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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 313621507
Report Date: 05/10/2021
Date Signed: 05/03/2023 11:03:07 AM

Unsubstantiated


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
03/30/2021 and conducted by Evaluator Katrina Owens
PUBLIC
COMPLAINT CONTROL NUMBER: 03-CC-20210330095028
FACILITY NAME:ROSEVILLE MONTESSORI ACADEMY (PS)FACILITY NUMBER:
313621507
ADMINISTRATOR:RICHARDSON, KARENFACILITY TYPE:
850
ADDRESS:1370 BASELINE ROADTELEPHONE:
(916) 780-0230
CITY:ROSEVILLESTATE: CAZIP CODE:
95747
CAPACITY:96CENSUS: 23DATE:
05/10/2021
UNANNOUNCEDTIME BEGAN:
11:45 AM
MET WITH:Karen Richards-DirectorTIME COMPLETED:
12:30 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
PERSONAL RIGHTS: Staff did not provided water to child.
PERSONAL RIGHTS: Staff hit child.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
This is an Amended report to change from confidental to public.

An unannounced telephone call was conducted by Licensing Program Analyst Owens due to COVID-19. LPA Owens spoke with Director, Karen Richardson. The purpose of the telephone call is to close a complaint investigation that was originally opened on April 7, 2021.

Based on conflicting interviews and the time lapse from when the original alleged incidents happened, the allegations that staff did not provide water to a child and staff hit a child is 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.

An exit interview was conducted. Appeal rights were emailed and explained to the licensee. No citation issued.
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: 05/10/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/10/2021
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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