434414335-8-25-2022-07-CC-JSEA-CHZV24-20220906160230

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 434414335
Report Date: 08/25/2022
Date Signed: 08/25/2022 03:45:01 PM

Substantiated

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
06/13/2022 and conducted by Evaluator Samantha Yip

PUBLIC

COMPLAINT CONTROL NUMBER: 07-CC-20220613143646

FACILITY NAME:	ABC LEARNING MONTESSORI, LLC		FACILITY NUMBER:	434414335
ADMINISTRATOR:	SANDRA YVETTE CALDERON		FACILITY TYPE:	850
ADDRESS:	15345 CALLE ENRIQUE		TELEPHONE:	(408) 465-2015
CITY:	MORGAN HILL	STATE: CA	ZIP CODE:	95037
CAPACITY:	50	CENSUS: 34	DATE:	08/25/2022
		UNANNOUNCED	TIME BEGAN:	09:26 AM
MET WITH:	Sandra Yvette Calderon		TIME COMPLETED:	11:15 AM

ALLEGATION(S):

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Lack of supervision resulting in child sustaining an injury
Facility failed to follow manufacture guidelines resulting in a child getting injured

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Samantha Yip conducted an unannounced subsequent complaint investigation for the above allegations. LPA met with Director Sandra Yvette Calderon and explained the reason for the inspection.

During the course of this investigation, LPA conducted interviews with staff, children, and third party. LPA also reviewed pertain documents, such as playground rules, employee handbook, and Playground Boss: Customer's Guide. Based on the information obtained, the above allegations are found to be SUBSTANTIATED, meaning the preponderance of the evidence standard has been met.
-------------------continues on 9099 dated 08/25/2022 page 2----------------------

Substantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Joel Segura	TELEPHONE: (408) 334-8550
LICENSING EVALUATOR NAME: Samantha Yip	TELEPHONE: (408) 529-8128
LICENSING EVALUATOR SIGNATURE:	DATE: 08/25/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/25/2022

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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Control Number 07-CC-20220613143646

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

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

FACILITY NAME: ABC LEARNING MONTESSORI, LLC	FACILITY NUMBER: 434414335
	VISIT DATE: 08/25/2022

NARRATIVE

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Based on interviews and record reviews, staff stated that a child slipped while trying to jump off the ladder on the play structure and fell. There is resilient material around the play-structure. The child sustained a left arm montesggia fracture. There was one staff present with nine children at the time of the incident. The staff was standing by the gate facing the playground, but could not visually observe children on the ladder. Staff stated that they did not see the incident occur. Facility called 9-11 following the incident. The facility self-reported the incident to the San Jose Regional office on 05/10/2022. LPA discussed with Director that supervision includes visual observation of children.

LPA also reviewed Playground Boss- Customer's Guide- Supervision Guidelines, which states it is "essential to recognize that preschool-age children require more attentive supervision on playground equipment than older children." It also states to "look out for or dangerous horseplay, such as...jumping from heights..." The Director stated that children were asked to stop jumping off the ladder prior the incident occurring. However, children continued to jump off the ladder. LPA discussed with Director about ensuring that the center is following the manufacture guidelines at all time. LPA discussed with Director about plans for the ladder located on the play-structure. Playground is for ages 2 to 5 years old.

Director stated that she has conducted training with all staff since the incident and has changed the playground rules. She stated that they will have two staff outside on the playground at all time when in use. She stated that she has reminded staff to position themselves where they can always see the children. Director conducted a staff meeting on 08/19/2022, where she discussed the playground rules again with staff.

As a result of this investigation, two Type B citations were issued. Exit interview conducted and report was reviewed with Director Yvette Calderon. 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.

SUPERVISOR'S NAME: Joel Segura	TELEPHONE: (408) 334-8550
LICENSING EVALUATOR NAME: Samantha Yip	TELEPHONE: (408) 529-8128
LICENSING EVALUATOR SIGNATURE:	DATE: 08/25/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/25/2022

LIC9099 (FAS) - (06/04)

Page: 2 of 4

Control Number 07-CC-20220613143646

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

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

FACILITY NAME: ABC LEARNING MONTESSORI, LLC	FACILITY NUMBER: 434414335
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 08/25/2022

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 09/01/2022 Section Cited CCR 101229(a)(1)	1 2 3 4 5 6 7	Responsibility for Providing Care and Supervision. The licensee shall provide care and supervision as necessary to meet the children's needs. No child(ren) shall be left without the supervision of a teacher at any time, except as specified in Sections 101216.2(e)(1) and 101230(c)(1). Supervision shall include visual observation. This requirement is not met as evident by:	1 2 3 4 5 6 7	Defienciency has been cleared. Director conducted training with staff about playground rules and supervision.
	8 9 10 11 12 13 14	Based on interviews, at the time of the incident there was a staff present; however, the staff was standing by the gate facing the playground. The staff could not visually observe the children where the ladder is, which resulted in a child slipping and falling. The child sustained a left arm montesggia fracture. This poses a potential health and safety risk to children in care.	8 9 10 11 12 13 14	Director will send a list of the staff who attended the meeting to Licensing by 09/01/2022.
Type B 09/01/2022 Section Cited CCR 101223(a)(2)	1 2 3 4 5 6 7	Personal Rights. The licensee shall ensure that each child is accorded the following personal rights: To be accorded safe, healthful and comfortable accommodations, furnishings and equipment to meet his/her needs. This requirement is not met as evident by:	1 2 3 4 5 6 7	By 09/01/2022, Director stated that she will submit a written statement that she understands the manufacture guidelines.
	8 9 10 11 12 13 14	Based on record reviews and interviews, the Playground Boss-Customer's Guide states under supervision guidelines to "look out for dangerous horseplay, such as...jumpinng for heights... A child slipped while trying to jump off the ladder, which resulted in the child sustaining a left arm montesggia fracture. This poses a potential health and safety risk to children in care.	8 9 10 11 12 13 14	Director has conducted training with staff on 08/19/2022 in regards to playground rules and ensuring that children are visually supervised at all times outside.

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: Joel Segura	TELEPHONE: (408) 334-8550
LICENSING EVALUATOR NAME: Samantha Yip	TELEPHONE: (408) 529-8128
LICENSING EVALUATOR SIGNATURE:	DATE: 08/25/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/25/2022

LIC9099 (FAS) - (06/04)

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