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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 376700282
Report Date: 05/06/2021
Date Signed: 05/06/2021 12:21:06 PM



STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108
This is an official report of an unannounced visit/investigation of a complaint received in our office on
03/23/2021 and conducted by Evaluator Keturah Lane
PUBLIC
COMPLAINT CONTROL NUMBER: 51-CC-20210323161616
FACILITY NAME:MONTESSORI SCHOOL OF KEARNY MESAFACILITY NUMBER:
376700282
ADMINISTRATOR:AMITHA PERUSINGHEFACILITY TYPE:
850
ADDRESS:3411 SANDROCK ROADTELEPHONE:
(858) 505-0332
CITY:SAN DIEGOSTATE: CAZIP CODE:
92123
CAPACITY:57CENSUS: 33DATE:
05/06/2021
UNANNOUNCEDTIME BEGAN:
08:35 AM
MET WITH:Amitha PerusingheTIME COMPLETED:
12:30 PM
ALLEGATION(S):
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Facility operating out of ratio
INVESTIGATION FINDINGS:
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On 5/6/21 at 8:35 AM, Licensing Program Analysts (LPAs) Keturah Lane and LeAndra Dolliole, conducted an unannounced complaint inspection in reference to the above allegation at the facility. LPAs met with Director Amitha Perusinghe and toured the facility. Census was 19 children in room 4 with staff members Maribel Cruz and Natividad Gimony, 14 children in room 3 with staff members Susantha Wijesinghe and Maria Morales. Facility also has an infant license #376700281.
During tour, LPAs observed appropriate capacity and ratios within regulation and checked again at 11:42 AM after concluding staff and children interviews. At 11:42 AM, LPAs found the following ratios: 23 children in room 4 with staff members Maribel Cruz, Natividad Gimony and Teresa Sotelo; 20 children in room 3 with staff members Susantha Wijesinghe and Maria Morales. Facility was also using room 2 as a transition room for toddlers moving into the preschool room and there were 6 children in room 2 with staff member Shantal Sanchez. Children’s records were reviewed and found to be in order. (continued on LIC9099-C...)
Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Monica CuddyTELEPHONE: (619) 767-2249
LICENSING EVALUATOR NAME: Keturah LaneTELEPHONE: (619) 767-2223
LICENSING EVALUATOR SIGNATURE:

DATE: 05/06/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/06/2021
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 51-CC-20210323161616
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108
FACILITY NAME: MONTESSORI SCHOOL OF KEARNY MESA
FACILITY NUMBER: 376700282
VISIT DATE: 05/06/2021
NARRATIVE
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The Department fully investigated the above allegation and obtained information from the facility file review, facility documents, staff records, interviews with staff, children, parents and LPAs observations at the facility. Based upon this information, although the allegation of facility operating out of ratio may have happened or is valid, there is not a preponderance of evidence to prove that the alleged violation occurred at this facility and is therefore UNSUBSTANTIATED. (Continued on LIC9099-C… )

An exit interview was conducted with the Director. A Notice of Site Visit (LIC9213) and Appeal Rights (LIC9058) were provided to Director and signature on this form acknowledges receipt of these rights. LPAs observed Notice of Site Visit being posted. Notice of Site visit must remain posted at the facility for 30 days.
SUPERVISOR'S NAME: Monica CuddyTELEPHONE: (619) 767-2249
LICENSING EVALUATOR NAME: Keturah LaneTELEPHONE: (619) 767-2223
LICENSING EVALUATOR SIGNATURE:

DATE: 05/06/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/06/2021
LIC9099 (FAS) - (06/04)
Page: 2 of 2