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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 070208839
Report Date: 05/14/2025
Date Signed: 05/14/2025 03:45:54 PM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
OAKLAND CC RO, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612
This is an official report of an unannounced visit/investigation of a complaint received in our office on
05/08/2025 and conducted by Evaluator Jaleesa Jackson
PUBLIC
COMPLAINT CONTROL NUMBER: 02-CC-20250508162525
FACILITY NAME:DIABLO VALLEY MONTESSORI SCHOOLFACILITY NUMBER:
070208839
ADMINISTRATOR:MARTIN, JAYNEFACILITY TYPE:
850
ADDRESS:3390 DEERHILL ROADTELEPHONE:
(925) 283-6036
CITY:LAFAYETTESTATE: CAZIP CODE:
94549
CAPACITY:138CENSUS: 100DATE:
05/14/2025
UNANNOUNCEDTIME BEGAN:
08:55 AM
MET WITH:Jayne MartinTIME COMPLETED:
04:00 PM
ALLEGATION(S):
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Child received injuries while in care due to lack of supervison
INVESTIGATION FINDINGS:
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On 5/14/2025, Licensing Program Analyst (LPA) Jaleesa Jackson met with Director Jayne Martin to investigate a complaint filed against the Child Care Center (CCC) regarding the allegation that a child received injuries while in care due to lack of supervison. Present for the inspection were the 100 preschool aged children and 19 staff.

Based on interviews conducted, observations, and record review, the allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore, the allegation is UNSUBSTANTIATED.

A notice of site visit was given and must remain posted for 30 days.

Appeal Rights were given and discussed. An exit interview was conducted.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Jason Jang
LICENSING EVALUATOR NAME: Jaleesa Jackson
LICENSING EVALUATOR SIGNATURE:

DATE: 05/14/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/14/2025
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
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
OAKLAND CC RO, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612
This is an official report of an unannounced visit/investigation of a complaint received in our office on
05/08/2025 and conducted by Evaluator Jaleesa Jackson
PUBLIC
COMPLAINT CONTROL NUMBER: 02-CC-20250508162525

FACILITY NAME:DIABLO VALLEY MONTESSORI SCHOOLFACILITY NUMBER:
070208839
ADMINISTRATOR:MARTIN, JAYNEFACILITY TYPE:
850
ADDRESS:3390 DEERHILL ROADTELEPHONE:
(925) 283-6036
CITY:LAFAYETTESTATE: CAZIP CODE:
94549
CAPACITY:138CENSUS: 100DATE:
05/14/2025
UNANNOUNCEDTIME BEGAN:
08:55 AM
MET WITH:Jayne MartinTIME COMPLETED:
04:00 PM
ALLEGATION(S):
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Incident(s) not reported to licensing in a timely manner
INVESTIGATION FINDINGS:
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On 5/14/2025, Licensing Program Analyst (LPA) Jaleesa Jackson met with Director Jayne Martin to investigate a complaint filed against Child Care Center regarding the allegation that incident(s) not reported to licensing in a timely manner. Present during the inspection were 19 staff and 100 preschool aged children.

LPA conducted an interview and record review. LPA found that an incident occured at the facility on 2/12/25. The Director was notified by parents that C1 required medical treatment on 2/12/25 after hours. Director acknowledge the message the next morning on 2/13/25. The incident was not reported to the Regional offce until 2/18/25. The Child Care Center was closed for a 4 day weekend from 2/14/25 to 2/17/25. The center reopened on 2/18/25.

Continued 9099-C
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Jason Jang
LICENSING EVALUATOR NAME: Jaleesa Jackson
LICENSING EVALUATOR SIGNATURE:

DATE: 05/14/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/14/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 2 of 4
Control Number 02-CC-20250508162525
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
OAKLAND CC RO, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612

FACILITY NAME: DIABLO VALLEY MONTESSORI SCHOOL
FACILITY NUMBER: 070208839
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/14/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
05/21/2025
Section Cited
CCR
101212(d)(1)(B)
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Upon the occurrence, during the operation of the child care center of any of the events ... a report shall be made to the Department by telephone or fax within the Department's next working day... Events reported shall include the following: Any injury to any child that requires medical treatment.
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Director will review the "Child Care Reporting Requirements" video on ccld.childcarevideos.org and submit a signed and dated statement of understanding of the regulation to LPA by email by POC dated 5/21/2025.
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This requirement is not met as evidenced by:
Based on interview and record review the school was notified 2/12/25 that C1 recieved medical treatment but did not inform licensing until 2/18/25, which poses a potential health and safety risk to children in care.
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Failure to correct will result in a $100 per day civil penalty until corrected. Repeat violations are $250 per violation and $100 per day until corrected.
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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: Jason Jang
LICENSING EVALUATOR NAME: Jaleesa Jackson
LICENSING EVALUATOR SIGNATURE:

DATE: 05/14/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/14/2025
LIC9099 (FAS) - (06/04)
Page: 3 of 4
Control Number 02-CC-20250508162525
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
OAKLAND CC RO, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612
FACILITY NAME: DIABLO VALLEY MONTESSORI SCHOOL
FACILITY NUMBER: 070208839
VISIT DATE: 05/14/2025
NARRATIVE
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The allegation incident(s) not reported to licensing in a timely manner has been SUBSTANTIATED. Based on LPA's interview and record review, the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED. See 9099-D for deficiency.

A notice of site visit was given and must remain posted for 30 days.

Appeal Rights were given and discussed. An exit interview was conducted.
SUPERVISORS NAME: Jason Jang
LICENSING EVALUATOR NAME: Jaleesa Jackson
LICENSING EVALUATOR SIGNATURE:

DATE: 05/14/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/14/2025
LIC9099 (FAS) - (06/04)
Page: 4 of 4