384004587-12-7-2023-05-CC-GLEG-CYK565-20231215184009

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 384004587
Report Date: 12/07/2023
Date Signed: 12/07/2023 11:46:22 AM

Substantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN BRUNO CHILD CARE, 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
10/04/2023 and conducted by Evaluator Brendon Van

PUBLIC

COMPLAINT CONTROL NUMBER: 05-CC-20231004081614

FACILITY NAME:	MISSION MONTESSORI (PS)		FACILITY NUMBER:	384004587
ADMINISTRATOR:	DOMINGO, ROCHELLE		FACILITY TYPE:	850
ADDRESS:	50 FELL STREET		TELEPHONE:	(415) 805-8315
CITY:	SAN FRANCISCO	STATE: CA	ZIP CODE:	94102
CAPACITY:	120	CENSUS: 66	DATE:	12/07/2023
		UNANNOUNCED	TIME BEGAN:	10:45 AM
MET WITH:	Mia Acuna		TIME COMPLETED:	12:00 PM

ALLEGATION(S):

1
2
3
4
5
6
7
8
9

-Staff do not properly supervise day care children

INVESTIGATION FINDINGS:

1
2
3
4
5
6
7
8
9
10
11
12
13

On December 7, 2023., Licensing Program Analysts (LPAs) Van and Leong met with the site Director, Mia Acuna, and Director of Finance & Operation, Dana Yeager Squires. Today’s purpose of the inspection was to close the complaint that the Department received on 10/4/2023. Eleven teachers, including the Director, supervised 66 children today.
As part of the investigation, facility physical files were reviewed, including all recent unusual incident reports the Center reported. The Center self-reported to the Department on September 20, 2023, an incident that occurred during an outdoor recreation activity. A child (C1) was reported missing from the group. Subsequently, it was discovered that C1 had entered the elementary children's bathroom. The details of the incident remain unclear, including the specific time C1 left the group. C1 was found in the bathroom designated for elementary children.
The Department investigated the incident and completed it. As a result, the Center was cited in a case management report on September 26, 2023.
Based on interviews and records reviewed, the allegation related to the incident the Department had investigated during the case management on September 26. Therefore, the preponderance of evidence standard has been met, and the above allegation is found to be SUBSTANTIATED.
The exit interview was conducted, and the report was reviewed with the Director, Mia Acuna.

Substantiated

Estimated Days of Completion:

SUPERVISORS NAME: Garfield Leung
LICENSING EVALUATOR NAME: Brendon Van
LICENSING EVALUATOR SIGNATURE:	DATE: 12/07/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/07/2023

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 3