
LICENSING EVALUATOR SIGNATURE:

DATE: 10/18/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/18/2022
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 4
Control Number 03-CC-20221014081715
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: AMERICAN MONTESSORI ACADEMY
FACILITY NUMBER: 313619751
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/18/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
10/24/2022
Section Cited
CCR
101238(a)
1
2
3
4
5
6
7
BUILDING AND GROUND:
The child care center shall be clean, safe, sanitary and in good repair at all times to ensure the safety and well-being of children, employees and visitors.
1
2
3
4
5
6
7
Director, Michelle Wise stated cracked dome will be removed from the play ground by the owner or property management on or before 10/24/2022. She will send picture showing the dome has been removed.
8
9
10
11
12
13
14
This requirement is not met as evidence by LPA's observed play equipment that is a square box with a plastic doom on top of it that has a crack it in, the plastic is split separating from each other that can be a risk to a child. The play structure is technically called a Tube Junction Cube. There is also a self made wooden house / box on the play ground that has rusted nails that are coming out of the splinter wood / the roof part of the house - box.
These are a potential risk to a child
8
9
10
11
12
13
14
The wooden box will remove the rusted nails or remove the structure. This will be done on or before 10/24/2022. She will send pictures to LPA. If not corrected by 10/24/22 a civil penalty may be accessed.
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 PetersTELEPHONE: (916) 263-5728
LICENSING EVALUATOR NAME: Katrina OwensTELEPHONE: 916-263-6280
LICENSING EVALUATOR SIGNATURE:

DATE: 10/18/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/18/2022
LIC9099 (FAS) - (06/04)
Page: 3 of 4
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
10/14/2022 and conducted by Evaluator Katrina Owens
COMPLAINT CONTROL NUMBER: 03-CC-20221014081715

FACILITY NAME:AMERICAN MONTESSORI ACADEMYFACILITY NUMBER:
313619751
ADMINISTRATOR:WISE, MICHELLEFACILITY TYPE:
850
ADDRESS:1050 DOUGLAS BLVDTELEPHONE:
(916) 786-3636
CITY:ROSEVILLESTATE: CAZIP CODE:
95678
CAPACITY:128CENSUS: 31DATE:
10/18/2022
UNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Michelle Wise - DirectorTIME COMPLETED:
01:30 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
PHYSICAL PLANT: Staff does not ensure outdoor activity space is free of debris.
PERSONAL RIGHTS: Staff handle children in a rough manner.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
An unannounced inspection was conducted today by Licensing Program Analyst Owens and Gallo. LPA's met with Director, Michelle Wise. The purpose of the inspection is to open and close a complaint investigation. Present at time of inspection were 31 preschool children and 6 staff. Interviews were conducted and a tour of the classrooms and playground were conducted at time of inspection.

Based on conflicting interviews, the above allegations are unsubstantiated. Although the allegations may have happened or is valid, there is not a preponderance of evidence to prove the allegations did or did not occur. No citation issued.

An exit interview was conducted. Appeal rights were given and explained to the licensee at time of inspection.

Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Keven PetersTELEPHONE: (916) 263-5728
LICENSING EVALUATOR NAME: Katrina OwensTELEPHONE: 916-263-6280
LICENSING EVALUATOR SIGNATURE:

DATE: 10/18/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/18/2022
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 4 of 4