LEARN AND PLAY MONTESSORI DUBLIN

Type B citation - potential risk if not corrected

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25Licensing Program Analyst (LPA) Jyoti Saini met with Director Gabriela Arrizon for an unannounced case management inspection in response to an unusual Incident that the facility self reported to the Department on 01/30/2026. LPA Saini conducted staff interviews and reviewed video surveillance footage. Based on the interviews, record reviews, and the facility’s acknowledgment, LPA determined that the incident did occur. On 1/30/2026 at approximately 11:02 a.m., Staff 1 (S1) was observed assisting a child with a bathroom break. At 11:03 a.m., S1 closed the bathroom door without conducting a visual sweep of the bathroom. At approximately 11:05 a.m., staff heard knocking coming from the bathroom located inside the classroom, prompting them to check the area. Staff subsequently discovered the child inside the bathroom. It was confirmed that the child remained unsupervised in the bathroom for at least three (3) minutes. At the time of the incident, two additional teachers were engaged assisting remaining children in the classroom. The evidence supports the fact that staff did not provide adequate supervision to the children in care. This constitutes a violation of California Code of Regulations, Title 22, Division 12, Section 101229(a)(1), which is cited on the attached LIC 809D. Appeal rights were given. A notice of site visit was given and must remain posted for 30 days. An exit interview was conducted with the director, Gabriela Arrizon. NAME OF LICENSING PROGRAM MANAGER: Wynn Norona NAME OF LICENSING PROGRAM ANALYST: Jyoti Saini LICENSING PROGRAM ANALYST SIGNATURE: DATE: 02/12/2026 I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/12/2026 This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC809 (FAS) - (06/04)Page: 1 of 3 FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form. DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies: Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care. Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care. PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency. CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given. CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certifi

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25Licensing Program Analyst (LPA) Jyoti Saini met with Director Gabriela Arrizon for an unannounced case management inspection in response to an unusual Incident that the facility self reported to the Department on 01/30/2026. LPA Saini conducted staff interviews and reviewed video surveillance footage. Based on the interviews, record reviews, and the facility’s acknowledgment, LPA determined that the incident did occur. On 1/30/2026 at approximately 11:02 a.m., Staff 1 (S1) was observed assisting a child with a bathroom break. At 11:03 a.m., S1 closed the bathroom door without conducting a visual sweep of the bathroom. At approximately 11:05 a.m., staff heard knocking coming from the bathroom located inside the classroom, prompting them to check the area. Staff subsequently discovered the child inside the bathroom. It was confirmed that the child remained unsupervised in the bathroom for at least three (3) minutes. At the time of the incident, two additional teachers were engaged assisting remaining children in the classroom. The evidence supports the fact that staff did not provide adequate supervision to the children in care. This constitutes a violation of California Code of Regulations, Title 22, Division 12, Section 101229(a)(1), which is cited on the attached LIC 809D. Appeal rights were given. A notice of site visit was given and must remain posted for 30 days. An exit interview was conducted with the director, Gabriela Arrizon. NAME OF LICENSING PROGRAM MANAGER: Wynn Norona NAME OF LICENSING PROGRAM ANALYST: Jyoti Saini LICENSING PROGRAM ANALYST SIGNATURE: DATE: 02/12/2026 I acknowledge receipt of this form and understand my licensing appeal rights as explained and received. FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/12/2026 This report must be available at Child Care and Group Home facilities for public review for 3 years. LIC809 (FAS) - (06/04)Page: 1 of 3 FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form. DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies: Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care. Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care. PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency. CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given. CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certifi