197493008-10-22-2021-12-CC-CBEL-C8JAR9-20211107002644

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197493008
Report Date: 10/22/2021
Date Signed: 10/22/2021 05:38:28 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, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

This is an official report of an unannounced visit/investigation of a complaint received in our office on
08/17/2021 and conducted by Evaluator Isabel Ortega

COMPLAINT CONTROL NUMBER: 12-CC-20210817114646

FACILITY NAME:	MAGIC CAROUSEL MONTESSORI PRESCHOOL		FACILITY NUMBER:	197493008
ADMINISTRATOR:	NICOLE MEDINA		FACILITY TYPE:	830
ADDRESS:	17956 SIERRA HIGHWAY		TELEPHONE:	(661) 298-4065
CITY:	CANYON	STATE: CA	ZIP CODE:	91351
CAPACITY:	12	CENSUS: 7	DATE:	10/22/2021
		UNANNOUNCED	TIME BEGAN:	03:31 PM
MET WITH:	Shirley Johnson		TIME COMPLETED:	04:00 PM

ALLEGATION(S):

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Allegation: Personal Rights: Licensee does not isolate children who show obvious signs of illness

INVESTIGATION FINDINGS:

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On October 20, 2021 at 3:31 p.m., Licensing Program Analyst (LPA) Isabel Ortega conducted an unannounced complaint subsequent inspection on the above allegation. LPA disclosed the purpose of inspection and was permitted entry by Director who guided LPA on tour of the facility. LPA counted 7 children with 2 staff present.

During inspection, LPA interviewed Director, Staff and observation of facility records and notebook for children send home. there was consistent disclosures that children are isolated if a child begins to show any signs of illness.

Based on evidence obtained and interviews conducted, the above allegation is deemed Unsubstantiated. A finding that the complaint is unsubstantiated means that although the allegations may have happened or are valid, there is not a preponderance of the evidence to prove that the alleged violations did or did not occur. An exit interview was conducted, a copy of this report, Appeal Rights, and a notice of site visit were provided to the Director, Shirley Johnson.

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Carissa Bell
LICENSING EVALUATOR NAME: Isabel Ortega
LICENSING EVALUATOR SIGNATURE:	DATE: 10/22/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/22/2021

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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