073405026-10-5-2021-02-CC-SJON-C8PQPX-20211112112129

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 073405026
Report Date: 10/05/2021
Date Signed: 10/05/2021 03:11:50 PM

Unsubstantiated

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
08/12/2021 and conducted by Evaluator Monica Mathur

PUBLIC

COMPLAINT CONTROL NUMBER: 02-CC-20210812085945

FACILITY NAME:	SPRINGFIELD MONTESSORI SCHOOL		FACILITY NUMBER:	073405026
ADMINISTRATOR:	SHASHI LAL		FACILITY TYPE:	850
ADDRESS:	2780 MITCHELL DRIVE		TELEPHONE:	(925) 944-0626
CITY:	WALNUT CREEK	STATE: CA	ZIP CODE:	94598
CAPACITY:	226	CENSUS: 128	DATE:	10/05/2021
		UNANNOUNCED	TIME BEGAN:	01:45 PM
MET WITH:	Shashi Lal		TIME COMPLETED:	03:30 PM

ALLEGATION(S):

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Personal rights - Staff handled child in a rough manner

INVESTIGATION FINDINGS:

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On 10/5/21 at 1:45 pm Licensing Program Analysts (LPAs) Monica Mathur and Michelle Sutton conducted an unannounced Subsequent Complaint Investigation at Springfield Montessori School. LPA met with Director/Licensee, Shashi Lal and explained the purpose of today’s investigation. The finding for the above allegation was delivered. During the course of the investigation LPA completed a physical plant inspection, reviewed facility records and conducted interviews. Based on the interviews and information obtained throughout the investigation, the allegation is UNSUBSTANTIATED which means although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur. No Deficiency has been cited for this allegation. Exit interview conducted with Director. Appeal rights were provided.

A NOTICE OF SITE VISIT WAS ISSUED AND MUST BE POSTED FOR 30 DAYS.

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Sherelle Johnson
LICENSING EVALUATOR NAME: Monica Mathur
LICENSING EVALUATOR SIGNATURE:	DATE: 10/05/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/05/2021

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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