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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 073408897
Report Date: 03/22/2023
Date Signed: 04/12/2023 09:12:47 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
03/21/2023 and conducted by Evaluator Monica Mathur
PUBLIC
COMPLAINT CONTROL NUMBER: 02-CC-20230321133052
FACILITY NAME:FOUNTAINHEAD MONTESSORI SCHOOL-PLEASANT HILLFACILITY NUMBER:
073408897
ADMINISTRATOR:RIZVI, SUMAIRAFACILITY TYPE:
850
ADDRESS:1715 OAK PARK BOULEVARDTELEPHONE:
(925) 967-2655
CITY:PLEASANT HILLSTATE: CAZIP CODE:
94523
CAPACITY:99CENSUS: 20DATE:
03/22/2023
UNANNOUNCEDTIME BEGAN:
01:30 PM
MET WITH:Sumaira RizviTIME COMPLETED:
03:30 PM
ALLEGATION(S):
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Building & Grounds: Facility has rodent infestation
INVESTIGATION FINDINGS:
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THIS IS AN AMENDED REPORT.
On 3/22/23 Licensing Program Analysts (LPAs) Monica Mathur and Christina Watts conducted an unannounced Complaint Investigation at Fountainhead Montessori Preschool. LPA met with Director, Sumaira Rizvi and explained purpose of investigation.
During the course of the investigation, LPAs inspected facility and conducted interviews. It was determined that on 3/17/23 staff observed a mouse and its droppings in the Toddler room. Director states she informed Licensee requesting for exterminator services. On Monday 3/20/23 and Tuesday 3/21/23 more droppings were observed and staff continued to clean, sanitize children beds, sheets, counters, dishes, areas and items in the room before children arrived. Exterminator service did not come during this period and children continued to use Toddler room for 3 days on 3/20/23, 3/21/23 and 3/22/23. Today 3/22/23 during investigation the exterminator service arrived, installed traps and plugged potential crawl spaces in the outdoor grounds where rodents could potentially come in. Due to facility failing to close the toddler room and children being present, having access to all areas on days when rodent droppings were observed, it posed a potential risk to health/safety of children in care.

continued on 9099C
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Sherelle Johnson
LICENSING EVALUATOR NAME: Monica Mathur
LICENSING EVALUATOR SIGNATURE:

DATE: 03/22/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/22/2023
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-20230321133052
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: FOUNTAINHEAD MONTESSORI SCHOOL-PLEASANT HILL
FACILITY NUMBER: 073408897
VISIT DATE: 03/22/2023
NARRATIVE
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Based on the interviews and information obtained throughout the investigation, the preponderance of evidence standard has been met. Therefore, the allegation is SUBSTANTIATED. California Code of Regulations, Title 22, Division 12 is being cited on 9099-D page.

Exit interview was conducted with Director, Sumaira Rizvi. A NOTICE OF SITE VISIT WAS ISSUED AND MUST BE POSTED FOR 30 DAYS
SUPERVISORS NAME: Sherelle Johnson
LICENSING EVALUATOR NAME: Monica Mathur
LICENSING EVALUATOR SIGNATURE:

DATE: 03/22/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/22/2023
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 02-CC-20230321133052
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: FOUNTAINHEAD MONTESSORI SCHOOL-PLEASANT HILL
FACILITY NUMBER: 073408897
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/22/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Request Denied
Type B
03/22/2023
Section Cited
CCR
101238(a)
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101238 Building & 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 is not met as evidenced by:
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Exterminator service came today on 3/22/23. No droppings have been observed today. This citation was cleared during visit.
Director understands if such an incident happens again, affected areas should be made
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Per investigation, rodent and droppings were observed in Toddler Room on 3/17/23, 3/20, 3/21. Facility failed to close the room, staff cleaned droppings and equipment in the morning and children continued to have access to the room during this period. Exterminator service did not come in until today. This posed a potential risk to health/safety of children in care.
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 inaccessible to children until professional services are called and space is deemed safe and sanitary for use.
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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: Sherelle Johnson
LICENSING EVALUATOR NAME: Monica Mathur
LICENSING EVALUATOR SIGNATURE:

DATE: 03/22/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/22/2023
LIC9099 (FAS) - (06/04)
Page: 3 of 3