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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 313622396
Report Date: 10/19/2021
Date Signed: 10/19/2021 12:16:36 PM



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
08/30/2021 and conducted by Evaluator Amanda Blesi
PUBLIC
COMPLAINT CONTROL NUMBER: 03-CC-20210830082014
FACILITY NAME:BAMBINI MONTESSORI (INF)FACILITY NUMBER:
313622396
ADMINISTRATOR:PAOLO SARMIENTOFACILITY TYPE:
830
ADDRESS:821 STERLING PARKWAY, STE 100TELEPHONE:
(916) 434-7000
CITY:LINCOLNSTATE: CAZIP CODE:
95648
CAPACITY:28CENSUS: 15DATE:
10/19/2021
UNANNOUNCEDTIME BEGAN:
09:55 AM
MET WITH:Paolo SarmientoTIME COMPLETED:
12:30 PM
ALLEGATION(S):
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Supervision - children are eating in high chairs without supervision
INVESTIGATION FINDINGS:
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LPA Amanda Blesi met with Paolo Sarmiento to close the complaint. Prior to entry into the facility, a Covid-19 risk assessment was conducted over the phone. Present today were 9 infants and 6 toddlers supervised by 5 staff. During the investigation, interviews were conducted, and observations were made at the facility. Based on those interviewed, it was learned that there was at least one occasion where there were two infants were seated in high chairs and the staff member stepped around the corner to go into the kitchen area while the other staff was in the back changing a diaper. Although the staff in the kitchen was in close proximity to the infants, she did not have direct visual observation and supervision of the infants who were eating in the high chairs. The preponderance of evidence standard has been met and the allegation is SUBSTANTIATED.

Per California Code of Regulations, Title 22, Division 12, Chapter 1, deficiencies are noted on the following report; LIC 9099-D. Appeal rights provided. Licensing report was reviewed and discussed with licensee / licensing representative, Paolo.

A Type A deficiency is being cited. Licensee acknowledges, that FOR TYPE A DEFICIENCIES ONLY upon receipt, licensee shall post LIC9099-D with Type A deficiencies for 30 days and provide copies of this licensing report to parents/guardians of children in care at the facility and to parents/guardians of children newly enrolled at the facility during the next 12 months. The LIC 9224 must be signed by parents/guardians and kept with the children's forms as a receipt whenever any Type A documents are provided by the licensee (LIC 9224 provided during visit

Substantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Keven PetersTELEPHONE: (916) 263-5728
LICENSING EVALUATOR NAME: Amanda BlesiTELEPHONE: (916) 208-3427
LICENSING EVALUATOR SIGNATURE:

DATE: 10/19/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/19/2021
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 2
Control Number 03-CC-20210830082014
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: BAMBINI MONTESSORI (INF)
FACILITY NUMBER: 313622396
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/19/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
10/20/2021
Section Cited
CCR
101429(a)(1)
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Responsibility for Providing Care and Supervision for Infants: In addition to Section 101229, the following shall apply: Each infant shall be constantly supervised and under direct visual observation and supervision by a staff person at all times. This requirement was not met as evidenced by: a staff who was supervising two infants eating in high chairs stepped around the corner to go into the kitchen area leaving the two infants in high chairs without direct visual observation and supervision. This is an immediate risk to the health and safety of children in care.
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Paolo states that he will have converstation with staff regarding 100% visiual observation and supervision of infants as well as create a new staff schedule to ensure there are always sufficient staff supervising the infants so if one staff needs to step around the corner or change a diaper there will be sufficient coverage. To correct the deficiency owner shall submit a revised staff schedule to LPA.
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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: Amanda BlesiTELEPHONE: (916) 208-3427
LICENSING EVALUATOR SIGNATURE:

DATE: 10/19/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/19/2021
LIC9099 (FAS) - (06/04)
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