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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 376105015
Report Date: 07/21/2022
Date Signed: 07/21/2022 03:10:57 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, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108
This is an official report of an unannounced visit/investigation of a complaint received in our office on
07/21/2022 and conducted by Evaluator Tyra Block
PUBLIC
COMPLAINT CONTROL NUMBER: 51-CC-20220721104108
FACILITY NAME:INTELLICHILDREN MONTESSORI INSTITUTEFACILITY NUMBER:
376105015
ADMINISTRATOR:BRANDY PEARCEFACILITY TYPE:
830
ADDRESS:212 WEST SAN MARCOS BOULEVARDTELEPHONE:
(760) 471-0221
CITY:SAN MARCOSSTATE: CAZIP CODE:
92069
CAPACITY:20CENSUS: 7DATE:
07/21/2022
UNANNOUNCEDTIME BEGAN:
01:12 PM
MET WITH:Janet AndradeTIME COMPLETED:
01:28 PM
ALLEGATION(S):
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Blankets are used in infant cribs
INVESTIGATION FINDINGS:
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On 7/21/22, Licensing Program Analyst (LPA), Tyra Block made an unannounced initial 10-day visit to investigate the above referenced allegation. LPA met with Licensee, Janet Andrade. Also present were 2 staff and 7 infants. All staff has criminal record clearances and associated to the facility. LPA toured the facility and obtained a copy of the children’s roster.

Based on the information obtained during interviews and observation it is determined that the allegation is SUBSTANTIATED. Infants were observed with blankets inside and on the sides of the cribs. The allegation is valid because the preponderance of the evidence has been met. California Code of Regulations, (Title 22, Division 12, Chapter number) the deficiency is being cited on the attached LIC 9099D. The Notice of Site Visit was provided. Licensee is advised it must remain posted for 30 days.

An exit interview was conducted with licensee, Janet Andrade.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Tashima Daniel
LICENSING EVALUATOR NAME: Tyra Block
LICENSING EVALUATOR SIGNATURE:

DATE: 07/21/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/21/2022
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 2
Control Number 51-CC-20220721104108
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108

FACILITY NAME: INTELLICHILDREN MONTESSORI INSTITUTE
FACILITY NUMBER: 376105015
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/21/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
07/21/2022
Section Cited
CCR
101439.1(f)
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101439.1(f)- Infant Care Center Sleeping Equipment: Cribs shall be free from all loose articles and objects, including blankets and pillows. This requirement was not met as evidenced by:
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Blankets were removed from infants during the visit. A signed training agenda to discuss safe sleep will be provided to LPA by 7/28/22.
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LPA observed 2 infants asleep covered with blankets and other cribs with blankets and pillow inside. This poses an immediate 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: Tashima Daniel
LICENSING EVALUATOR NAME: Tyra Block
LICENSING EVALUATOR SIGNATURE:

DATE: 07/21/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/21/2022
LIC9099 (FAS) - (06/04)
Page: 2 of 2