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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198019813
Report Date: 10/12/2022
Date Signed: 10/12/2022 01:17:04 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, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
This is an official report of an unannounced visit/investigation of a complaint received in our office on
09/19/2022 and conducted by Evaluator Bardo Baluyot
PUBLIC
COMPLAINT CONTROL NUMBER: 33-CC-20220919114232
FACILITY NAME:PRIMANTI MONTESSORI ACADEMYFACILITY NUMBER:
198019813
ADMINISTRATOR:HARSHINI GUNASEKARAFACILITY TYPE:
830
ADDRESS:10947 VALLEY HOME AVETELEPHONE:
(562) 943-0246
CITY:WHITIERSTATE: CAZIP CODE:
90603
CAPACITY:54CENSUS: 10DATE:
10/12/2022
UNANNOUNCEDTIME BEGAN:
11:45 AM
MET WITH:Director, Maribeth PeraltaTIME COMPLETED:
01:30 PM
ALLEGATION(S):
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Facility is operating out of ratio.
INVESTIGATION FINDINGS:
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At approximately 10:30 AM, Licensing Program Analyst (LPA) Bardo Baluyot conducted an unannounced follow up inspection to present findings on the complaint allegation listed above. A COVID-19 risk assessment was conducted upon entering the facility. LPA met with Director, Maribeth Peralta, who guided the LPA on a tour of the facility. LPA observed 10 children present with 4 staff. Required staff to children ratio was observed.

LPA conducted interviews with parents and staff regarding the above allegation. LPA also obtained documents, including, facility roster, staff and children's sign in/sign out sheets.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Ana Chico
LICENSING EVALUATOR NAME: Bardo Baluyot
LICENSING EVALUATOR SIGNATURE:

DATE: 10/12/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/12/2022
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 5
Control Number 33-CC-20220919114232
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: PRIMANTI MONTESSORI ACADEMY
FACILITY NUMBER: 198019813
VISIT DATE: 10/12/2022
NARRATIVE
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This agency has investigated the complaint alleging that, “Facility is operating out of ratio”. According to the allegation, the RP states that, “RP was able to look through the windows of the Infant Center and noticed there were 2 staff to 16 infants.” LPA conducted interviews with Director, entire Infant Staff and parents. By (S3), (S4) and (S5) own admission, the facility has operated out of ratio for a few minutes during transition periods and during pick up and drop off on a few occasions. Based on consistent statements obtained through interviews with staff, this agency has investigated the complaint alleging “Facility is operating out of ratio” and have found that the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED.

California Code of Regulations, (Title 22, Division 12 & Chapter Number 1), are being cited on the attached LIC 9099D. One deficiency was cited during today’s visit.

Upon receipt, the Licensee shall post the “D” page of the Licensing report. This page shall be posted for 30 consecutive days. Failure to maintain posting as required will result in a $100 civil penalty. A copy of this report shall be provided to the parents/guardians of the children currently enrolled by the next business day or immediately upon return. A copy of this report shall also be provided to the parents/guardians of any children newly enrolled at the facility for the next 12 months. The LIC 9224 Acknowledgement of Receipt of Licensing Reports must be maintained in each child's file immediately upon receipt from the parent. LPA provided Director with a blank copy of the LIC 9224 Acknowledgement of Receipt of Licensing Report.



Exit interview was conducted with Director, Maribeth Peralta.
SUPERVISORS NAME: Ana Chico
LICENSING EVALUATOR NAME: Bardo Baluyot
LICENSING EVALUATOR SIGNATURE:

DATE: 10/12/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/12/2022
LIC9099 (FAS) - (06/04)
Page: 2 of 5
Control Number 33-CC-20220919114232
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: PRIMANTI MONTESSORI ACADEMY
FACILITY NUMBER: 198019813
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/12/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
10/12/2022
Section Cited
CCR
101416.5(b)
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101416.5 Staff-Infant Ratio (b)There shall be a ratio of one teacher for every four infants in attendance.

The requirement is not met as evidenced by: Based on Licensing Program Analyst (LPA) interviews conducted, the Director
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Director shall submit a detailed staff schedule outlining staff room assignments and coverage. Per Director, they are continuously trying to hire additional staff. Director will also conduct a training on teacher-child ratios and provide a copy of the sign-in sheet and training agenda by the POC due date of 10/13/2022.
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did not ensure that the facility maintain teacher to infant ratio during transition periods or during pick up/drop off times. This poses an immediate Health, Safety or Personal Rights risk to children in care.
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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: Ana Chico
LICENSING EVALUATOR NAME: Bardo Baluyot
LICENSING EVALUATOR SIGNATURE:

DATE: 10/12/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/12/2022
LIC9099 (FAS) - (06/04)
Page: 3 of 5