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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 343616551
Report Date: 06/08/2022
Date Signed: 06/08/2022 04:21:53 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
06/06/2022 and conducted by Evaluator Karyn Guerra
PUBLIC
COMPLAINT CONTROL NUMBER: 03-CC-20220606160421
FACILITY NAME:COUNTRYHILL MONTESSORIFACILITY NUMBER:
343616551
ADMINISTRATOR:WALKER, REONNAFACILITY TYPE:
850
ADDRESS:7048 SUNRISE BLVD.TELEPHONE:
(916) 728-2929
CITY:CITRUS HEIGHTSSTATE: CAZIP CODE:
95610
CAPACITY:102CENSUS: 53DATE:
06/08/2022
UNANNOUNCEDTIME BEGAN:
09:45 AM
MET WITH:Anna RoyalTIME COMPLETED:
04:45 PM
ALLEGATION(S):
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Staff did not prevent inappropriate behavior between children

Licensee is operating over ratio

Unqualified staff are supervising children
INVESTIGATION FINDINGS:
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At 9:45 a.m. Licensing Program Analysts (LPAs) Karyn Guerra and Amanda Sutter met with Director, Anna Royal, for the purpose of an unannounced complaint inspection. It was alleged that staff did not prevent inappropriate behavior between children, licensee is operating over ratio, and unqualified staff are supervising children. During today's inspection, LPAs conducted interviews and observations, obtained documents, and reviewed files. It was learned that an incident occurred at the facility on 6/2/2022 involving inappropriate touching between children. Children were stated to be playing in the "bubble" portion of the play structure that is an enclosed component with some openings on the side and a plastic dome structure on top. Two staff were outside with the children, however, one of the two staff was in and out supporting children in the bathroom and conducting housekeeping duties. It was stated that staff came to learn of the

report continued on 809-C.
Substantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Seychelle De LucaTELEPHONE: (916) 263-5719
LICENSING EVALUATOR NAME: Karyn GuerraTELEPHONE: (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)
Page: 1 of 4
Control Number 03-CC-20220606160421
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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inappropriate touching between children and observed it after they were alerted by a parent who visually observed it first, while picking up their child. LPA also came to learn that the facility was short staffed from 5/23/2022-6/3/2022 due to staff illnesses, and resignations. LPA observed staffing schedules for this time period and reviewed staff qualifications. Based on file review, the facility was over ratio and unqualified staff were supervising children. During today's inspection, at 11:57 a.m. LPA Guerra observed Staff 1 (S1) alone in the toddler yard with 8 toddler children. One of the staff (S2) at the facility is stated to have completion of 6 ECE units and enrollment in additional units, however, the facility could not supply documentation of the enrolled coursework. The preponderance of evidence standard has been met, and the allegations are 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 9099D 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, Anna Royal. An exit interview was conducted. A Notice of Site Visit was provided and shall remain posted for a period of 30 days.
SUPERVISOR'S NAME: Seychelle De LucaTELEPHONE: (916) 263-5719
LICENSING EVALUATOR NAME: Karyn GuerraTELEPHONE: (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)
Page: 2 of 4
Control Number 03-CC-20220606160421
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)
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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:
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Facility will conduct a training with staff regarding supervision requirement and will provide evidence to LPA by POC due date.
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Based on interview and observation, the facility did not provide adequate supervision to children. This poses an immediate risk to the health and safety of children in care.
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Type A
06/09/2022
Section Cited
CCR
101216(3)(b)(1)
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(1) A ratio of one fully qualified teacher (as specified in Section 101216.1(c)) and one aide for every 18 children in attendance in a preschool program is allowed when the aide meets the qualifications specified in Section 101216.2(d). This requirement was not met, as evidenced by:
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LPA will conduct a follow up inspection to clear the citation.
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Based on documentation and observation, Facility did not comply with staffing ratios for staff and children. This poses an immediate risk to the health and safety of children in care.
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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: Seychelle De LucaTELEPHONE: (916) 263-5719
LICENSING EVALUATOR NAME: Karyn GuerraTELEPHONE: (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)
Page: 3 of 4
Control Number 03-CC-20220606160421
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
1012161
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1012161 Teacher Qualifications and Duties. (b) Prior to employment a teacher shall meet the specified requirements...This requirement was not met, as evidenced by:
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LPA will conduct a follow up inspection to clear the citation.
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Based on observation, interview, and file review, unqualified staff were supervising children in care. This poses an immediate risk to the health and safety of children in care.
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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: Seychelle De LucaTELEPHONE: (916) 263-5719
LICENSING EVALUATOR NAME: Karyn GuerraTELEPHONE: (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)
Page: 4 of 4