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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 414005194
Report Date: 06/29/2026
Date Signed: 06/29/2026 10:11:29 AM

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
04/22/2026 and conducted by Evaluator Man Tso
PUBLIC
COMPLAINT CONTROL NUMBER: 05-CC-20260422103545
FACILITY NAME:NEO IMMERSION MONTESSORI SCHOOLFACILITY NUMBER:
414005194
ADMINISTRATOR:ELINA CHENFACILITY TYPE:
860
ADDRESS:830 ROSITA ROAD #C-18TELEPHONE:
(650) 898-8468
CITY:PACIFICASTATE: CAZIP CODE:
94044
CAPACITY:21CENSUS: 2DATE:
06/29/2026
UNANNOUNCEDTIME BEGAN:
08:30 AM
MET WITH:Teacher, Vivien QinTIME COMPLETED:
10:30 AM
ALLEGATION(S):
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Staff does not ensure the outdoor play area is free of hazards
Staff do not ensure daycare children play in a safe area
INVESTIGATION FINDINGS:
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On June 29, 2026, at 8.30AM, Licensing Program Analyst (LPA) Tso conducted an unannounced visit for delivery of the complaint investigation findings and met with Teacher, Vivien Qin. LPA explained the purpose of the inspection and were granted entry to the facility by the Teacher. Present, a teacher was supervising 2 children.

During the course of the investigation, interviews were conducted with staff members and relevant documents were gathered. Based on the interviews and observation, there was no sufficient evidence to prove that the allegations listed above, occurred. Although the allegations may have happened or is valid, there is no preponderance of evidence to prove the alleged violations did or did not occur. Therefore, the allegations are UNSUBSTANTIATED.

Exit interview conducted and this report was reviewed with the teacher whose signature confirmed that she had read the report. Report must be made available for public review upon request. A copy of this report and appeal rights have been discussed and left with the Teacher. Notice of Site Visit shall remain posted for 30 days.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Garfield Leung
LICENSING EVALUATOR NAME: Man Tso
LICENSING EVALUATOR SIGNATURE:

DATE: 06/29/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/29/2026
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 3
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
04/22/2026 and conducted by Evaluator Man Tso
PUBLIC
COMPLAINT CONTROL NUMBER: 05-CC-20260422103545

FACILITY NAME:NEO IMMERSION MONTESSORI SCHOOLFACILITY NUMBER:
414005194
ADMINISTRATOR:ELINA CHENFACILITY TYPE:
860
ADDRESS:830 ROSITA ROAD #C-18TELEPHONE:
(650) 898-8468
CITY:PACIFICASTATE: CAZIP CODE:
94044
CAPACITY:21CENSUS: 2DATE:
06/29/2026
UNANNOUNCEDTIME BEGAN:
08:30 AM
MET WITH:Teacher, Vivien QinTIME COMPLETED:
10:30 AM
ALLEGATION(S):
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9
Uncleared adult supervising children.
INVESTIGATION FINDINGS:
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On June 29, 2026, at 8.30AM, Licensing Program Analyst (LPA) Tso conducted an unannounced visit for delivery of the complaint investigation findings and met with the Teacher, Vivien Qin. LPA explained the purpose of the inspection and were granted entry to the facility by the Teacher. Present, a teacher was supervising 2 children.

Based on LPA’s gathered information through observation, interviews and records reviews, the agency has investigated the complaint allegation above. The facility did not comply with the criminal records clearance regulations. A staff obtained the criminal records clearance but did not associate to the facility. The preponderance of evidence standard has been met. The above allegation is found to be SUBSTANTIATED. A Type B violation was issued today, June 29, 2026 in accordance with the California Code of Regulations, Title 22, Division 12, citation was being cited on the attached LIC 9099D. Since the criminal records clearance of the staff was associated to the facility on 4/29/2026. The deficiency was cleared on today, June 29, 2026 visit.

Exit interview conducted and a copy of this report and appeal rights were discussed and left with the Teacher, Vivien Qin, whose signature on this form confirms receipt of these reports. Notice of Site Visit (The Notice) was provided. The Notice is to remain posted for 30 days.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Garfield Leung
LICENSING EVALUATOR NAME: Man Tso
LICENSING EVALUATOR SIGNATURE:

DATE: 06/29/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/29/2026
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 05-CC-20260422103545
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: NEO IMMERSION MONTESSORI SCHOOL
FACILITY NUMBER: 414005194
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/29/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
07/06/2026
Section Cited
CCR
101170(e)(2)
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101170 Criminal Record Clearance
(e) All individuals subject to a criminal record review pursuant to Health and Safety Code Section 1596.871 shall prior to working, residing or volunteering in a licensed facility: (2) Request a transfer of a criminal record clearance as specified in Section 101170(f)

This requirement is not met as evidenced by:
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The staff’s criminal record clearance was transferred and associated to the facility on 4/29/2026. The deficiency was cleared on 6/29/2026.
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Based on observation, interviews and record review, the owner of the facility did not comply with the section cited above that the staff working at the facility before transferring the criminal record clearance and associated to the facility, which pose a 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: 06/29/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/29/2026
LIC9099 (FAS) - (06/04)
Page: 3 of 3