073408293-7-11-2022-02-CC-SJON-CGZMEE-20220805093238

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 073408293
Report Date: 07/11/2022
Date Signed: 07/11/2022 01:44:28 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
06/23/2022 and conducted by Evaluator Monica Mathur

PUBLIC

COMPLAINT CONTROL NUMBER: 02-CC-20220623172656

FACILITY NAME:	EMPIRE MONTESSORI PRESCHOOL		FACILITY NUMBER:	073408293
ADMINISTRATOR:	LIN, LI		FACILITY TYPE:	850
ADDRESS:	409 BOYD RD.		TELEPHONE:	(925) 280-1600
CITY:	PLEASANT HILL	STATE: CA	ZIP CODE:	94523
CAPACITY:	79	CENSUS: 41	DATE:	07/11/2022
		UNANNOUNCED	TIME BEGAN:	01:00 PM
MET WITH:	Li Lin		TIME COMPLETED:	02:00 PM

ALLEGATION(S):

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Staff hit and scolded day-care child
Staff discriminated against day-care child and was not allowed to participate in activities.

INVESTIGATION FINDINGS:

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On 7/11/22 at 1:00 pm Licensing Program Analyst (LPA) Monica Mathur conducted an unannounced Subsequent Complaint Investigation at Empire Montessori Preschool. LPA met with Director, Li Lin and explained the purpose of today’s inspection. The finding for the above allegations was delivered during the inspection.
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 allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur. No Deficiency has been cited for the allegations.
Exit interview conducted with Director, Li Lin.
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: 07/11/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/11/2022

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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