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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 384002471
Report Date: 04/20/2020
Date Signed: 04/20/2020 05:24:30 PM



STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
This is an official report of an unannounced visit/investigation of a complaint received in our office on
02/14/2020 and conducted by Evaluator Cindy Mok
PUBLIC
COMPLAINT CONTROL NUMBER: 05-CC-20200214144949
FACILITY NAME:BAMBINI MONTESSORI SCHOOLFACILITY NUMBER:
384002471
ADMINISTRATOR:MARY CHANFACILITY TYPE:
850
ADDRESS:2042 CLEMENT STREETTELEPHONE:
(415) 668-8828
CITY:SAN FRANCISCOSTATE: CAZIP CODE:
94121
CAPACITY:30CENSUS: 0DATE:
04/20/2020
UNANNOUNCEDTIME BEGAN:
11:00 AM
MET WITH:Mary ChanTIME COMPLETED:
01:00 PM
ALLEGATION(S):
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*Family staff hit and grabbed day care children
*Facility staff refused to allow daycare children to use the restroom.
*Facility staff forced daycare child to go outside in the rain.

INVESTIGATION FINDINGS:
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CDSS suspended field inspections temporarily due to the COVID19 pandemic. This complaint was finalized and delivered to the licensee via e-mail. LPA interviewed staff members, witnesses, and gathered relevant documents during the investigation.

Although the allegations of staff members hit, grabbed, refused to allow daycare children to use the bathroom, and forced daycare child to go outside in the rain may have happened or maybe valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur. Therefore the allegations are found as 'UNSUBSTANTIATED".
Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Ali ZebilaTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Cindy MokTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:

DATE: 04/20/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/20/2020
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 4
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
This is an official report of an unannounced visit/investigation of a complaint received in our office on
02/14/2020 and conducted by Evaluator Cindy Mok
PUBLIC
COMPLAINT CONTROL NUMBER: 05-CC-20200214144949

FACILITY NAME:BAMBINI MONTESSORI SCHOOLFACILITY NUMBER:
384002471
ADMINISTRATOR:MARY CHANFACILITY TYPE:
850
ADDRESS:2042 CLEMENT STREETTELEPHONE:
(415) 668-8828
CITY:SAN FRANCISCOSTATE: CAZIP CODE:
94121
CAPACITY:30CENSUS: 0DATE:
04/20/2020
UNANNOUNCEDTIME BEGAN:
11:00 AM
MET WITH:Mary ChanTIME COMPLETED:
01:00 PM
ALLEGATION(S):
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Unqualified staff provided care & supervision to daycare children alone
INVESTIGATION FINDINGS:
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CDSS suspended field inspections temporarily due to the COVID19 pandemic. This complaint was finalized and delivered to the licensee via e-mail. LPA interviewed staff members, witnesses, and gathered relevant documents during the investigation. Based on the interviews, a staff who has no E.C.E units was left alone with the children in the facility's play yard when a qualified teacher went inside the building to take some pictures of the school activities for a couple of minutes.

Based on LPAs interviews which were conducted, the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED. California Code of Regulations, (Title 22, Division 12 & Chapter 3), are being cited on the attached LIC 9099D.
Substantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Ali ZebilaTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Cindy MokTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:

DATE: 04/20/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/20/2020
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 3 of 4
Control Number 05-CC-20200214144949
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME: BAMBINI MONTESSORI SCHOOL
FACILITY NUMBER: 384002471
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/20/2020
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
04/24/2020
Section Cited
CCR
101216.2(e)
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101216.2(e) Teacher Aide Qualifications and Duties:
An aide shall work only under the direct supervision of a teacher.
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Licensee shall ensure the children can be supervised alone by the qualified teacher except for nap time. Licensee shall submit a plan of correction to CCL by April 24, 2020
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This requirement was not met as evidence-based upon interviews, an unqualified teacher who doesn't have 12 E.C.E units supervised the daycare children alone during outdoor play time when a qualified teacher went into the classroom to take pictures of the school activities for couple minutes. This poses a potential health 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.
SUPERVISOR'S NAME: Ali ZebilaTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Cindy MokTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:

DATE: 04/20/2020
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/20/2020
LIC9099 (FAS) - (06/04)
Page: 4 of 4