213002280-3-28-2022-05-CC-KMEO-CCXTST-20220328145939

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 213002280
Report Date: 03/28/2022
Date Signed: 03/28/2022 03:00:45 PM

Document Has Been Signed on 03/28/2022 03:00 PM - It Cannot Be Edited

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:	CORTE MADERA MONTESSORI		FACILITY NUMBER:	213002280
ADMINISTRATOR:	SHEEHAN, KAREN		FACILITY TYPE:	850
ADDRESS:	50 EL CAMINO DRIVE		TELEPHONE:	(415) 927-0919
CITY:	CORTE MADERA	STATE: CA	ZIP CODE:	94925
CAPACITY:	75	CENSUS: 49	DATE:	03/28/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	12:35 PM
MET WITH:	Facility Representative, Sharra Weasler		TIME COMPLETED:	03:15 PM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	On March 28th, 2022 at 12:35pm , Licensing Program Analyst (LPA) Kassandra Medrano conducted an annual required inspection. Analyst toured the facility building and grounds, conducted an evaluation of the physical plant, and reviewed children, staff and facility records. A review of staff records during today’s visit indicates that all staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions, facility representative was reminded that all adults 18 and over, including employees and volunteers, 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 up to $500.00 maximum per day/per person will be assessed if this regulation is violated. Days and hours of operation are: M-F, 8AM-6PM. The following was observed today: at 12:45 P current facility director is Sharra Weasler, per weasler she has been at facility as director since September, no documentation has been received. The following items were reviewed as part of today's visit: Care and Supervision of the Children, Child Discipline Procedures, Emergency Evacuation Procedures (smoke and carbon monoxide detectors present and in working order), Medication Policies, Isolation of Sick Children, Napping Requirements, Food Service, Transportation, 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. Facility Representative 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. Facility Representative was advised of Pesticides training. For More information about changes to the Healthy Schools Act, templates, articles, and required training you can inspect the DPR website at: https://apps.cdpr.ca.gov/schoolipm/childcare/training/main.cfm.

SUPERVISOR'S NAME: Ali Zebila	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Kassandra Medrano	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 03/28/2022

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/28/2022

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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME: CORTE MADERA MONTESSORI	FACILITY NUMBER: 213002280
	VISIT DATE: 03/28/2022

NARRATIVE

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Facility Representative was informed about the Provider Information Notices (PINs) on CCLD website. Director was reminded of Mandated Reporter Training available on CCLD website. Training must be renewed every two years. LPA discussed the safe sleep regulations with facility representative and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed facility representative of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment. Facility is clean and in good repair. To improve the quality and value of the new inspection process, a survey will 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 tools, please send them by email 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. Exit interview conducted and report was reviewed with the facility representative, Sharra Weasler.

The following items need to be completed and returned to Licensing by 04/29/22:

-PERSONNEL REPORT (LIC 500)
-EMERGENCY DISASTER PLAN (LIC 610)
-NEW DIRECTOR INFORMATION: DESIGNATION OF ADMIN RESP (LIC 308), PERSONNEL RECORD (LIC 501), HEALTH SCREENING REPORT (LIC 503), IMMUNIZATION RECORD FOR MEASLES, PERTUSSIS AND INFLUENZA DECLARATION, LETTERS OF EXPERIENCE FROM PREVIOUS EMPLOYERS, TRANSCRIPTS/DEGREE/VALID CHILD DEVELOPMENT PERMIT, SIGNED STATEMENT ACKNOWLEDGING REQUIREMENT TO REPORT SUSPECTED CHILD ABUSE, SIGNED NOTICE OF EMPLOYEE RIGHTS AND CRIMINAL RECORD STATEMENT, PROOF OF COMPLETION OF 16 HOURS PREVENTATIVE HEALTH PRACTICES, INCLUDING CPR AND FIRST AID.
A notice of site visit was given and must remain posted for 30 days.

California Code of Regulations, Title 22 deficiencies are being cited on the following page(s):

SUPERVISOR'S NAME: Ali Zebila	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Kassandra Medrano	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 03/28/2022

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/28/2022

LIC809 (FAS) - (06/04)

Page: 2 of 4

Document Has Been Signed on 03/28/2022 03:00 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME: CORTE MADERA MONTESSORI	FACILITY NUMBER: 213002280
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 03/28/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

101212(b)

Reporting Requirements

(b) The name of the child care center director, and any fully qualified teacher(s) designated to act in the child care center director's absence, shall be reported to the Department within 10 days of a change of child care center director or designee(s). This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on interview and record review, the facility did not comply with the section cited above by not sending new documentation of change in director since september 2021, which poses a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 04/29/2022
	Plan of Correction
1 2 3 4	Faicility Representative Sharralyn Weasler stated she will get a new directors packet in within the month.

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

SUPERVISOR'S NAME: Ali Zebila	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Kassandra Medrano	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 03/28/2022

I acknowledge receipt of this form and understand my appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/28/2022

LIC809 (FAS) - (06/04)

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