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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 073408259
Report Date: 11/03/2022
Date Signed: 11/03/2022 03:57:37 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, SUITE 1102
OAKLAND, CA 94612
This is an official report of an unannounced visit/investigation of a complaint received in our office on
08/15/2022 and conducted by Evaluator Phyllis Dyer
PUBLIC
COMPLAINT CONTROL NUMBER: 02-CC-20220815135021

FACILITY NAME:CREATIVE MONTESSORI PRESCHOOLFACILITY NUMBER:
073408259
ADMINISTRATOR:AKTER, SILVIAFACILITY TYPE:
830
ADDRESS:1350 MORAGA WAYTELEPHONE:
(925) 377-8314
CITY:MORAGASTATE: CAZIP CODE:
94556
CAPACITY:14CENSUS: 8DATE:
11/03/2022
UNANNOUNCEDTIME BEGAN:
12:10 PM
MET WITH:Silvia AkterTIME COMPLETED:
04:20 PM
ALLEGATION(S):
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Qualifications - Staff do not meet the qualifications to care and supervise children.
INVESTIGATION FINDINGS:
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LPA Dyer conducted an unannounced complaint inspection to deliver the findings of the above allegation. LPA met with director Sylvia Akter. Present at the facility: the director, 1 infant, and 8 infant children.
It was alleged that staff do not meet the qualifications to care and supervise children. During the course of the investigation, interviews were conducted and file reviews were completed. It was determined that there are Staff who worked with infants at the facility that do not have the required qualifications/records in file.
Based on the LPA's observations and interviews which were conducted and record review(s), the preponderance of evidence standard has been met. Therefore, the above allegation is found to be SUBSTANTIATED. California Code of Regulations, (Title 22, Division 12), are being cited on the attached LIC 9099D and must be corrected by the due date.
Licensee was provided copy of their appeal rights. Notice of Site visit must be posted for 30 days. Exit interview conducted.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Loretta Dyson
LICENSING EVALUATOR NAME: Phyllis Dyer
LICENSING EVALUATOR SIGNATURE:

DATE: 11/03/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/03/2022
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 6
Control Number 02-CC-20220815135021
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, SUITE 1102
OAKLAND, CA 94612

FACILITY NAME: CREATIVE MONTESSORI PRESCHOOL
FACILITY NUMBER: 073408259
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/03/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
12/05/2022
Section Cited
CCR
101416.2(d)
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Infant Care. A photocopy of each teacher's transcript(s) documenting successful completion of required course work shall be maintained at the center.
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Director states that she will provide the required records by the POC due date. Records shall be provided by mail, fax or e-mail.

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This requirement was not met as evidenced by record review: LPA reviewed records and there were no transcripts of infant classes of the infant teacher.
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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: Loretta Dyson
LICENSING EVALUATOR NAME: Phyllis Dyer
LICENSING EVALUATOR SIGNATURE:

DATE: 11/03/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/03/2022
LIC9099 (FAS) - (06/04)
Page: 3 of 6