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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 073408260
Report Date: 09/05/2023
Date Signed: 09/05/2023 10:58:46 AM

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
08/29/2023 and conducted by Evaluator Ashley Curry
PUBLIC
COMPLAINT CONTROL NUMBER: 02-CC-20230829091931
FACILITY NAME:CREATIVE MONTESSORI PRESCHOOLFACILITY NUMBER:
073408260
ADMINISTRATOR:AKTER, SILVIAFACILITY TYPE:
850
ADDRESS:1350 MORAGA WAYTELEPHONE:
(925) 377-8314
CITY:MORAGASTATE: CAZIP CODE:
94556
CAPACITY:23CENSUS: 7DATE:
09/05/2023
UNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Silvia AkterTIME COMPLETED:
12:30 PM
ALLEGATION(S):
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Facility play structure is in disrepair.

Staff do not maintain facility in a clean and sanitary condition.
INVESTIGATION FINDINGS:
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On 09/05/2023 at 10:00AM Licensing Program Analysts (LPAs) A. Curry and S. Blue arrived at the facility to conduct an unannounced complaint inspection. LPAs met with the Director, Silvia Akter, to explain the purpose of todays visit. The LPAs toured the facility, made observations, retrieved documentation. LPAs observed nails sticking out of of the wood that is connected to the playground. LPAs also observed soiled and unsanitary carpets throughout the classroom. Based on the LPA’s observation the preponderance of evidence standard has been met. Therefore the above allegation is found to be SUBSTANTIATED.

An exit interview was conducted, appeal rights were given, and the report was reviewed with the director, Sivia Akter
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Loretta Dyson
LICENSING EVALUATOR NAME: Ashley Curry
LICENSING EVALUATOR SIGNATURE:

DATE: 09/05/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/05/2023
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 3
Control Number 02-CC-20230829091931
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: 073408260
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/05/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
09/06/2023
Section Cited
CCR
101238.2(d)(2)
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101238.2 Outdoor Activity Space(d) The surface of the outdoor activity space shall be maintained:(2) Free of hazards including, but not limited to, holes, broken glass and other debris, and dry grasses that pose a fire hazard.
This requirement is not met as evidence by:
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By 09/06/2023, the director will repair the nails that are pretruding out the wood and send picture to LPA.
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Based on observations the facility did not comply with the section cited above by ensuring the playground is free of hazards, which is an immediate risk to the health, safety, and personal rights of children in care.
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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: Ashley Curry
LICENSING EVALUATOR SIGNATURE:

DATE: 09/05/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/05/2023
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 02-CC-20230829091931
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: 073408260
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/05/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
09/29/2023
Section Cited
CCR
101238(a)
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101238Buildings and Grounds (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.
This requirement was not met as evidence by:
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by 09/29/2023 will submit proof of clean carpets to LPA.
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Based on observation the facility did not comply with section cited above by ensuring the carpets are clean, sanitary, and in good repair, which poses as a potential risk to health, safety, and personal rights of children in care.
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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: Ashley Curry
LICENSING EVALUATOR SIGNATURE:

DATE: 09/05/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/05/2023
LIC9099 (FAS) - (06/04)
Page: 3 of 3