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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 384004643
Report Date: 03/25/2026
Date Signed: 03/25/2026 06:10:28 PM

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
03/24/2026 and conducted by Evaluator Jovanna Badger
COMPLAINT CONTROL NUMBER: 05-CC-20260324225252
FACILITY NAME:POTRERO HILL MONTESSORI SCHOOLFACILITY NUMBER:
384004643
ADMINISTRATOR:YANG, LIUFACILITY TYPE:
850
ADDRESS:1701 17TH STREETTELEPHONE:
(650) 476-3015
CITY:SAN FRANCISCOSTATE: CAZIP CODE:
94103
CAPACITY:54CENSUS: 27DATE:
03/25/2026
UNANNOUNCEDTIME BEGAN:
03:29 PM
MET WITH:Liu YangTIME COMPLETED:
06:30 PM
ALLEGATION(S):
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Staff have inadequate record keeping for the daycare children
INVESTIGATION FINDINGS:
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On March 25, 2026, Licensing Program Analysts (LPAs) J. Badger and Tso, conducted an unannounced complaint investigation visit at the above-named facility. LPA met with facility director, Liu Yang (Jessica), and explained the purpose of the visit. Present during the visit were 27 children in care with 6 teachers.

Based on the LPA’s gathered information through observation and interviews, the agency has investigated the complaint allegations above. The facility failed to comply with the personal rights and infant care personal service regulations.

The preponderance of evidence standard has been met. The above allegations were found to be SUBSTANTIATED..
Notice of Site Visit was given and shall remain posted for 30 days.
Exit interview conducted and report was reviewed with the director, Liu Yang (Jessica).
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Daniel J Oquendo
LICENSING EVALUATOR NAME: Jovanna Badger
LICENSING EVALUATOR SIGNATURE:

DATE: 03/25/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/25/2026
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-20260324225252
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: POTRERO HILL MONTESSORI SCHOOL
FACILITY NUMBER: 384004643
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/25/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
03/25/2026
Section Cited
CCR
101212(d)
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101212 Reporting Requirement (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. (1) Events reported shall include the following: ...
(C) Any unusual incident or child absence that threatens the physical or emotional health or safety of any child.

This requirement is not met as evidenced by:
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The facility should create and submit a plan for how to comply with reporting requirement on or before the plan of correction due date,3/26/2026.
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Based on the observation, interview and records review, the facility did not comply with the section cited above that not reporting the unusual incident to the Licensing Office, which poses /posed immediate health, safety , or personal rights risk to the 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: Daniel J Oquendo
LICENSING EVALUATOR NAME: Jovanna Badger
LICENSING EVALUATOR SIGNATURE:

DATE: 03/25/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/25/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 2