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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 073402302
Report Date: 10/17/2023
Date Signed: 10/17/2023 01:58:32 PM

Substantiated


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
10/10/2023 and conducted by Evaluator Randall Dunevant
COMPLAINT CONTROL NUMBER: 02-CC-20231010131354
FACILITY NAME:ANGELS MONTESSORI PRESCHOOL - CONCORDFACILITY NUMBER:
073402302
ADMINISTRATOR:KARAMPOUR, ANGELFACILITY TYPE:
850
ADDRESS:1566 BAILEY ROADTELEPHONE:
(925) 686-5621
CITY:CONCORDSTATE: CAZIP CODE:
94521
CAPACITY:49CENSUS: 14DATE:
10/17/2023
UNANNOUNCEDTIME BEGAN:
11:00 AM
MET WITH:TIME COMPLETED:
02:14 PM
ALLEGATION(S):
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Staff are not adequately supervising children in care.
INVESTIGATION FINDINGS:
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On 10/17/23 Licensing Program Analyst (LPA) Randall Dunevant and Licensing Program Manager (LPM) Lorreta arrived at the facility for an unannounced complaint investigation. LPA and LPM met with the Director, Maryam Karampour. There were 14 children in care and 1 additional staff member and 3 behavioral technicians also present. LPA and LPM informed the facility of the complaint and above allegation. LPA requested a roster and sign in/out sheets for children and conducted staff and behavior tech interviews, as well as made observations. LPA observed children with out supervisons while in care during today visit.

Based on LPAs observations and interviews which were conducted and record review(s), the preponderance of evidence standard has been met, therefore the above allegation(s) is found to be SUBSTANTIATED. California Code of Regulations, 101229(a)(1), are being cited on the attached LIC. 9099D

******Contuined on 9099C*******
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Loretta Dyson
LICENSING EVALUATOR NAME: Randall Dunevant
LICENSING EVALUATOR SIGNATURE:

DATE: 10/17/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/17/2023
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 6
Control Number 02-CC-20231010131354
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: ANGELS MONTESSORI PRESCHOOL - CONCORD
FACILITY NUMBER: 073402302
VISIT DATE: 10/17/2023
NARRATIVE
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A Type A deficiency was cited during this visit. The Licensee acknowledges that for Type A Deficiency only upon receipt, the licensee shall post the LIC 9099 with Type A deficiency for 30 days and provide copies of this licensing report to parents/guardians of children in care at the facility and to parents/ guardians of children newly enrolled at the facility during the next 12 months. The LIC 9224 must be signed by parents/ guardians and kept with the children's forms as a receipt whenever any Type A documents are provided by the licensee. A copy of the LIC 9224, and AB 633 fact sheet, was given to licensee at time of this inspection.

See 9099D for deficiencies cited. This report shall remain on file for 3 years.

An exit interview was conducted with the director. The report, appeal rights and a Notice of Site Visit was provided. The director was reminded to have the Notice of Site Visit posted for 30 days.
SUPERVISORS NAME: Loretta Dyson
LICENSING EVALUATOR NAME: Randall Dunevant
LICENSING EVALUATOR SIGNATURE:

DATE: 10/17/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/17/2023
LIC9099 (FAS) - (06/04)
Page: 2 of 6
Control Number 02-CC-20231010131354
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: ANGELS MONTESSORI PRESCHOOL - CONCORD
FACILITY NUMBER: 073402302
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/17/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
10/18/2023
Section Cited
CCR
101229(a)(1)
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(a) The licensee shall provide care and supervision as necessary to meet the children's needs.

(1) No child(ren) shall be left without the supervision of a teacher at any time, except as specified in Sections
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Facility and all staff will watch Community Care Licensing Video Supervising Children in Child Care Centers available on CCLD website. Facility will proved LPA with receipt of completion of training.
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 101216.2(e)(1) and 101230(c)(1). Supervision shall include visual observation. Supervision shall include visual observation. This requirement was not met as evidence by LPAs observations of children within facility without visual supervision.
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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: Loretta Dyson
LICENSING EVALUATOR NAME: Randall Dunevant
LICENSING EVALUATOR SIGNATURE:

DATE: 10/17/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/17/2023
LIC9099 (FAS) - (06/04)
Page: 3 of 6
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
10/10/2023 and conducted by Evaluator Randall Dunevant
COMPLAINT CONTROL NUMBER: 02-CC-20231010131354

