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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 343616551
Report Date: 07/31/2023
Date Signed: 07/31/2023 03:12:38 PM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
This is an official report of an unannounced visit/investigation of a complaint received in our office on
07/07/2023 and conducted by Evaluator Karyn Guerra
PUBLIC
COMPLAINT CONTROL NUMBER: 03-CC-20230707110359
FACILITY NAME:COUNTRYHILL MONTESSORIFACILITY NUMBER:
343616551
ADMINISTRATOR:APRIL VASQUEZFACILITY TYPE:
850
ADDRESS:7048 SUNRISE BOULEVARDTELEPHONE:
(916) 728-2929
CITY:CITRUS HEIGHTSSTATE: CAZIP CODE:
95610
CAPACITY:102CENSUS: 45DATE:
07/31/2023
UNANNOUNCEDTIME BEGAN:
12:00 PM
MET WITH:April VasquezTIME COMPLETED:
03:30 PM
ALLEGATION(S):
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Children are not adequately supervised by staff
INVESTIGATION FINDINGS:
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At 12:00 p.m. on Monday, July 31st, 2023, Licensing Program Analyst (LPA) Karyn Guerra met with Director, April Vasquez, for the purpose of a complaint inspection and to deliver findings. It was alleged that children are not adequately supervised by staff, with concerns of biting, and children left unsupervised outside. Throughout the course of the investigation, LPA made interviews and observations. LPA came to learn via staff interviews of an incident in which a child (C1) was found in a closed shed/sotrage box outside during outdoor play time. Director stated that the shed was not fully closed but did interfere with visual supervision. The amount of time the child was left in the closed shed was unknown. It was stated that the children were excited about the shed because it was new. It was stated that the child was found when screaming was heard coming from the shed. Child interviews also revealed an incident of a children being left outside without staff supervision for an unknown amount of time. This poses

report continued on 9099-C.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Seychelle De Luca
LICENSING EVALUATOR NAME: Karyn Guerra
LICENSING EVALUATOR SIGNATURE:

DATE: 07/31/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/31/2023
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 03-CC-20230707110359
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME: COUNTRYHILL MONTESSORI
FACILITY NUMBER: 343616551
VISIT DATE: 07/31/2023
NARRATIVE
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an immediate risk to the health and safety of children in care. The preponderance of has been met, and the allegation is substantiated.

Title 22 deficiencies are cited on the subsequent pages of this report. Civil penalties were assessed. Licensee acknowledges, that FOR TYPE A DEFICIENCIES ONLY upon receipt, licensee shall post LIC 9099D with Type A deficiencies for 30 days and provide copies of this licensing report to parents/guardians of children in care at the facility and to parents/guardians of children newly enrolled at the facility during the next 12 months. LIC 9224 must be signed by parents/guardians and kept with the children's forms as a receipt whenever any Type A documents are provided by the licensee. LIC 9224 and Appeal Rights were provided. Licensee's signature on this report acknowledges receipt of these rights. This report was reviewed with the Director, April Vasquez. An exit interview was conducted. A Notice of Site Visit was provided and shall remain posted for a period of 30 days.
SUPERVISORS NAME: Seychelle De Luca
LICENSING EVALUATOR NAME: Karyn Guerra
LICENSING EVALUATOR SIGNATURE:

DATE: 07/31/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/31/2023
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 03-CC-20230707110359
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

FACILITY NAME: COUNTRYHILL MONTESSORI
FACILITY NUMBER: 343616551
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/31/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
08/01/2023
Section Cited
CCR
101229(a)(1)
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101229 Responsibility for Providing Care and Supervision (1) No child(ren) shall be left without the supervision of a teacher at any time, except as specified in Sections 101216.2(e)(1) and 101230(c)(1). Supervision shall include visual observation. This requirement was not met, as evidenced by:
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Director will conduct a supervision training with staff and will provide documentation of completed training by POC due date.
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Based on interviews, the licensee did not comply with the above regulation as it was learned that C1 was found in a shed for an unknown amount of time, and children have been left alone outside without staff supervision. This poses an immediate risk to the health and safety of children in care. Civil penalties were assessed.
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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: Seychelle De Luca
LICENSING EVALUATOR NAME: Karyn Guerra
LICENSING EVALUATOR SIGNATURE:

DATE: 07/31/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/31/2023
LIC9099 (FAS) - (06/04)
Page: 3 of 3