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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 384004114
Report Date: 03/25/2024
Date Signed: 03/25/2024 10:56:47 AM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN BRUNO CC RO, 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
02/12/2024 and conducted by Evaluator Man Tso
PUBLIC
COMPLAINT CONTROL NUMBER: 05-CC-20240212131521
FACILITY NAME:STUDIO MONTESSORI, LLC (PS)FACILITY NUMBER:
384004114
ADMINISTRATOR:DOMINGO, ROCHELLEFACILITY TYPE:
850
ADDRESS:633 8TH STREETTELEPHONE:
(415) 510-1287
CITY:SAN FRANCISCOSTATE: CAZIP CODE:
94103
CAPACITY:31CENSUS: 19DATE:
03/25/2024
UNANNOUNCEDTIME BEGAN:
08:41 AM
MET WITH:Licensee Zoe Paul / Director Rochelle DomingoTIME COMPLETED:
11:10 AM
ALLEGATION(S):
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Not keep the child care center’s stored equipment clean and sanitary at all times
INVESTIGATION FINDINGS:
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On March 25, 2024, at 8.20AM, Licensing Program Analyst (LPA) Tso conducted an unannounced subsequent complaint investigation and met with the Licensee, Zoe Paul and Director, Rochelle Domingo. LPA explained the purpose of the inspection and were granted entry to the facility by the Licensee. Present, the Licensee, Director, and 3 teachers are supervising 19 children.

Based on LPA’s gathered information through observation, and interviews, the agency has investigated the complaint allegation above for the equipment stored outside the facility area. The facility failed to comply with the buildings and grounds regulations. The preponderance of evidence standard has been met. The allegation, Not keep the child care center’s stored equipment clean and sanitary at all times, is found to be SUBSTANTIATED. Type B violation was issued today, March 25, 2024 in accordance with the California Code of Regulations, Title 22, Division 12, citation is being cited on the attached LIC 9099D. A copy of this report and appeal rights were discussed and given to the Licensee. Notice of Site Visit was provided. Notice to remain posted for 30 days.

Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Garfield Leung
LICENSING EVALUATOR NAME: Man Tso
LICENSING EVALUATOR SIGNATURE:

DATE: 03/25/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/25/2024
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-20240212131521
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN BRUNO CC RO, 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: 03/25/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
04/09/2024
Section Cited
CCR
101238(a)
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101238 Buildings and Grounds
(a) The child care center shall be clean, safe, sanitary and in good repair at all times to ensure the safety and well-being of children, employees and visitors.

This requirement is not met as evidenced by:
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The Licensee should provide the measures to the Licensing Office to keep the facility’s equipment clean and sanitary on or before April 9, 2024.
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Based on observation and interviews, the Licensee did not comply with the section cited above that the licensee admitted, and LPA observed that the droppings of rodent(s) were found on the buggies stored outside the facility, which poses/posed potential health, safety, or personal rights risk to persons 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: Man Tso
LICENSING EVALUATOR SIGNATURE:

DATE: 03/25/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/25/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 2