444417076-8-17-2023-07-CC-JSEA-CVWUHC-20230922153544

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 444417076
Report Date: 08/17/2023
Date Signed: 08/17/2023 09:17:47 AM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

This is an official report of an unannounced visit/investigation of a complaint received in our office on
07/13/2023 and conducted by Evaluator Cortney Nelson

PUBLIC

COMPLAINT CONTROL NUMBER: 07-CC-20230713083721

FACILITY NAME:	MONTESSORI COMMUNITY SCHOOL		FACILITY NUMBER:	444417076
ADMINISTRATOR:	MADELYNN VAN DEN HEUVEL		FACILITY TYPE:	850
ADDRESS:	123 SOUTH NAVARRA DRIVE		TELEPHONE:	(831) 439-9625
CITY:	SCOTTS VALLEY	STATE: CA	ZIP CODE:	95066
CAPACITY:	90	CENSUS: 42	DATE:	08/17/2023
		UNANNOUNCED	TIME BEGAN:	08:51 AM
MET WITH:	Madelynn Van Den Heuvel		TIME COMPLETED:	09:27 AM

ALLEGATION(S):

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Facility is malodorous.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA), Cortney Nelson, met with the Site Director, Madelynn Van Den Heuvel, and explained purpose of visit- deliver complaint investigation findings for the above allegation. LPA was admitted into the facility by Madelynn upon arrival and toured the nap room during today's visit.

LPA Nelson conducted interviews with the Site Director, Assistant Director, and staff as well as observed the nap room on three different occassions. None (0) of the staff or Directors reported a smell/odor from the nap room and LPA did not observe a smell/odor from the nap room on three (3) separate observations. Based on the available evidence, it is concluded that although the allegation listed above may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur. The allegation is thus UNSUBSTANTIATED.

As a result of this investigation, no deficiencies were cited. Exit interview was conducted and report was reviewed with Site Director, Madelynn Van Den Heuvel.

A NOTICE OF SITE VISIT WAS GIVEN AND MUST REMAIN POSTED FOR 30 DAYS. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Joel Segura
LICENSING EVALUATOR NAME: Cortney Nelson
LICENSING EVALUATOR SIGNATURE:	DATE: 08/17/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/17/2023

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

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