503603196-10-18-2019-04-CC-SFAG-BH6NLB-20191021103314

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 503603196
Report Date: 10/17/2019
Date Signed: 10/18/2019 08:50:55 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1310 E. SHAW AVE,
FRESNO, CA 93710

This is an official report of an unannounced visit/investigation of a complaint received in our office on
07/22/2019 and conducted by Evaluator Robert Gutierrez

PUBLIC

COMPLAINT CONTROL NUMBER: 04-CC-20190722095453

FACILITY NAME:	MONTESSORI SCHOOL OF MODESTO		FACILITY NUMBER:	503603196
ADMINISTRATOR:	SEGURA, EVA		FACILITY TYPE:	850
ADDRESS:	3501 SAN CLEMENTE AVE.		TELEPHONE:	(209) 567-1115
CITY:	MODESTO	STATE: CA	ZIP CODE:	95356
CAPACITY:	140	CENSUS: 69	DATE:	10/17/2019
		UNANNOUNCED	TIME BEGAN:	08:45 AM
MET WITH:	Eva Segura		TIME COMPLETED:	12:30 PM

ALLEGATION(S):

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Children are not given food or water when requested.

INVESTIGATION FINDINGS:

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Licensing Program Analysts (LPAs) Robert Gutierrez & Diane Mercado conducted an unannounced complaint inspection to provide findings. LPA met with Director, Eva Segura. Licensee accompanied LPAs during tour of facility both inside and outside. LPA discussed the allegations and took a census. During the course of the inspection, LPA Gutierrez & LPA Jose Penate interviewed staff, children, witnesses and reviewed facility records. Based on the interviews conducted it was determined during the morning snack between the hours of 9:00 AM – 11:00 AM staff bring in food and badges into the classroom. Food is placed on the table and badges are placed onto the classroom wall. Children then must grab a badge in order to eat, if a child does not grab a badge in time or is not paying attention they must wait until a badge is placed back onto the wall in order to eat. Typically, four badges are placed on the wall of each classroom, on average twenty-four children are in a classroom when the morning snack is being provided. Based on snacks being withheld from children. This has resulted in a personal rights violation to children in care.

Continued on 9099-C

Substantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Susie Fanning	TELEPHONE: (559) 650-7890
LICENSING EVALUATOR NAME: Robert Gutierrez	TELEPHONE: 559-243-4588
LICENSING EVALUATOR SIGNATURE:	DATE: 10/17/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/17/2019

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 04-CC-20190722095453

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1310 E. SHAW AVE,
FRESNO, CA 93710

FACILITY NAME: MONTESSORI SCHOOL OF MODESTO	FACILITY NUMBER: 503603196
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 10/17/2019

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 10/24/2019 Section Cited CCR 101223(a)(3)	1 2 3 4 5 6 7	To be free from corporal or unusual punishment, infliction of pain, humiliation, intimidation, ridicule, coercion, threat, mental abuse or other actions of a punitive nature including but not limited to: interference with functions of daily living including eating, sleeping or toileting; or withholding of shelter, clothing, medication or aids to physical functioning. This requirement is not met as evidenced by interviews conducted during the course of the investigation.	1 2 3 4 5 6 7	Ms. Segura agreed to have children be served at once so they all eat together and/or get rid of the badges so children can eat freely without a badge when food is in the classroom.
	8 9 10 11 12 13 14	Please look at LIC 9099 for further information. This poses as a potential risk to the health, safety, or personal rights of children in care.	8 9 10 11 12 13 14	Ms. Segura agreed to send a letter to Community Care Licensing to inform them on the new serving of snack procedures. Proof of this correction shall be submitted by the given due date.
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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: Susie Fanning	TELEPHONE: (559) 650-7890
LICENSING EVALUATOR NAME: Robert Gutierrez	TELEPHONE: 559-243-4588
LICENSING EVALUATOR SIGNATURE:	DATE: 10/17/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/17/2019

LIC9099 (FAS) - (06/04)

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Control Number 04-CC-20190722095453

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1310 E. SHAW AVE,
FRESNO, CA 93710

FACILITY NAME: MONTESSORI SCHOOL OF MODESTO	FACILITY NUMBER: 503603196
	VISIT DATE: 10/17/2019

NARRATIVE

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Based upon observations, and information gathered through interviews, the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED.

An exit interview conducted with Director Eva Segura. A copy of this report and Appeal Rights were provided and discussed with Ms. Segura.
A Notice of Site Inspection Form was posted to parent's board and must remain posted for 30 days.

SUPERVISOR'S NAME: Susie Fanning	TELEPHONE: (559) 650-7890
LICENSING EVALUATOR NAME: Robert Gutierrez	TELEPHONE: 559-243-4588
LICENSING EVALUATOR SIGNATURE:	DATE: 10/17/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/17/2019

LIC9099 (FAS) - (06/04)

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