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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 214005503
Report Date: 12/01/2021
Date Signed: 12/01/2021 11:46:53 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, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
This is an official report of an unannounced visit/investigation of a complaint received in our office on
11/22/2021 and conducted by Evaluator Kassandra Medrano
PUBLIC
COMPLAINT CONTROL NUMBER: 05-CC-20211122135833
FACILITY NAME:GUIDEPOST MONTESSORI AT MILL VALLEYFACILITY NUMBER:
214005503
ADMINISTRATOR:HENNIGAN, ERINFACILITY TYPE:
850
ADDRESS:270 MILLER AVETELEPHONE:
(949) 354-2259
CITY:MILL VALLEYSTATE: CAZIP CODE:
94941
CAPACITY:25CENSUS: DATE:
12/01/2021
UNANNOUNCEDTIME BEGAN:
11:00 AM
MET WITH:Compliance Director Tricia QuinnTIME COMPLETED:
12:00 PM
ALLEGATION(S):
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Care and Supervision provided off of licensed premises
INVESTIGATION FINDINGS:
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On December 1, 2021 at 9:30 am, Licensing Program Analyst (LPA) Kassandra Medrano spoke to Compliance Director,Tricia Quinn.The purpose of the call today was to conduct an initial complaint investigation that was received on November 22, 2021.

Due to the nature of this allegation RO has decided that a phone call would be sufficient. On 10/24/2021 facility's campus was hit by a mudlside, forcing them out of their campus and in search for a tempory site until they can correct the damages and local fire department can secure the land surrounding the facility. Facility has kept RO updated with situation and search for temporary facility. Facility has submitted a waiver request for this operation, but has not yet been approved for a temporary re-location.Tricia states that they are operating out of 5 home pods.

Based on interview, observations made, and documents received, the perponderance of evidence has been met. Therefore the above allegaton is found to be SUBSTANTIATED. California Code of Regulations, (Title 22, Division 12, Chapter 1), are being cited on attached 9099D. A copy of this report and appeak rights were provided and reviewed. Notice of Site Visit shall be posted for 30 days.


A copy of this report was emailed to the facility email, as well as to Tricia Quinn.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Ali Zebila
LICENSING EVALUATOR NAME: Kassandra Medrano
LICENSING EVALUATOR SIGNATURE:

DATE: 12/01/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/01/2021
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 05-CC-20211122135833
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME: GUIDEPOST MONTESSORI AT MILL VALLEY
FACILITY NUMBER: 214005503
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/01/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
12/31/2021
Section Cited
CCR
101161(a)
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101161(a) Limitations on Capacity
A licensee shall not operate a child care center beyond the conditions and limitations specified on the license...

This requirement was not me as evidenced by:
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Per director, facility will cease operations or gain approval from regional office of Home Pods by the end of the month .

Facility to send documentation of next direction of facility.
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Based off of interview with Director of Compliance, facility has been operating within 5 home pods since the beginning of the november. This poses an potential health and safety risk to 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: Ali Zebila
LICENSING EVALUATOR NAME: Kassandra Medrano
LICENSING EVALUATOR SIGNATURE:

DATE: 12/01/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/01/2021
LIC9099 (FAS) - (06/04)
Page: 3 of 3