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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 384004588
Report Date: 10/25/2024
Date Signed: 10/25/2024 04:30:25 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
10/22/2024 and conducted by Evaluator Zeynep Basak
PUBLIC
COMPLAINT CONTROL NUMBER: 05-CC-20241022143528
FACILITY NAME:MISSION MONTESSORI (INF)FACILITY NUMBER:
384004588
ADMINISTRATOR:DOMINGO, ROCHELLEFACILITY TYPE:
830
ADDRESS:50 FELL STREETTELEPHONE:
(415) 805-8315
CITY:SAN FRANCISCOSTATE: CAZIP CODE:
94102
CAPACITY:54CENSUS: 32DATE:
10/25/2024
UNANNOUNCEDTIME BEGAN:
01:40 PM
MET WITH:Dr. LaRhonda MartinTIME COMPLETED:
01:41 PM
ALLEGATION(S):
1
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9
Staff do not follow proper sanitation practices between diaper changes.
Staff do not ensure sanitary accommodations are provided to infants.
Day care is not providing snacks to children.
INVESTIGATION FINDINGS:
1
2
3
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5
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7
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9
10
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13
On 10/25/2024 Licensing Program Analyst, (LPA) Zeynep Basak conducted an unannounced visit to open the complaint and met with the executive director, Dr LaRohanda Martin. The purpose of the inspection was explained upon entry.
LPA observed 7 staff, 14 infants, and 18 toddlers present during today's visit.
LPA verified fingerprint clearance of teachers on the Guardian website.

LPA obtained pertinent documents, reviewed the records, and interviewed with 7 staff members.

Based on the investigation, observation and the information obtained the above allegations are found to be unsubstantiated and complaint to be closed.

A copy of this report was reviewed, given to the director, Dr. LaRohanda Martin, and findings were delivered.
An exit interview was conducted and Notice of Site Visit was provided to be posted for 30 days.

Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Daniel J Oquendo
LICENSING EVALUATOR NAME: Zeynep Basak
LICENSING EVALUATOR SIGNATURE:

DATE: 10/25/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/25/2024
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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