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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 410518732
Report Date: 12/14/2021
Date Signed: 12/14/2021 03:39:18 PM



STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
This is an official report of an unannounced visit/investigation of a complaint received in our office on
10/20/2021 and conducted by Evaluator Jyoti Saini
PUBLIC
COMPLAINT CONTROL NUMBER: 05-CC-20211020163302
FACILITY NAME:GLEN OAKS MONTESSORI SCHOOLFACILITY NUMBER:
410518732
ADMINISTRATOR:LYNETTE CARONFACILITY TYPE:
850
ADDRESS:797 SANTA MARGARITA STE ATELEPHONE:
(650) 872-1112
CITY:MILLBRAESTATE: CAZIP CODE:
94030
CAPACITY:60CENSUS: 24DATE:
12/14/2021
UNANNOUNCEDTIME BEGAN:
11:40 AM
MET WITH:Director Megan DunwoodyTIME COMPLETED:
01:15 PM
ALLEGATION(S):
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Staff do not dispose gloves after use.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Saini arrived at the facility unannounced to close the complaint investigation into the above allegation and met with Director Megan Dunwoody. Present in the facility is director, 5 teachers, supervising 24 preschoolers. During the course of investigation, LPA Saini conducted interviews, reviewed and obtained pertaining records.
Based on LPA's observation, on 10/26/2021, from 9:50 am to 10:15 am, LPA observed multiple instances where staff did not dispose of gloves after use. LPA observed that S1 took off the gloves, set them aside, reused same gloves to help the children with the job presentation. Later on, during the visit, LPA observed S2 helping toileting children, holding the child's hand, taking C1 to wash hands, and not disposing of gloves.The preponderance of evidence standard has been met; therefore, the allegation of Staff does not dispose gloves after use is found to be SUBSTANTIATED.
***See attached page for deficiencies cited against the facility under CCR,Title 22, Div. 12, Chapt. 1.***
This report will be kept in the facility file and will be made available for Public Review upon request. This report and rights to comment and appeal have been discussed with Director Megan Dunwoody.
Copy of this report was reviewed and will be sent to the director at email address schooloffice@glenoaksmontessori.com by the close of business on 12/14/2021. Confirmation of receipt is required. Signed copy of this report will be stored in the facility file.


Substantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Daniel J OquendoTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Jyoti SainiTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:

DATE: 12/14/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/14/2021
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 05-CC-20211020163302
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME: GLEN OAKS MONTESSORI SCHOOL
FACILITY NUMBER: 410518732
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/14/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
01/14/2022
Section Cited
CCR
101223(a)(2)
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101223(a)(2)Personal Rights
To be accorded safe, healthful and comfortable accommodations, furnishings and equipment to meet his/her needs.This requirement is not met as evidenced by:
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The Facility shall submit a written Plan of Correction (POC) describing how to ensure a safe and healthy environment for the children in care. POC shall be received in CCLD Office by POC due date 01/14/2022
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Based on LPA’s observation, the facility did not ensure a safe and healthy environment for children in care. LPA observed S1 took off gloves and set them aside for future use. LPA also observed that S2 did not dispose of the gloves after helping a child with toileting.This poses a potential health and safety risk to 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: Daniel J OquendoTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Jyoti SainiTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:

DATE: 12/14/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/14/2021
LIC9099 (FAS) - (06/04)
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