573603060-12-20-2019-53-CC-MMAA-BL4VE8-20200123152155

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 573603060
Report Date: 12/20/2019
Date Signed: 12/20/2019 11:48:14 AM

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
11/07/2019 and conducted by Evaluator Amy Silva

PUBLIC

COMPLAINT CONTROL NUMBER: 53-CC-20191107115255

FACILITY NAME:	MONTESSORI COUNTRY DAY II		FACILITY NUMBER:	573603060
ADMINISTRATOR:	LORI HANNAGAN		FACILITY TYPE:	830
ADDRESS:	2802 SPAFFORD		TELEPHONE:	(530) 753-5225
CITY:	DAVIS	STATE: CA	ZIP CODE:	95616
CAPACITY:	8	CENSUS: 4	DATE:	12/20/2019
		UNANNOUNCED	TIME BEGAN:	11:15 AM
MET WITH:	Director- Donna Bonner		TIME COMPLETED:	12:00 PM

ALLEGATION(S):

1
2
3
4
5
6
7
8
9

Staff restrained day care child
Day care child sustained injury while in care

INVESTIGATION FINDINGS:

1
2
3
4
5
6
7
8
9
10
11
12
13

Licensing Program Analyst (LPA) Amy Silva met with Director Donna Bonner to close a complaint investigation. It was alleged that a day care child sustained an injury while in care and facility staff could not explain how the injuries occurred. The Department received a report that stated a child sustained a deep scratch on her chin. Throughout the investigation, LPA conducted interviews with the complainant, parents and staff; reviewed documents; obtained the facility's roster; and made observations of the facility. Staff stated that the child scratched them self while staff were changing the child’s diaper. Furthermore. Parent stated child’s nails were cut that night. LPA obtained a photo of the scratch. LPA was unable to determine how the alleged injury occurred. Based on interviews and observations, LPA determined the information obtained during the investigation revealed inconsistencies. Based on the information obtained, this allegation is found to be UNSUBSTANTIATED.
Report continued on LIC812C

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Maria Mayorga	TELEPHONE: (916) 263-1414
LICENSING EVALUATOR NAME: Amy Silva	TELEPHONE: (916) 926-9100
LICENSING EVALUATOR SIGNATURE:	DATE: 12/20/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/20/2019

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 2

Control Number 53-CC-20191107115255

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: MONTESSORI COUNTRY DAY II	FACILITY NUMBER: 573603060
	VISIT DATE: 12/20/2019

NARRATIVE

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32

It was alleged that Staff restrained a day care child. The Department received a report that stated staff swaddled a child tightly, multiple times so the child wouldn’t crawl away. It was stated that staff were asked multiple times to stop swaddling the child by the child’s parent, but they kept doing it. Interviews did not identify any individuals who swaddle children without parental consent. Throughout the investigation, LPA conducted interviews with the complainant, parents and staff; reviewed documents; obtained the facility's roster; and made observations of the facility.

Based on interviews and observations, LPA determined the information obtained during the investigation revealed inconsistencies. Based on the information obtained, allegations are found to be UNSUBSTANTIATED. An unsubstantiated finding means that although the allegation may have happened or is valid, there is not a preponderance of evidence to prove allegations did or did not occur, therefore these allegations are unsubstantiated.

Exit interview conducted. Appeal rights provided. Notice of site visit was issued and must remain posted for 30 days.

SUPERVISOR'S NAME: Maria Mayorga	TELEPHONE: (916) 263-1414
LICENSING EVALUATOR NAME: Amy Silva	TELEPHONE: (916) 926-9100
LICENSING EVALUATOR SIGNATURE:	DATE: 12/20/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/19/2019

LIC9099 (FAS) - (06/04)

Page: 2 of 2