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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 070211836
Report Date: 07/12/2023
Date Signed: 07/12/2023 10:14:57 AM

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
06/02/2023 and conducted by Evaluator Ashley Curry
PUBLIC
COMPLAINT CONTROL NUMBER: 02-CC-20230602115028
FACILITY NAME:FOUNTAINHEAD MONTESSORI SCHOOL ORINDA CAMPUSFACILITY NUMBER:
070211836
ADMINISTRATOR:NOELL WHITEFACILITY TYPE:
850
ADDRESS:30 SANTA MARIA WAYTELEPHONE:
(925) 254-7110
CITY:ORINDASTATE: CAZIP CODE:
94563
CAPACITY:129CENSUS: 0DATE:
07/12/2023
UNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Sumaira Rizvi/Sarah CabalesTIME COMPLETED:
10:45 AM
ALLEGATION(S):
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Staff hit daycare child
INVESTIGATION FINDINGS:
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On 07/12/2023 at 9:00AM Licensing Program Analysts (LPAs), A. Curry and S. Blue conducted an unannounced subsequent complaint inspection. Fountainhead Montessori School Orinda Campus is now closed and their director, Sarah Cabales, is currently working at the Fountainhead Montessori Pleasant Hill location. LPAs met with Sarah Cabales and Sumaira Rizvi at the Pleasant Hill location to explain the purpose of today’s visit. LPA previously conducted interviews, made observations, and retrieved relevant information. Although the staff indicated the child was hit by accident, the child sustained a significant injury to the mouth, which violated the child’s personal rights. Based on the LPA’s interviews, the preponderance of evidence standard has been met. Therefore, the above allegation is found to be SUBSTANTIATED.

Exit interview conducted, appeal rights were given, and report was reviewed with Sarah Cabales and Sumaira Rizvi.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Loretta Dyson
LICENSING EVALUATOR NAME: Ashley Curry
LICENSING EVALUATOR SIGNATURE:

DATE: 07/12/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/12/2023
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 02-CC-20230602115028
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: FOUNTAINHEAD MONTESSORI SCHOOL ORINDA CAMPUS
FACILITY NUMBER: 070211836
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/12/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
07/13/2023
Section Cited
CCR
101223(a)(1)
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101223 Personal Right (a)The licensee shall ensure that each child is accorded the following personal rights: (3)To be free from corporal or unusual punishment, infliction of pain, humiliation, intimidation...

This requirement is not met as evidence by:
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Although the facility is now permanently closed, the staff are employed at other Fountainhead Montessori School locations.

By 07/13/2023 the owner will submit a written plan on how she will ensure all staff are trained on Personal Rights.
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Based on observation and interview the facility did not comply with the section cited above by ensuring staff did not violate a child’s personal rights. A child suffered a significant injury to the mouth by a staff, which violated the child’s personal rights.
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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.
SUPERVISORS NAME: Loretta Dyson
LICENSING EVALUATOR NAME: Ashley Curry
LICENSING EVALUATOR SIGNATURE:

DATE: 07/12/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/12/2023
LIC9099 (FAS) - (06/04)
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