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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 313619751
Report Date: 07/14/2025
Date Signed: 07/14/2025 11:17:48 AM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
This is an official report of an unannounced visit/investigation of a complaint received in our office on
07/02/2025 and conducted by Evaluator Jeremey McClain
PUBLIC
COMPLAINT CONTROL NUMBER: 03-CC-20250702141648
FACILITY NAME:AMERICAN MONTESSORI ACADEMYFACILITY NUMBER:
313619751
ADMINISTRATOR:WISE, MICHELLEFACILITY TYPE:
850
ADDRESS:1050 DOUGLAS BLVDTELEPHONE:
(916) 786-3636
CITY:ROSEVILLESTATE: CAZIP CODE:
95678
CAPACITY:128CENSUS: 52DATE:
07/14/2025
UNANNOUNCEDTIME BEGAN:
09:40 AM
MET WITH:Michelle WiseTIME COMPLETED:
11:20 AM
ALLEGATION(S):
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Licensee did not provide childrens parents documentation of facility receiving a type A violation.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Jeremey McClain met with facility representative Michelle Wise to deliver findings for a complaint investigation. LPA observed 52 children supervised by nine staff.
It was alleged that the facility did not provide a copy of the Type A citation.
During the investigation, LPA interviewed the licensee and facility representative, LPA interviewed parents, and LPA reviewed children’s files. Evidence gathered corroborates the allegation. LPA observed that 6 of 13 children files that were reviewed did not have proof that the families had received a copy of the Type A citation was issued on 01/06/2025. Interviews with parents were conclusive that not all parents received the same Type A citation.
The preponderance of evidence standard has been met; therefore, the allegation is determined to be SUBSTANTIATED.
Title 22 deficiencies are cited on the 9099-D page of this report. Appeal Rights were provided, and an exit interview was conducted with facility representative. A Notice of Site Visit was posted and shall remain posted for 30 days.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Mai Lor
LICENSING EVALUATOR NAME: Jeremey McClain
LICENSING EVALUATOR SIGNATURE:

DATE: 07/14/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/14/2025
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 03-CC-20250702141648
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

FACILITY NAME: AMERICAN MONTESSORI ACADEMY
FACILITY NUMBER: 313619751
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/14/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
08/01/2025
Section Cited
HSC
1596.8595(c)
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Reports to be provided to parents. (c)(1) A licensed child day care facility shall provide to the parents or guardians of each child receiving services in the facility copies of any licensing report that documents any Type A citation that represents an immediate risk to the health, safety, or personal rights of
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Licensee and facility representative have begun to issue the 9099-D report from 1/6/2025 that documents a Type-A citation, and has began collecting LIC 9224's. LPA will return by POC due date to review children's file to ensure 9224's have been received.
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children in care as set forth in paragraph (1) of subdivision (a) of Section 1596.893b.(2)Upon enrollment of a new child in a facility, the licensee shall provide to the parents or legal guardians of the newly enrolling child copies of any licensing report that the licensee has received during the prior 12-month period that documents any Type A citation that represents an immediate risk to the health, safety, or personal rights of children in care as set forth in paragraph (1) of subdivision (a) of Section 1596.893b. This requirement was not met as evidenced by file review and interviews. This poses a potential risk to the health and safety of children in care if not corrected.
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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: Mai Lor
LICENSING EVALUATOR NAME: Jeremey McClain
LICENSING EVALUATOR SIGNATURE:

DATE: 07/14/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/14/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 2