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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 213000400
Report Date: 10/14/2019
Date Signed: 10/14/2019 11:41:05 AM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME:MONTESSORI SCHOOL OF NOVATOFACILITY NUMBER:
213000400
ADMINISTRATOR:YOUNG, SUSAN M.FACILITY TYPE:
850
ADDRESS:1466 SOUTH NOVATO BLVD.TELEPHONE:
(415) 892-2228
CITY:NOVATOSTATE: CAZIP CODE:
94947
CAPACITY:60CENSUS: 24DATE:
10/14/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Malin GuerreroTIME COMPLETED:
11:50 AM
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LPA Jyoti Saini and Farhan Bashir-Tariq conducted an Annual Inspection today. LPAs met with teacher Malin Guerrero. Purpose of the inspection was explained. Present during the inspection were six teachers and 24 preschool aged children. Facility is operating within licensed capacity and ratio limits on this day. LPAs inspected inside and outside of the facility for health and safety hazards. LPAs reviewed facility records including 8 random children's files and 4 personnel files. LPAs inspected three classrooms and two play yards. A review of staff records during today’s visit indicates that multiple staff have CPR training and Mandated Reporter Training. Days and hours of operation are M-F 7:00AM- 5:30PM. Facility provides two snacks. Facility conducts fire drills and logs the drills. Per facility's log, last fire drill was recorded on 9/10/19. Each room has a separate sign in and sign out sheet.

The following items were reviewed as part of today's inspection: Child Discipline Procedures, Emergency Evacuation Procedures (Multiple smoke and carbon monoxide detectors were present and in working order), Medication Policies, Isolation of Sick Children, menus, Parents Rights, and Reporting Requirements. Posting requirements for site visits were also discussed as well as AB 633 requirements. Current forms and Title 22 Regulations can be obtained through the internet at www.ccld.ca.gov. Staff immunization are on file. Staff was reminded that as of September 1, 2016, a person may not be employed or volunteer at a child care facility unless he or she has been immunized against influenza, pertussis, and measles or qualifies for an exemption pursuant to Health and Safety code 1596.7995 and 1597.662. Influenza Declarations were also reviewed. Staff was advised of Pesticides training requirement. Further information, rules and regulations can be obtained on website at: www.ccld.ca.gov. Staff was informed about the Provider Information Notices (PINs) on CCLD website. Staff was reminded of Mandated Reporter Training available at “http://www.mandatedreporteca.com”. Training must be renewed every two years. Per Staff. there is no pool, spa or any other bodies of water present at the facility.

Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual – Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. 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)/ (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm

No deficiencies were cited today. A copy of this report was reviewed and left with teacher Malin along with a notice of site visit that remains posted for 30 days.

SUPERVISOR'S NAME: Alma MaligTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Jyoti SainiTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:

DATE: 10/14/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/14/2019
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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