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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 444408893
Report Date: 11/08/2021
Date Signed: 11/08/2021 01:42:32 PM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
This is an official report of an unannounced visit/investigation of a complaint received in our office on
09/15/2021 and conducted by Evaluator Kristal Goodell
PUBLIC
COMPLAINT CONTROL NUMBER: 07-CC-20210915112455
FACILITY NAME:QUAIL HOLLOW MONTESSORIFACILITY NUMBER:
444408893
ADMINISTRATOR:VICKI HIPWELLFACILITY TYPE:
850
ADDRESS:187 LAUREL DRIVETELEPHONE:
(831) 335-4710
CITY:FELTONSTATE: CAZIP CODE:
95018
CAPACITY:42CENSUS: 32DATE:
11/08/2021
UNANNOUNCEDTIME BEGAN:
09:45 AM
MET WITH:Martina ErsunayTIME COMPLETED:
02:15 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Physical Plant: Facility does not have electricity.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analyst (LPA) Goodell met with Assistant Director Martina Ersunay to deliver findings for the complaint investigation. LPA obtained a census of 9 children with one staff member in the outdoor area and 23 children with 4 staff members in the preschool classroom. During the investigation, LPA toured classrooms, restrooms and outdoor area. LPA obtained documents and information related to the allegation. LPA also conducted interviews with parents and staff. It was alleged that facility operated with no electricity however during interviews LPA learned that power outage was due to PG&E replacing a pole. LPA also learned that facility notified parents, lunches are provided by parents in lunch bags and care is provided in the outdoor area with restrooms accessible. In addition, LPA learned staff prepare snacks, drinking water accessible for children, and classrooms had natural lighting during hours of operation. LPA also observed lanterns in classrooms and restroom which staff stated are used during power outage. Due to conflicting information obtained from interviews LPA was unable to determine if a violation occurred. As a result, the allegation is UNSUBSTANTIATED.

No deficiencies cited. Report reviewed and copies of report were provided. Notice of Site Visit posted and must remain posted for 30 days. Appeal Rights also issued and discussed.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Diana Stephenson
LICENSING EVALUATOR NAME: Kristal Goodell
LICENSING EVALUATOR SIGNATURE:

DATE: 11/08/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/08/2021
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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