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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 070210062
Report Date: 10/31/2024
Date Signed: 10/31/2024 12:16:48 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
09/20/2024 and conducted by Evaluator Ashley Curry
PUBLIC
COMPLAINT CONTROL NUMBER: 02-CC-20240920133038

FACILITY NAME:FOUNTAINHEAD MONTESSORI SCHOOLFACILITY NUMBER:
070210062
ADMINISTRATOR:SAMAR SHAKALIAFACILITY TYPE:
850
ADDRESS:939 EL PINTADO ROADTELEPHONE:
(925) 820-6250
CITY:DANVILLESTATE: CAZIP CODE:
94526
CAPACITY:92CENSUS: 46DATE:
10/31/2024
UNANNOUNCEDTIME BEGAN:
08:45 AM
MET WITH:Samar Shakalia TIME COMPLETED:
12:30 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Child sustained an injury while in care
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On 10/31/2024 at 8:45AM Licensing Program Analyst (LPA), A. Curry conducted an unannounced subsequent complaint visit. LPA met with Director, Samar Shakalia, to discuss the above allegation. LPA previously toured the facility, retrieved documentation, and conducted interviews with staff and parents. Based on the interviews it could not be determined that a child sustained a significant injury. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove that the alleged violation did or did not occur. This allegation is Unsubstantiated.

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

Exit interview conducted, appeal rights were given, and report was reviewed with the Director, Samar Shakalia.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Monica Mathur
LICENSING EVALUATOR NAME: Ashley Curry
LICENSING EVALUATOR SIGNATURE:

DATE: 10/31/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/31/2024
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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