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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 384004587
Report Date: 08/07/2024
Date Signed: 08/07/2024 12:07:08 PM

Unsubstantiated


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
07/31/2024 and conducted by Evaluator Zeynep Basak
PUBLIC
COMPLAINT CONTROL NUMBER: 05-CC-20240731161638
FACILITY NAME:MISSION MONTESSORI (PS)FACILITY NUMBER:
384004587
ADMINISTRATOR:ACUNA, MIAFACILITY TYPE:
850
ADDRESS:50 FELL STREETTELEPHONE:
(415) 805-8315
CITY:SAN FRANCISCOSTATE: CAZIP CODE:
94102
CAPACITY:120CENSUS: 46DATE:
08/07/2024
UNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Dr. LaRohanda Martin AND Mia Acuna TIME COMPLETED:
12:00 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Staff are operating out of ratio
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On 8/7/2024 Licensing Program Analyst (LPA) Basak and Licensing Program Manager (LPM) Oquendo conduct an unannounced visit to open the complaint.The purpose of the inspection was explained. LPA and LPM observed there were 46 preschool children and 7 staff present during the complaint investigation today.
During the investigation, LPA and LPM interviewed the staff members and review the staff schedule, sign in/out records of children. Based on the investigation, observation and the information obtained the above allegation is found to be unsubstantiated and complaint to be closed.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Daniel J Oquendo
LICENSING EVALUATOR NAME: Zeynep Basak
LICENSING EVALUATOR SIGNATURE:

DATE: 08/07/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/07/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
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