343616551-6-8-2022-03-CC-SDLA-CFEL8U-20220615083230

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 343616551
Report Date: 06/08/2022
Date Signed: 06/08/2022 04:26:58 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
03/29/2022 and conducted by Evaluator Karyn Guerra

PUBLIC

COMPLAINT CONTROL NUMBER: 03-CC-20220329100504

FACILITY NAME:	COUNTRYHILL MONTESSORI		FACILITY NUMBER:	343616551
ADMINISTRATOR:	WALKER, REONNA		FACILITY TYPE:	850
ADDRESS:	7048 SUNRISE BLVD.		TELEPHONE:	(916) 728-2929
CITY:	CITRUS HEIGHTS	STATE: CA	ZIP CODE:	95610
CAPACITY:	102	CENSUS: 53	DATE:	06/08/2022
		UNANNOUNCED	TIME BEGAN:	09:30 AM
MET WITH:	Anna Royal		TIME COMPLETED:	04:45 PM

ALLEGATION(S):

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Staff did not provide adequate supervision

INVESTIGATION FINDINGS:

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At 9:45 a.m. on Thursday, June 8th, 2022, Licensing Program Analysts (LPAs) Karyn Guerra and Amanda Sutter met with Director, Anna Royal, for the purpose of an unannounced complaint inspection and to deliver findings. It was alleged that staff did not provide adequate supervision. There was a concern about inappropriate touching from a child in the school age option to a child in the preschool program. Throughout the course of the investigation, LPA conducted interviews, reviewed files, and made observations. The facility has written documentation of the incidents and reported it to the department and additional authorities. Incident was stated to have occurred behind the climbing wall on the outdoor play yard. While LPA could not determine if there was a lack of supervision when the incident occurred, LPA observed staffing and supervision concerns throughout the course of the investigation. On multiple occassions, staff were observed standing in the doorway between the indoor classroom and the outdoor play yard while children were using the

Substantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Seychelle De Luca	TELEPHONE: (916) 263-5719
LICENSING EVALUATOR NAME: Karyn Guerra	TELEPHONE: (916) 216-7790
LICENSING EVALUATOR SIGNATURE:	DATE: 06/08/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/08/2022

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-20220329100504

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: COUNTRYHILL MONTESSORI	FACILITY NUMBER: 343616551
	VISIT DATE: 06/08/2022

NARRATIVE

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restroom inside the classroom. Staff did not have visual supervision of children using the restroom and were also unable to adequately supervise children in areas of the play yard that pose a supervision barrier. During today's inspection, LPAs observed two children in the grass area of the play yard as staff's backs were turned while transitioning the children inside. Staff were notified and a correction was made. Interviews revealed supervision and staffing concerns. The preponderance of evidence standard has been met, and the allegation is substantiated.

Title 22 deficiencies are cited on the subsequent pages of this report. Director acknowledges, that FOR TYPE A DEFICIENCIES ONLY upon receipt, licensee shall post LIC 809D 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. 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 and Appeal Rights were provided. Director's signature on this report acknowledges receipt of these rights. This report was reviewed with the Director. An exit interview was conducted. A Notice of Site Visit was provided and shall remain posted for a period of 30 days for parental review.

SUPERVISOR'S NAME: Seychelle De Luca	TELEPHONE: (916) 263-5719
LICENSING EVALUATOR NAME: Karyn Guerra	TELEPHONE: (916) 216-7790
LICENSING EVALUATOR SIGNATURE:	DATE: 06/08/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/08/2022

LIC9099 (FAS) - (06/04)

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Control Number 03-CC-20220329100504

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: COUNTRYHILL MONTESSORI	FACILITY NUMBER: 343616551
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 06/08/2022

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type A 06/09/2022 Section Cited CCR 101229(a)(1)	1 2 3 4 5 6 7	101229 Responsibility for Providing Care and Supervision (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...Supervision shall include visual observation. This requirement was not met, as evidenced by:	1 2 3 4 5 6 7	Facility will conduct a training with staff regarding supervision requirement and will provide evidence to LPA by POC due date.
	8 9 10 11 12 13 14	Based on interview and observation, facility did not provide adequate supervision to children in care. This poses an immediate risk to the health and safety of children in care.	8 9 10 11 12 13 14
	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: Seychelle De Luca	TELEPHONE: (916) 263-5719
LICENSING EVALUATOR NAME: Karyn Guerra	TELEPHONE: (916) 216-7790
LICENSING EVALUATOR SIGNATURE:	DATE: 06/08/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/08/2022

LIC9099 (FAS) - (06/04)

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