376700138-3-17-2022-51-CC-TDAL-CCQVLQ-20220321163218

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 376700138
Report Date: 03/17/2022
Date Signed: 03/17/2022 10:08:29 AM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108

This is an official report of an unannounced visit/investigation of a complaint received in our office on
01/10/2022 and conducted by Evaluator Grace Curtis

COMPLAINT CONTROL NUMBER: 51-CC-20220110090531

FACILITY NAME:	CARMEL VALLEY MONTESSORI SCHOOL		FACILITY NUMBER:	376700138
ADMINISTRATOR:	HOLLY ROSA		FACILITY TYPE:	850
ADDRESS:	3800A MYKONOS LANE		TELEPHONE:	(858) 720-2181
CITY:	SAN DIEGO	STATE: CA	ZIP CODE:	92130
CAPACITY:	94	CENSUS: 0	DATE:	03/17/2022
		UNANNOUNCED	TIME BEGAN:	08:45 AM
MET WITH:	Karla Contillo		TIME COMPLETED:	09:14 AM

ALLEGATION(S):

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Covid-19 guidelines are not being followed.

INVESTIGATION FINDINGS:

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On March 17, 2022 at 8:45 a.m. Licensing Program Analyst (LPA) Leilani Curtis conducted an unannounced inspection to deliver the findings on the complaint allegation referenced above. Upon arrival LPA met with Assistant Teacher Karla Contillo and proceeded to tour the facility. There were no children present. LPA spoke with Director Holly Rosa via telephone while at the facility.

The initial complaint investigation was conducted by LPA Curtis on 1/12/22. Throughout the course of investigation, interviews were conducted with the complainant, several employees and several parents. Facility records were obtained and reviewed. The information gathered indicates that Covid-19 guidelines were not being followed when a child (C1) was allowed to wear a face shield instead of the required face mask without a medical exemption for the child on file. C1 also attended the facility on 1/10/22 without a face mask or face shield.

Substantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Tashima Daniel	TELEPHONE: (619) 767-2242
LICENSING EVALUATOR NAME: Grace Curtis	TELEPHONE: (619) 767-2235
LICENSING EVALUATOR SIGNATURE:	DATE: 03/17/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/17/2022

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 51-CC-20220110090531

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108

FACILITY NAME: CARMEL VALLEY MONTESSORI SCHOOL	FACILITY NUMBER: 376700138
	VISIT DATE: 03/17/2022

NARRATIVE

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Based on interviews conducted by LPA and record reviews the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED, California Code of Regulations, Title 22, 101223(a)(2) is being cited on the attached LIC 9099D.

An exit interview was conducted with the director via phone and Ms. Contillo. Appeal Rights (LIC 9058 1/16) were discussed. Ms. Contillo's signature on this form acknowledges receipt of these rights. LIC 9213 NOTICE OF SITE VISIT FORM IS REQUIRED TO BE POSTED FOR 30 DAYS. LPA observed Ms. Contillo post notice of site visit.

SUPERVISOR'S NAME: Tashima Daniel	TELEPHONE: (619) 767-2242
LICENSING EVALUATOR NAME: Grace Curtis	TELEPHONE: (619) 767-2235
LICENSING EVALUATOR SIGNATURE:	DATE: 03/17/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/17/2022

LIC9099 (FAS) - (06/04)

Page: 2 of 3

Control Number 51-CC-20220110090531

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108

FACILITY NAME: CARMEL VALLEY MONTESSORI SCHOOL	FACILITY NUMBER: 376700138
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 03/17/2022

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 03/17/2022 Section Cited CCR 101223(a)(2)	1 2 3 4 5 6 7	101223(a)(2) Personal Rights: (a) The licensee shall ensure that each child is accorded the following personal rights:(2) To be accorded safe, healthful and comfortable accommodations, furnishings and equipment to meet his/her needs. This requirement was not met as evidenced by:	1 2 3 4 5 6 7	Presently the face mask mandate/requirement has been lifted but face masks are still strongly recommended. The director understands that Covid-19 requirements, including the use of face masks/coverings may change at any time and she is required to follow the current requirement and/or mandate.
	8 9 10 11 12 13 14	Based on interviews with the director, staff and parents, the director did not enforce the use of face masks/coverings on children as required by state mandate in January 2022. This poses a potential health and safety risk to the children in care due to the COVID-19 pandemic.	8 9 10 11 12 13 14
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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: Tashima Daniel	TELEPHONE: (619) 767-2242
LICENSING EVALUATOR NAME: Grace Curtis	TELEPHONE: (619) 767-2235
LICENSING EVALUATOR SIGNATURE:	DATE: 03/17/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/17/2022

LIC9099 (FAS) - (06/04)

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