343614059-2-9-2022-03-CC-SDLA-CBPV35-20220216150410

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 343614059
Report Date: 02/09/2022
Date Signed: 02/09/2022 10:52:54 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
01/07/2022 and conducted by Evaluator Jan Hoshida

PUBLIC

COMPLAINT CONTROL NUMBER: 03-CC-20220107152903

FACILITY NAME:	LITTLE BLOSSOM MONTESSORI SCHOOL, INC.		FACILITY NUMBER:	343614059
ADMINISTRATOR:	PHILLIPS, FELICIA		FACILITY TYPE:	850
ADDRESS:	2075 ARENA BLVD		TELEPHONE:	(916) 515-0550
CITY:	SACRAMENTO	STATE: CA	ZIP CODE:	95834
CAPACITY:	165	CENSUS: 35	DATE:	02/09/2022
		UNANNOUNCED	TIME BEGAN:	09:00 AM
MET WITH:	Lakshman (Lucky) Rantunga		TIME COMPLETED:	11:00 AM

ALLEGATION(S):

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Facility doesn't follow COVID-19 guidelines
Facility is operating out of ratio

INVESTIGATION FINDINGS:

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On Wednesday, 02/09/2022, Licensing Program Analyst (LPA) Jan Hoshida made an unannounced inspection of the facility and met with Administrator Lakshman (Lucky) Rantunga to conduct a complaint investigation and deliver findings of the above allegations. Upon arrival, LPA observed 35 children supervised by four staff. During the investigation, LPA conducted interviews, reviewed documentation, and made observations.

It was alleged that the facility doesn't follow COVID-19 guidelines by children not wearing masks and that the facility is operating out of ratio.

During the 01/11/22 inspection, LPA observed all staff were masked and out of 25 total children, 22 children were observed wearing a mask in the four classrooms.

REPORT CONTINUED ON NEXT PAGE

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Seychelle De Luca	TELEPHONE: (916) 263-5719
LICENSING EVALUATOR NAME: Jan Hoshida	TELEPHONE: (916) 917-6572
LICENSING EVALUATOR SIGNATURE:	DATE: 02/09/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/09/2022

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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Control Number 03-CC-20220107152903

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: LITTLE BLOSSOM MONTESSORI SCHOOL, INC.	FACILITY NUMBER: 343614059
	VISIT DATE: 02/09/2022

NARRATIVE

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During today;s inspection, LPA observed all staff were masked and out of 35 total children, 24 children were observed wearing a mask in the four classrooms.

Staff stated that the staff encourage children to wear a mask, explain that it is to keep healthy, but they cannot force a child to wear a mask. LPA heard staff encourage children to put on their masks and to cover their mouths when they coughed or sneezed. Administrator stated that they follow the CDC guidelines for COVID-19 policies and procedures.

LPA advised that the Department of Public Health guidance states all individuals, including staff and parents, and children over two years old must wear a mask within the facility unless eating, drinking, or napping.

During the 01/11/22 inspection, LPA observed the following ratios: eight children supervised by one staff, five children supervised by one staff, five children supervised with one staff, and seven children with one staff.

During today's inspection, LPA observed the following ratios: ten children supervised by one staff, 12 children supervised by one staff, six children supervised by one staff, and seven children supervised by one staff.

Although the alleged violations may have happened or are valid, there is not a preponderance of evidence to fully prove or disprove that the alleged violations did or did not occur; therefore, the allegations are unsubstantiated.

There were no Title 22 deficiencies related to these allegations. LPA reviewed this report with the Administrator and provided a Notice of Site Visit that must be posted for 30 days.

SUPERVISOR'S NAME: Seychelle De Luca	TELEPHONE: (916) 263-5719
LICENSING EVALUATOR NAME: Jan Hoshida	TELEPHONE: (916) 917-6572
LICENSING EVALUATOR SIGNATURE:	DATE: 02/09/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/09/2022

LIC9099 (FAS) - (06/04)

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