<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 013412618
Report Date: 06/30/2023
Date Signed: 06/30/2023 02:36:20 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, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
This is an official report of an unannounced visit/investigation of a complaint received in our office on
06/20/2023 and conducted by Evaluator Morgan Pringle
PUBLIC
COMPLAINT CONTROL NUMBER: 52-CC-20230620122841
FACILITY NAME:MONTESSORI CHILDREN'S CENTERFACILITY NUMBER:
013412618
ADMINISTRATOR:KHAN, YASMINFACILITY TYPE:
850
ADDRESS:33170 LAKE MEAD DRIVETELEPHONE:
(510) 489-7510
CITY:FREMONTSTATE: CAZIP CODE:
94555
CAPACITY:110CENSUS: 48DATE:
06/30/2023
UNANNOUNCEDTIME BEGAN:
11:20 AM
MET WITH:Yasmin KhanTIME COMPLETED:
02:34 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Facility is out of ratio.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
At 11:20am on 6/30/2023 Licensing Program Analyst (LPA) Morgan Pringle met with Director Yasmin Khan to for a complant that was received against the facility is out of ratio. During LPA's visit two classrooms (Redwood and Sequoia) were inspected. Present during LPA's visit were six (6) staff and fourty eight (48) preschool age children. All staff present have obtained a criminal record clearance. LPA Pringle conducted interviews, file reviews and obtained the facility roster.
Through record review and observation it was found that the Redwood clasroom was out of ratio with two (2) Aides with twelve (12) preschool age children. Staff changes were made immediately to bring the classroom back into compliance. LPA determined the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED. California Code of Regulations, Title 22 is being cited on the attached LIC 9099D. Failure to submit Proof of Corrections (POC) by Plan of Correction date may result in civil penalties. A notice of site visit and appeal rights were given. Exit interview conducted and report was reviewed with Yasmin Khan.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Jason Jang
LICENSING EVALUATOR NAME: Morgan Pringle
LICENSING EVALUATOR SIGNATURE:

DATE: 06/30/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/30/2023
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 52-CC-20230620122841
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612

FACILITY NAME: MONTESSORI CHILDREN'S CENTER
FACILITY NUMBER: 013412618
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/30/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
07/06/2023
Section Cited
CCR
101216.3(a)
1
2
3
4
5
6
7
(a) There shall be a ratio of one teacher visually observing and supervising no more than 12 children in attendance...This requirement was not met as evidenced by, LPA Pringle observed the Redwood classroom out of ratio with two (2) aides and twelve (12) preschool age children.
1
2
3
4
5
6
7
During LPA's visit the classroom was brought into compliance. Director will send LPA Pringle a statement on how the facility will continue to remain in compliance regarding ratios.
8
9
10
11
12
13
14
This poses a potential risk to the health and safety of the children in care.
8
9
10
11
12
13
14
Director will also inform LPA the names of the teachers present in each preschool classroom until the POC date, 7/6/2023.
1
2
3
4
5
6
7
1
2
3
4
5
6
7
1
2
3
4
5
6
7
1
2
3
4
5
6
7
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: Jason Jang
LICENSING EVALUATOR NAME: Morgan Pringle
LICENSING EVALUATOR SIGNATURE:

DATE: 06/30/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/30/2023
LIC9099 (FAS) - (06/04)
Page: 2 of 2