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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 283008069
Report Date: 08/14/2024
Date Signed: 08/14/2024 03:44:13 PM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SANTA ROSA RO, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405
This is an official report of an unannounced visit/investigation of a complaint received in our office on
05/06/2024 and conducted by Evaluator Melinda Mohr
PUBLIC
COMPLAINT CONTROL NUMBER: 01-CC-20240506125536
FACILITY NAME:NAPA VALLEY MONTESSORI LEARNING CENTER - P/SFACILITY NUMBER:
283008069
ADMINISTRATOR:SMITH, TERESITAFACILITY TYPE:
850
ADDRESS:120W AMERICAN CANYON ROAD M 11TELEPHONE:
(707) 853-9580
CITY:AMERICAN CANYONSTATE: CAZIP CODE:
94503
CAPACITY:37CENSUS: 6DATE:
08/14/2024
UNANNOUNCEDTIME BEGAN:
02:10 PM
MET WITH:Rachelle PerezTIME COMPLETED:
03:58 PM
ALLEGATION(S):
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Staff did not provide children in care adequate supervision
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA), Mindy Mohr conducted an unannounced complaint investigation visit and met with Director Rachelle Perez to deliver the findings regarding the above allegations. LPA, Mohr previously met with prior Director Destiny Iniguez on 05/07/2024 to open the complaint. Subsequent visits were made on 07/01/2024 and 07/30/2024 to further investigate the complaint. It is alleged that staff did not provide children in care adequate supervision, resulting in a child sustaining an injury to their face.

During the course of the investigation, LPA Mohr toured the facility, obtained documents, conducted interviews and made observations. From 05/07/2024 through 07/30/2024, interviews were conducted with four staff (S1-S4), three children (C4 – C6), four adults (A1 – A4), and attempted additional parent interviews.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Leslie Lepori
LICENSING EVALUATOR NAME: Melinda Mohr
LICENSING EVALUATOR SIGNATURE:

DATE: 08/14/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/14/2024
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 5
Control Number 01-CC-20240506125536
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SANTA ROSA RO, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405
FACILITY NAME: NAPA VALLEY MONTESSORI LEARNING CENTER - P/S
FACILITY NUMBER: 283008069
VISIT DATE: 08/14/2024
NARRATIVE
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S1 explained there were nine children outside with one staff member (S2) at the time of the incident and the facility was within the staffing ratio. S1 further stated they did not see the incident occur but was told about the incident from S2 who was supervising the children at the time of the incident. S2 stated they did not see the incident but was told about the incident from a child involved (C2). C1 and C3 were involved in a disagreement over a toy truck which ended with C1 pushing C3 down, in which C3 was taken to the doctor. Children interviews (C4 & C5) confirmed C1 pushed C3 onto the truck and that S2 was outside when the incident occurred. S2 further stated that C1 was a bully and confirmed C3 sustained injuries to their face after falling. Staff interviews (S1 – S4) all acknowledge there have been multiple incidents involving C1 harming other children. S3 specifically stated that C1 is the top instigator and gets very physical, while S4 stated C1 would hurt other children every day and S1 stated C1 does not respect boundaries. C6 stated C1 is mean to them and has hit them, while both C4 and C5 stated C1 is mean.

Based on the information gathered during this investigation, staff identified C1 as having behaviors that could harm other children in care. Regulation requires the facility to provide care and supervision to the meet children’s needs and that no child shall be left without the teacher’s supervision, including visual observation, in order to protect the safety of children in care. Therefore, the preponderance of the evidence standard has been met and the allegation is determined to be substantiated. California Code of Regulations, Title 22, is being cited on the attached LIC 9099-D.

Licensee is also being cited an immediate civil penalty of $500 for a violation of regulation resulting in injury to a child in care. Appeal rights provided.

LPA Mohr informed Director Rachelle Perez that this report dated 08/14/2024 documents one Type A citation. Type A citations shall be posted for 30 consecutive days as there is an immediate risk to the health, safety, or personal rights of children in care.

LPA Mohr informed Director to provide a copy of this licensing report dated 08/14/2024 that documents any Type A citation to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification.

SUPERVISORS NAME: Leslie Lepori
LICENSING EVALUATOR NAME: Melinda Mohr
LICENSING EVALUATOR SIGNATURE:

DATE: 08/14/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/14/2024
LIC9099 (FAS) - (06/04)
Page: 4 of 5
Control Number 01-CC-20240506125536
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SANTA ROSA RO, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405

FACILITY NAME: NAPA VALLEY MONTESSORI LEARNING CENTER - P/S
FACILITY NUMBER: 283008069
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/14/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Request Denied
Type A
08/15/2024
Section Cited
CCR
101229(a)(1)
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(a) The licensee shall provide care and supervision as necessary to meet the children's needs.
(1) No child(ren) shall be left without the supervision of a teacher at any time …Supervision shall include visual observation.
This requirement is not met as evidenced by:
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Director stated they will always have 2 teachers supervising the children at all times. Director also stated they have just recently hired a new teacher.
Director stated they are going to have a staff training. LPA gave Director the Active Supervision Toolkit and Active Supervision-at-a-glance handouts for staff and to discuss in detail at the training. Director will email LPA Mohr the date of the training at Melinda.Mohr@dss.ca.gov
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Based on interviews the licensee failed to ensure staff were providing visual supervision of the children resulting in a child's injury. This poses an immediate Health, Safety or Personal Rights risk to the 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: Leslie Lepori
LICENSING EVALUATOR NAME: Melinda Mohr
LICENSING EVALUATOR SIGNATURE:

DATE: 08/14/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/14/2024
LIC9099 (FAS) - (06/04)
Page: 5 of 5