<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198016985
Report Date: 02/03/2023
Date Signed: 02/03/2023 02:57:57 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, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
This is an official report of an unannounced visit/investigation of a complaint received in our office on
12/06/2022 and conducted by Evaluator Carolyn Tuba
PUBLIC
COMPLAINT CONTROL NUMBER: 33-CC-20221206090307
FACILITY NAME:INTERNATIONAL MONTESSORI SCHOOL OF CLAREMONTFACILITY NUMBER:
198016985
ADMINISTRATOR:MITCHELL, WENDYFACILITY TYPE:
850
ADDRESS:341 W. SAN JOSE AVENUETELEPHONE:
(909) 621-1313
CITY:CLAREMONTSTATE: CAZIP CODE:
91711
CAPACITY:64CENSUS: 53DATE:
02/03/2023
UNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Wendy MitchellTIME COMPLETED:
03:00 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Facility has mold
Facility staff do not maintain facility in good repair
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On 2/3/2023 at 10:00 a.m., Licensing Program Analyst (LPA) Carolyn Tuba conducted an unannounced complaint inspection to deliver findings of the above allegations. A Covid risk assessment was conducted when entering the facility. LPA met with Director; Wendy Mitchell guided LPA on a tour of the facility. There was a total of 53 children present with 6 staff.

LPA conducted interviews with Staff #1 (S1), #2 (S2), #3 (S3) and #4 (S4). According to S1 in 2019 one of the classrooms was observed to have mold. Pictures were provided. S1 stated that the issue was fixed. No mold was observed by LPA. Also, during an inspection at the facility, LPA observed that a window in the facility was indeed broken. However, during this visit, LPA was informed and observed window to have been replaced. LPA was unable to interview RP as the complaint was anonymous.


Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Ana Chico
LICENSING EVALUATOR NAME: Carolyn Tuba
LICENSING EVALUATOR SIGNATURE:

DATE: 02/03/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/03/2023
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 33-CC-20221206090307
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: INTERNATIONAL MONTESSORI SCHOOL OF CLAREMONT
FACILITY NUMBER: 198016985
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/03/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
02/03/2023
Section Cited
CCR
101238(a)
1
2
3
4
5
6
7
Buildings and grounds
1
2
3
4
5
6
7
Mold has been repaired by removal of sink basin and window in classroom has been repaired.
1
2
3
4
5
6
7
1
2
3
4
5
6
7
1
2
3
4
5
6
7
1
2
3
4
5
6
7
1
2
3
4
5
6
7
1
2
3
4
5
6
7
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: Ana Chico
LICENSING EVALUATOR NAME: Carolyn Tuba
LICENSING EVALUATOR SIGNATURE:

DATE: 02/03/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/03/2023
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 33-CC-20221206090307
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: INTERNATIONAL MONTESSORI SCHOOL OF CLAREMONT
FACILITY NUMBER: 198016985
VISIT DATE: 02/03/2023
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
Based on interviews conducted and records reviewed, 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, Chapter 1, the following deficiency is being cited (see attached 9099D).

The Notice of Site Visit (LIC 9213) must remain posted for 30 days during the hours of operation after each site visit by a licensing representative. Exit interview was conducted and appeal rights were given to Director, Wendy Mitchell.
SUPERVISORS NAME: Ana Chico
LICENSING EVALUATOR NAME: Carolyn Tuba
LICENSING EVALUATOR SIGNATURE:

DATE: 02/03/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/03/2023
LIC9099 (FAS) - (06/04)
Page: 3 of 3