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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 384004114
Report Date: 05/31/2022
Date Signed: 05/31/2022 02:52:49 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, 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
03/02/2022 and conducted by Evaluator April Cowan
PUBLIC
COMPLAINT CONTROL NUMBER: 05-CC-20220302102202
FACILITY NAME:STUDIO MONTESSORI, LLC (PS)FACILITY NUMBER:
384004114
ADMINISTRATOR:PAUL, ZOE O.FACILITY TYPE:
850
ADDRESS:633 8TH STREETTELEPHONE:
(415) 510-1287
CITY:SAN FRANCISCOSTATE: CAZIP CODE:
94103
CAPACITY:31CENSUS: 8DATE:
05/31/2022
UNANNOUNCEDTIME BEGAN:
01:35 PM
MET WITH:Zoe PaulTIME COMPLETED:
02:15 PM
ALLEGATION(S):
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Lack of Supervision
Failure to report
INVESTIGATION FINDINGS:
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On 5/31/22 at 1:35 PM, Licensing Program Analyst (LPA) Cowan conducted a visit to close this complaint. LPA met with site director Zoe Paul. The purpose of the visit was explained. There are 9 children napping and 2 staff members present today. The Department's Investigation Branch (IB) has investigated this complaint and determined the findings to be substantiated. When this incident occurred, Licensee was buying lunch for the children, Assistant Teacher was with the 9 children in a non-authorized play area. The staff ratio should be 1:6 when they’re off site. Through record review, it is discovered that the incident was never reported to Licensing. Based on IB’s interviews and record review conducted, the preponderance of evidence standard has been met, therefore the above allegations is founded to be SUBSTANTIATED. California Code of Regulations, (Title 22, Division & Chapter number), are being cited on the attached LIC 9099D.
This report is emailed to director Zoe Paul at zoe@studiomontessorisf.com with a request for reply by the end of business 5/31/22.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Garfield Leung
LICENSING EVALUATOR NAME: April Cowan
LICENSING EVALUATOR SIGNATURE:

DATE: 05/31/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/31/2022
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 05-CC-20220302102202
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: STUDIO MONTESSORI, LLC (PS)
FACILITY NUMBER: 384004114
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/31/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
05/31/2022
Section Cited
CCR
101229(a)(1)
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101229 Responsibility for Providing Care and Supervision
(a) the licensee shall provide care and supervision as necessary to meet the children's needs. (1) No child(ren) shall be left without the supervision of a teacher at any time, except as specified in Sections 101216.2(e)(1) and 101230(c)(1). Supervision shall include visual observation. This requirement is not met as evidenced by:
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Director has hired a new director to take over the operations of running the day care. Director states that the new director is highly trained and can prevent such deficiencies.
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Based on interviews, licensee did not ensure proper ratios of 1:6 of staff to children. This is a potential risk to children in care.
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Type B
05/31/2022
Section Cited
CCR
101212(a)(d)(B)
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101212 Reporting Requirements
(a)Each licensee or applicant shall furnish to the Department reports as required by the Department including, but not limited to, the following: d) Upon the occurrence, during the operation of the child care center of any of the events specified in (d)(1) below, a report shall be made to the Department by telephone or fax within the Department's next working day and during its normal business hours. In addition, a written report containing the information specified in (d)(2) below shall be submitted to the Department within seven days following the occurrence of such event. (B) Any injury to any child that requires medical treatment. This requirement is not met as evidenced by:
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Director has hired a new director to take over the operations of running the day care. Director states that the new director is highly trained and can prevent such deficiencies.
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Based on record reviews, licensee did not ensure that child’s injury accident was reported to Licensing. This is a potential 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: Garfield Leung
LICENSING EVALUATOR NAME: April Cowan
LICENSING EVALUATOR SIGNATURE:

DATE: 05/31/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/31/2022
LIC9099 (FAS) - (06/04)
Page: 2 of 2