013420948-4-26-2023-02-CC-DPEZ-CRC3NB-20230428182337

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 013420948
Report Date: 04/26/2023
Date Signed: 04/26/2023 04:05:26 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, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612

This is an official report of an unannounced visit/investigation of a complaint received in our office on
02/22/2023 and conducted by Evaluator Catherine Fernandes

PUBLIC

COMPLAINT CONTROL NUMBER: 02-CC-20230222103737

FACILITY NAME:	CHILD UNIQUE MONTESSORI SCHOOL, THE		FACILITY NUMBER:	013420948
ADMINISTRATOR:	BATTLE, TIFFANI		FACILITY TYPE:	840
ADDRESS:	1400 - 6TH ST		TELEPHONE:	(510) 524-9229
CITY:	ALAMEDA	STATE: CA	ZIP CODE:	94501
CAPACITY:	23	CENSUS: 15	DATE:	04/26/2023
		UNANNOUNCED	TIME BEGAN:	02:48 PM
MET WITH:	Justin Rivers		TIME COMPLETED:	04:15 PM

ALLEGATION(S):

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Unqualified staff caring for day care children

INVESTIGATION FINDINGS:

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On 4/26/23, at 2:48AM, Licensing Program Analyst (LPA) Catherine Fernandes arrived unannounced to deliver the findings to the above allegation and met with staff member Justin Rivers soon after Cindy Acker arrived. Present in care were 15 school age children and an additional four staff members. During the course of the investigation LPA Fernandes did a walk through of the center, reviewed center files and conducted interviews.
Interviews indicated that the center has had unqualified staff providing care to the children. Therefore, the allegation is SUBSTANTIATED, the preponderance of evidence standard has been met. LPA Fernandes informed the licensee to provide a copy of this licensing report dated 4/26/23 that document a Type A citation to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification. Title 22, California Code of Regulation is being cited on the attached LIC 9099D.
Notice of site visit was provided and must be posted for 30 days.
Exit interview conducted. Report, Appeal Rights and LIC9224 provided

Substantiated

Estimated Days of Completion:

SUPERVISORS NAME: Mayla Mendoza
LICENSING EVALUATOR NAME: Catherine Fernandes
LICENSING EVALUATOR SIGNATURE:	DATE: 04/26/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/26/2023

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 02-CC-20230222103737

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612

FACILITY NAME: CHILD UNIQUE MONTESSORI SCHOOL, THE	FACILITY NUMBER: 013420948
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 04/26/2023

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type A 04/27/2023 Section Cited CCR 101229(a)(1)	1 2 3 4 5 6 7	Responsibility for Providing Care and Supervision- No child(ren) shall be left without the supervision of a teacher at any time, except as specified in Sections 101216.2(e)(1) and 101230(c)(1). Supervision shall include visual observation. This requirement has not been met as evidenced by:	1 2 3 4 5 6 7	The center will reassess all classrooms and come up with a plan to ensure compliance, then send the plan to CCLD by Proof of correction date. Cleared during visit.
	8 9 10 11 12 13 14	Based on interviews and reviewed evidence the center has had unqualified staff providing care to the children, which is an immediate risk to children in care.	8 9 10 11 12 13 14
	1 2 3 4 5 6 7		1 2 3 4 5 6 7
	1 2 3 4 5 6 7		1 2 3 4 5 6 7

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

SUPERVISORS NAME: Mayla Mendoza
LICENSING EVALUATOR NAME: Catherine Fernandes
LICENSING EVALUATOR SIGNATURE:	DATE: 04/26/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/26/2023

LIC9099 (FAS) - (06/04)

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