FACILITY NAME:ANGELS MONTESSORI PRESCHOOL - CONCORDFACILITY NUMBER:
073402302
ADMINISTRATOR:KARAMPOUR, ANGELFACILITY TYPE:
850
ADDRESS:1566 BAILEY ROADTELEPHONE:
(925) 686-5621
CITY:CONCORDSTATE: CAZIP CODE:
94521
CAPACITY:49CENSUS: 14DATE:
10/17/2023
UNANNOUNCEDTIME BEGAN:
11:00 AM
MET WITH:Mariyam KarampourTIME COMPLETED:
02:14 PM
ALLEGATION(S):
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Staff did not keep the facility free of flies
Hazardous objects are accessible to children in care
Staff do not keep the facility clean or sanitary
The facility is in disrepair
INVESTIGATION FINDINGS:
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On 10/17/23 Licensing Program Analyst (LPA) Randall Dunevant and Licensing Program Manager (LPM) Loretta arrived at the facility for an unannounced complaint investigation. LPA and LPM met with the Director, Maryam Karampour. There were 14 children in care and 1 additional staff member and 3 behavioral technicians also present. LPA and LPM informed the facility of the complaint and above allegation. LPA requested a roster and sign in/out sheets for children and conducted staff and behavior tech interviews, as well as made observations. LPA observed flies in facility, cleaning products accessible to children, trash and the lack of sanitary practices throughout the facility

Based on LPAs observations and interviews which were conducted and record review(s), the preponderance of evidence standard has been met, therefore the above allegation(s) is found to be SUBSTANTIATED. California Code of Regulations, 101238(a)(1)(2), are being cited on the attached LIC. 9099D

******Contuined on 9099C*******
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Loretta Dyson
LICENSING EVALUATOR NAME: Randall Dunevant
LICENSING EVALUATOR SIGNATURE:

DATE: 10/17/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/17/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 4 of 6
Control Number 02-CC-20231010131354
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: ANGELS MONTESSORI PRESCHOOL - CONCORD
FACILITY NUMBER: 073402302
VISIT DATE: 10/17/2023
NARRATIVE
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A Type A deficiency was cited during this visit. The Licensee acknowledges that for Type A Deficiency only upon receipt, the licensee shall post the LIC 9099 with Type A deficiency for 30 days and provide copies of this licensing report to parents/guardians of children in care at the facility and to parents/ guardians of children newly enrolled at the facility during the next 12 months. The LIC 9224 must be signed by parents/ guardians and kept with the children's forms as a receipt whenever any Type A documents are provided by the licensee. A copy of the LIC 9224, and AB 633 fact sheet, was given to licensee at time of this inspection.

See 9099D for deficiencies cited. This report shall remain on file for 3 years.

An exit interview was conducted with the director. The report, appeal rights and a Notice of Site Visit was provided. The director was reminded to have the Notice of Site Visit posted for 30 days.
SUPERVISORS NAME: Loretta Dyson
LICENSING EVALUATOR NAME: Randall Dunevant
LICENSING EVALUATOR SIGNATURE:

DATE: 10/17/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/17/2023
LIC9099 (FAS) - (06/04)
Page: 5 of 6
Control Number 02-CC-20231010131354
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: ANGELS MONTESSORI PRESCHOOL - CONCORD
FACILITY NUMBER: 073402302
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/17/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
10/17/2023
Section Cited
CCR
101238(a)(1)(2)
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(a) The child care center shall be clean, safe, sanitary and in good repair at all times to ensure the safety and well-being of children, employees and visitors.
(1) The licensee shall take measures to keep the center free of flies, other insects, and rodents.
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Facility will immediately move all cleaning supplies to proper storage area away from children in care. Facility will be cleaned and items need to be stored in an organized manner. Trash will be removed daily to prevent insects.
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(2) The licensee shall safely dispose of water and any disinfectants/solutions that have been used for cleaning. This requirement is not met as evidence by LPA observations of flies in facility, cleaning products accessible to children, trash and the lack of sanitary practices throughout the facility
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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: Loretta Dyson
LICENSING EVALUATOR NAME: Randall Dunevant
LICENSING EVALUATOR SIGNATURE:

DATE: 10/17/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/17/2023
LIC9099 (FAS) - (06/04)
Page: 6 of 6