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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 313623436
Report Date: 09/29/2022
Date Signed: 09/29/2022 09:40:25 AM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833
This is an official report of an unannounced visit/investigation of a complaint received in our office on
09/28/2022 and conducted by Evaluator Amanda Blesi
PUBLIC
COMPLAINT CONTROL NUMBER: 03-CC-20220928074631
FACILITY NAME:ROCKLIN RANCH MONTESSORIFACILITY NUMBER:
313623436
ADMINISTRATOR:PUREWAL, AMANFACILITY TYPE:
830
ADDRESS:4149 ROCKLIN ROADTELEPHONE:
(916) 715-0255
CITY:ROCKLINSTATE: CAZIP CODE:
95677
CAPACITY:52CENSUS: 32DATE:
09/29/2022
UNANNOUNCEDTIME BEGAN:
08:15 AM
MET WITH:Aman PurewalTIME COMPLETED:
10:03 AM
ALLEGATION(S):
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Facility mismanaged children in care medications
INVESTIGATION FINDINGS:
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LPAs Amanda Blesi and Matthew Gallo arrived at the facility unannounced to open a complaint. LPAs met with Administrative Assistant, Jackie Wygal. Director Aman Purewal arrived later during the inspection. Upon arrival, LPAs observed 6 infants and 26 toddlers supervised by eight staff. LPAs conducted interviews and obtained necessary documents pertinent to the investigation. Director Aman confirmed that on 9/15/22 Child #1 was sent home with the wrong medication belonging to another child with the same name. She states Child #1 was never administered the incorrect medication; however, they inadvertently gave the family the wrong medication to take home that day. Based on the director’s own admittance, the preponderance of evidence standard has been met and the allegation that the facility mismanaged children’s medication is SUBSTANTIATED.

Title 22 Deficiency is cited on the subsequent page of this report. See LIC 9099-D.
Exit interview with Aman Purewal.
Substantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Keven PetersTELEPHONE: (916) 263-5728
LICENSING EVALUATOR NAME: Amanda BlesiTELEPHONE: (916) 208-3427
LICENSING EVALUATOR SIGNATURE:

DATE: 09/29/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/29/2022
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 3
Control Number 03-CC-20220928074631
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833
FACILITY NAME: ROCKLIN RANCH MONTESSORI
FACILITY NUMBER: 313623436
VISIT DATE: 09/29/2022
NARRATIVE
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LPA Amanda Blesi informed licensee Aman Purewal that this report dated September 29, 2022 document(s) one Type A citation(s) which shall be posted for 30 consecutive days as there is/are immediate risk(s) to the health, safety, or personal rights of children in care. Also, LPA Amanda Blesi informed the licensee Aman Purewal to provide a copy of this licensing report dated September 29, 2022 that documents any Type A citation(s) to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification.

Appeal Rights given.
SUPERVISOR'S NAME: Keven PetersTELEPHONE: (916) 263-5728
LICENSING EVALUATOR NAME: Amanda BlesiTELEPHONE: (916) 208-3427
LICENSING EVALUATOR SIGNATURE:

DATE: 09/29/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/29/2022
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 03-CC-20220928074631
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833

FACILITY NAME: ROCKLIN RANCH MONTESSORI
FACILITY NUMBER: 313623436
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/29/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
09/30/2022
Section Cited
CCR
101223(a)(2)
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PERSONAL RIGHTS: The licensee shall ensure that each child is accorded the following personal rights: To be accorded safe, healthful and comfortable
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Director states all medication will be administered by office staff only therefore, office staff will be in charge of releasing the medication to the family.
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accommodations, furnishings and equipment to meet his/her needs. This requirement was not met when child #1 was sent home with the wrong medication which was prescribed to another child. This is an immediate risk to the health and safety of 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.
SUPERVISOR'S NAME: Keven PetersTELEPHONE: (916) 263-5728
LICENSING EVALUATOR NAME: Amanda BlesiTELEPHONE: (916) 208-3427
LICENSING EVALUATOR SIGNATURE:

DATE: 09/29/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/29/2022
LIC9099 (FAS) - (06/04)
Page: 3 of 3