364845471-2-7-2023-09-CC-GSEA-CP3UVN-20230215145522

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 364845471
Report Date: 02/07/2023
Date Signed: 02/07/2023 10:26:31 AM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501

This is an official report of an unannounced visit/investigation of a complaint received in our office on
01/20/2023 and conducted by Evaluator Patricia Berry

PUBLIC

COMPLAINT CONTROL NUMBER: 09-CC-20230120111742

FACILITY NAME:	MONTESSORI ACADEMY OF UPLAND		FACILITY NUMBER:	364845471
ADMINISTRATOR:	THEWES, ADAM		FACILITY TYPE:	850
ADDRESS:	934 N. MOUNTAIN AVE., UNIT E		TELEPHONE:	(909) 931-0511
CITY:	UPLAND	STATE: CA	ZIP CODE:	91786
CAPACITY:	99	CENSUS: 67	DATE:	02/07/2023
		UNANNOUNCED	TIME BEGAN:	09:45 AM
MET WITH:	Adam Thewes/Licensee/Director		TIME COMPLETED:	10:45 AM

ALLEGATION(S):

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Facility staff is not following COVID-19 guidelines.
Facility does not provide a safe environment for day care children

INVESTIGATION FINDINGS:

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On 2/7/23 at 9:45 am, Licensing Program Analyst's (LPA's) Patricia Berry and Claudia Caywood conducted a subsequent complaint investigation to deliver final findings. LPA's were granted access into the facility and met with the director. LPA's torued facility and took a census.

Allegations: Facility staff is not following COVID-19 guidelines and facility does not provide a safe environment for day care children.

It was alleged the facility is not following COVID- guidelines and the facility does not provide a safe environment for day care children. LPA toured the facility, interviewed staff, obtained documentation, and observed postings.

(Cont on 9099C)

Unsubstantiated

Estimated Days of Completion: 0

SUPERVISORS NAME: Gilbert Sena
LICENSING EVALUATOR NAME: Patricia Berry
LICENSING EVALUATOR SIGNATURE:	DATE: 02/07/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/07/2023

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

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Control Number 09-CC-20230120111742

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501

FACILITY NAME: MONTESSORI ACADEMY OF UPLAND	FACILITY NUMBER: 364845471
	VISIT DATE: 02/07/2023

NARRATIVE

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It was alleged a facility staff member had tested positive while present at the facility and did not immediately leave.

Staff stated a staff member was experiencing allergy symptoms and was isolated in the office. Staff stated due to continuing experiencing the symptoms, the staff member took a COVID test, and the test was positive. Staff stated the staff member left the facility and did not come back until cleared. Staff stated prior to testing positive, the staff member exited the office to push a food cart to a classroom. Staff stated the staff member was wearing gloves and a mask.

While at the facility, LPA obtained the following documentation: COVID Decision Tree regarding COVID guidelines (available for staff/parents) and COVID- 19, 11-Day Guidance information sheet regarding feeling sick and testing positive (available for staff/parents).

LPA observed COVID-19 return to school protocols are posted outside each classroom and reviewed emails/text, which were sent to parents and staff, informing them of COVID cases.
In addition, conflicting information was received as the whether the facility follows the California Department of Public Health (CDPH) recommended exposure guidelines.

Based on LPA’s observation, documentation obtained, and interviews conducted, there is conflicting information on whether the facility is not following COVID- guidelines and if the facility does not provide a safe environment for day care children, therefore the above allegations are unsubstantiated.

Although the allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegation is unsubstantiated.

Exit interview conducted with director, report, appeal rights and notice of site visit issued.

Notice of Site Visit must be posted for 30 days.

SUPERVISORS NAME: Gilbert Sena
LICENSING EVALUATOR NAME: Patricia Berry
LICENSING EVALUATOR SIGNATURE:	DATE: 02/07/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/07/2023

LIC9099 (FAS) - (06/04)

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