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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 343624324
Report Date: 08/20/2024
Date Signed: 08/20/2024 10:54:55 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
07/09/2024 and conducted by Evaluator Mandie Goodwin
PUBLIC
COMPLAINT CONTROL NUMBER: 03-CC-20240709153134
FACILITY NAME:ADVENTURE MONTESSORI S.T.E.A.M ACADEMY LLCFACILITY NUMBER:
343624324
ADMINISTRATOR:ROBERTA MANLEYFACILITY TYPE:
850
ADDRESS:3541 N FREEWAY BLVD SUITE 100TELEPHONE:
(916) 370-6113
CITY:SACRAMENTOSTATE: CAZIP CODE:
95834
CAPACITY:35CENSUS: 18DATE:
08/20/2024
UNANNOUNCEDTIME BEGAN:
08:15 AM
MET WITH:Sithumini MillawabandaraTIME COMPLETED:
11:15 AM
ALLEGATION(S):
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Staff have inappropriate interactions with daycare children
INVESTIGATION FINDINGS:
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On August 20th 2024 Licensing Program Analyst (LPA) Mandie Goodwin met with owner Sithumini Millawabandara to conduct further investigation and close a complaint investigation regarding the above allegations. Upon arrival there were 18 preschool age children supervised by 3 staff members.

Throughout the course of the investigation LPA conducted interviews with staff, clients and children, obtained documentation, and made observations. LPA observed documentation of a staff member (S1) moving a child by picking them up by the arms between their shoulder and their elbow. After setting the child down the child was observed to be rubbing their arm where the staff member had carried them. LPA observed seperate documentation of the same staff member pulling a seated child by their leg towards the carpet. The staff member then took the child's arm and pulled them over rotating their body so they were facing the carpet. Based on the documentation obtained the preponderance of evidence standard has been met; therefore, the above allegations are substantiated. Continued on 9099-C
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Seychelle De Luca
LICENSING EVALUATOR NAME: Mandie Goodwin
LICENSING EVALUATOR SIGNATURE:

DATE: 08/20/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/20/2024
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 4
Control Number 03-CC-20240709153134
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: ADVENTURE MONTESSORI S.T.E.A.M ACADEMY LLC
FACILITY NUMBER: 343624324
VISIT DATE: 08/20/2024
NARRATIVE
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LPA Mandie Goodwin informed owner that this report dated 8/20/24 documents a Type A citation which shall be posted for 30 consecutive days as there is immediate risk to the health, safety, or personal rights of children in care. Also, LPA Mandie Goodwin informed the owner to provide a copy of this licensing report dated 8/20/24 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. Exit interview with Owner was conducted and appeal rights were provided.

See LIC 9099-D for deficiencies.
SUPERVISORS NAME: Seychelle De Luca
LICENSING EVALUATOR NAME: Mandie Goodwin
LICENSING EVALUATOR SIGNATURE:

DATE: 08/20/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/20/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 4
Citations on this Visit Report are Under Appeal!

Control Number 03-CC-20240709153134
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: ADVENTURE MONTESSORI S.T.E.A.M ACADEMY LLC
FACILITY NUMBER: 343624324
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/20/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Under Appeal
Type A
08/21/2024
Section Cited
CCR
101223(a)(3)
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PERSONAL RIGHTS: (a) The licensee shall ensure that each child is accorded the following personal rights: ...(3) To be free from corporal or unusual punishment, infliction of pain, humiliation, intimidation... This requirement is not met as evidence by:
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Owner will provide training on how to handle and talk to child. Owner will send LPA staff signatures on the training provided.
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Based on documentation review S1 moved children in an inappropriate manner by carrying them by the arms or pulling their leg, causing one child to rub their arm which poses an immediate health, safety, or personal rights risk to pesons 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: Seychelle De Luca
LICENSING EVALUATOR NAME: Mandie Goodwin
LICENSING EVALUATOR SIGNATURE:

DATE: 08/20/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/20/2024
LIC9099 (FAS) - (06/04)
Page: 3 of 4
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
07/09/2024 and conducted by Evaluator Mandie Goodwin
PUBLIC
COMPLAINT CONTROL NUMBER: 03-CC-20240709153134

FACILITY NAME:ADVENTURE MONTESSORI S.T.E.A.M ACADEMY LLCFACILITY NUMBER:
343624324
ADMINISTRATOR:ROBERTA MANLEYFACILITY TYPE:
850
ADDRESS:3541 N FREEWAY BLVD SUITE 100TELEPHONE:
(916) 370-6113
CITY:SACRAMENTOSTATE: CAZIP CODE:
95834
CAPACITY:35CENSUS: 18DATE:
08/20/2024
UNANNOUNCEDTIME BEGAN:
08:15 AM
MET WITH:Sithumini MillawabandaraTIME COMPLETED:
11:15 AM
ALLEGATION(S):
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Staff do not provide a comfortable environment for daycare children
Staff isolate daycare children
INVESTIGATION FINDINGS:
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On August 20th 2024 Licensing Program Analyst (LPA) Mandie Goodwin met with owner Sithumini Millawabandara to conduct further investigation and close a complaint investigation regarding the above allegations. Upon arrival there were 18 children supervised by 3 staff members.

Throughout the course of the investigation LPA conducted interviews with staff, clients, and children, obtained documentation, and made observations. Interviews conducted did not reveal a concern that the environment was uncomfortable or that children were isolated. LPA additionally did not observe the environment to be uncomfortable during visits to the facility and LPA did not observe any child being isolated from the group. Although the alleged violations may have happened or are valid, the preponderance of evidence standard has not been met to fully prove or disprove that they did or did not occur, therefore, they are unsubstantiated. An exit interview was conducted with owner Sithumini Millawabandara and a notice of site visit provided. Notice of site visit shall remain posted for 30 days.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Seychelle De Luca
LICENSING EVALUATOR NAME: Mandie Goodwin
LICENSING EVALUATOR SIGNATURE:

DATE: 08/20/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/20/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 4 of 4