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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 343611397
Report Date: 11/01/2022
Date Signed: 11/01/2022 03:25:46 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
10/07/2022 and conducted by Evaluator Alize Tillery
PUBLIC
COMPLAINT CONTROL NUMBER: 03-CC-20221007094025
FACILITY NAME:LINCOLN PLAZA MONTESSORIFACILITY NUMBER:
343611397
ADMINISTRATOR:JACOBSON, BRENDAFACILITY TYPE:
850
ADDRESS:400 Q STREET, #1704TELEPHONE:
(916) 795-4111
CITY:SACRAMENTOSTATE: CAZIP CODE:
95814
CAPACITY:59CENSUS: 46DATE:
11/01/2022
UNANNOUNCEDTIME BEGAN:
12:00 PM
MET WITH:Brenda Jacobson and Kristen MillerTIME COMPLETED:
03:45 PM
ALLEGATION(S):
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Staff did not supervise day care children adequately
INVESTIGATION FINDINGS:
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On November 1, 2022, at approximately 12:00 PM, Licensing Program Analysts (LPAs ) Alize Tillery and Matt Gallo met with Licensee’s Brenda Jacobson and Kristen Miller conducted an unannounced inspection, to conclude the complaint investigation, regarding the allegation listed above. Upon arrival, LPA observed 15 toddler children, supervised by 3 staff; and 31 preschool children supervised by 3 staff.

During the course of the investigation, LPAs conducted interviews with the reporting party, children, staff and parents. It was alleged that staff did not supervise day care children adequately. Based on LPAs file review, LPAs observed incident reports that revealed information of an incident that happened 10/17/2022, on the playground between two children, that staff were not aware of.
When LPA asked Staff #1 about the incident report, Staff #1 responded that she and her coteacher, Staff #2, did not see the incident occur, but that they were informed by Child #1 of the inappropriate play that happened; the incident report revealed that Child #2 confirmed that the inappropriate play did occur. Licensees stated that they have since had conversations with children about safe play and a plan of correction has been put in place and children undserstand that they may not hide under play structures where they can go unseen.
Report continues...
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Seychelle De Luca
LICENSING EVALUATOR NAME: Alize Tillery
LICENSING EVALUATOR SIGNATURE:

DATE: 11/01/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/01/2022
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-20221007094025
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: LINCOLN PLAZA MONTESSORI
FACILITY NUMBER: 343611397
VISIT DATE: 11/01/2022
NARRATIVE
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Based on information obtained through staff interviews and file reviews, the preponderance of evidence standard has been met, therefore the allegation - Staff did not supervise day care children adequately - is found to be SUBSTANTIATED. A lack of supervision poses as an immediate risk to children in care ; a Type A deficiency is being cited for a Lack of Supervision. Deficiency is listed on the following 809D page.

Licensee acknowledges, that for TYPE A DEFICIENCIES ONLY upon receipt, Licensees shall post LIC 9099-D with Type A deficiency 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. LIC9224 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 Licensees. LIC9224 and Appeal Rights were provided. An exit interview was conducted and a Notice of Site Visit posted.
SUPERVISORS NAME: Seychelle De Luca
LICENSING EVALUATOR NAME: Alize Tillery
LICENSING EVALUATOR SIGNATURE:

DATE: 11/01/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/01/2022
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 03-CC-20221007094025
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: LINCOLN PLAZA MONTESSORI
FACILITY NUMBER: 343611397
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/01/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Request Denied
Type A
11/02/2022
Section Cited
CCR
101229(a)(1)
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(a) The licensee shall provide care and supervision as necessary to meet the children's needs.
(1) No child(ren) shall be left without the supervision of a teacher at any time, except as specified in Sections 101216.2(e)(1) and 101230(c)(1). Supervision shall include visual observation.
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Licensee's will conduct a training regarding supervision with all staff and submit proof to LPA Tillery.
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This requirement was not met, evidenced by:
LPAs learned through incident reports and staff interviews, that inappropriate play occurred that staff were not aware of, until child #1 brought it to Staff #1 attention.
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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.
SUPERVISORS NAME: Seychelle De Luca
LICENSING EVALUATOR NAME: Alize Tillery
LICENSING EVALUATOR SIGNATURE:

DATE: 11/01/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/01/2022
LIC9099 (FAS) - (06/04)
Page: 3 of 3