384004644-3-26-2026-05-CC-JBAR-DSJN5Y-20260326101015

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 384004644
Report Date: 03/25/2026
Date Signed: 03/26/2026 10:10:37 AM

Document Has Been Signed on 03/26/2026 10:10 AM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

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:	384004644
ADMINISTRATOR/ DIRECTOR:	YANG, LIU		FACILITY TYPE:	830
ADDRESS:	1701 17TH STREET		TELEPHONE:	(650) 476-3015
CITY:	SAN FRANCISCO	STATE: CA	ZIP CODE:	94103
CAPACITY: 16	TOTAL ENROLLED CHILDREN: 16	CENSUS: 13	DATE:	03/25/2026
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	10:07 AM
MET WITH:	Liu Yang		TIME VISIT/ INSPECTION COMPLETED:	10:08 AM

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On 3/25/2026, LPAs Badger and Tso, arrived at the facility to conduct an unannounced annual visit. LPAs were greeted by the lead Infant teacher, as the Director, Yang Liu was not present at that time. The Director, Liu Yang (Jessica), arrived at the facility at 10:25 AM. LPAs explained the purpose of the visit to the Head Teacher and later to the director.

This is a combination Center with Infants and Preschool programs operating in the same building with two separate licenses. Present in the infant program, including five staff members and 13 infants present today. All staff members present during the inspection had their criminal record clearances verified through the CDSS Guardian Background Check site and were found to have an eligible clearance status.

The center is operating within its capacity and in accordance with the required staff-to-child ratio.

The days and hours of operation are Monday- Friday, 8:00 am- 5:30 pm.

LPA toured and inspected the physical plant for potential health and safety hazards. The facility uses an electronic Application to maintain a record of sign-in/out for infants; each parent has an individual PIN associated with their name so that teachers can know which parent signed in and out for the day. The infants' classroom environment appeared clean and organized, with appropriate heating, lighting, and ventilation.

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NAME OF LICENSING PROGRAM MANAGER: Daniel J Oquendo
NAME OF LICENSING PROGRAM ANALYST: Jovanna Badger
LICENSING PROGRAM ANALYST 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.

LIC809 (FAS) - (06/04)

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California Health & Human Services Agency

California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:

Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.

Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)

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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION 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: 384004644
	VISIT DATE: 03/25/2026

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There are a variety of age-appropriate toys, furnishings, changing tables, and equipment. LPA did not observe any pools, spas, or other bodies of water, nor did they notice any bouncers, exersaucers, or similar equipment at the facility.

According to the Director, there are no firearms or weapons present at the Center. All cleaning materials and potentially hazardous objects are kept out of reach of children. Personnel restrooms are separate from children. All solid waste storage containers have tightly fitted lids.

The facility has carbon monoxide, centralized smoke detectors, and a fully charged fire extinguisher on the premises. There are telephones located in each classroom. All hazardous materials, including cleaning solutions and poisons, are kept out of the reach of children.

Additionally, children sleep in a separate room designated for napping, there were age-appropriate cribs and mats were observed in the infant sleeping area. Parents bring infant bedding home to be washed weekly, and when needed. Crib sheets are washed daily on site.

LPA inspected the facility’s First Aid kit. LPA observed that each child has designated cubbies that are available for parents to store their children’s belongings. LPAs observed the infant changing table to be positioned near an accessible sink for hand washing.

LPA observed that the kitchen was clean and sanitary. LPA observed infant bottles to be properly stored and labeled with each child's name and date. LPA observed that the infant formula and breast milk were properly labeled, dated, and stored. The facility has an outdoor waiver approved by the Department that allows the facility to use the nearby playground.

LPA reviewed five personnel records for the infant classroom. Three of the five files reviewed were missing valid Mandated Reporter Certificates. The director was also missing a valid Mandated Reporter Certificate.

Records review showed two children were missing immunization records.

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NAME OF LICENSING PROGRAM MANAGER: Daniel J Oquendo
NAME OF LICENSING PROGRAM ANALYST: Jovanna Badger
LICENSING PROGRAM ANALYST 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

LIC809 (FAS) - (06/04)

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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION 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: 384004644
	VISIT DATE: 03/25/2026

NARRATIVE

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The most recent emergency drill was conducted on 1/9/2026.

The Director was reminded that all adults 18 and over, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a Child Care Center. A civil penalty of $100.00 minimum/day for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.

Assembly Bill (AB) 2370, Chapter 676, Statutes of 2018, requires all licensed Child Care Centers (CCCs) constructed before January 1, 2010, to test their water (used for drinking and food preparation) for lead contamination before January 1, 2023, and then every 5-years after the date of the first test.

CCC COMPLETED TESTING AND NO LEAD EXCEEDANCES:

LPA verified that the lead testing was completed in accordance with the Written Directives outlined in PIN 21-21.1-CCP.

Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02-CCP. When any IMS is provided, an updated Plan of Operation that includes IMS must be submitted to the Department. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice) or (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA are available at: https://www.ada.gov/resources/child-care-centers/.

The Director was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

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NAME OF LICENSING PROGRAM MANAGER: Daniel J Oquendo
NAME OF LICENSING PROGRAM ANALYST: Jovanna Badger
LICENSING PROGRAM ANALYST 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

LIC809 (FAS) - (06/04)

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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION 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: 384004644
	VISIT DATE: 03/25/2026

NARRATIVE

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LPA discussed Child Abuse Mandated Training AB1207 with the Director. As of January 1, 2018, all staff must complete Mandated Reporter Training every two years. The training can be obtained online at www.mandatedreporterca.com.

Pesticide regulations were discussed with the Site Director. In accordance with the Healthy Schools Act, California law requires that anyone using any pesticide must be trained every year in integrated pest management and the safe use of pesticides around children. The director was advised that a free one-hour online course is available on the Department of Pesticide Regulation's website: www.cdpr.ca.gov/schoolipm/training. For questions, email ccipmlist@cdpr.ca.gov.

To improve the quality and value of the new inspection process, a survey may be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or CARE tools, please send email inquiries to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/inspection-process.

A Technical violation was issued for three of the five files reviewed, which were missing valid Mandated Reporter Certificates.

A Type A violation was issued, due to two infant children with missing immunization records.

A notice of site visit was given and must remain posted for 30 days.

An exit interview was conducted, and a report was reviewed with the Director, Jessica Liu Yang.

NAME OF LICENSING PROGRAM MANAGER: Daniel J Oquendo
NAME OF LICENSING PROGRAM ANALYST: Jovanna Badger
LICENSING PROGRAM ANALYST 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

LIC809 (FAS) - (06/04)

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