213004840-2-21-2023-05-CC-HLEG-CP9RNB-20230221121004

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 213004840
Report Date: 02/21/2023
Date Signed: 02/21/2023 12:10:14 PM

Document Has Been Signed on 02/21/2023 12:10 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
SAN BRUNO CHILD CARE, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME:	ABBEY MONTESSORI CHILDREN'S CENTER - PRESCHOOL		FACILITY NUMBER:	213004840
ADMINISTRATOR:	COSTELO, ELIZABETH		FACILITY TYPE:	850
ADDRESS:	138 N. SAN PEDRO ROAD		TELEPHONE:	(415) 479-8865
CITY:	SAN RAFAEL	STATE: CA	ZIP CODE:	94903
CAPACITY:	30	CENSUS: 17	DATE:	02/21/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	09:25 AM
MET WITH:	Elizabeth Costelo		TIME COMPLETED:	12:25 PM

NARRATIVE

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On 2/21/2023, Licensing Program Analyst (LPA), Hanson Leong, made an unannounced annual visit to the Abbey Montessori Preschool facility. The LPA was granted entry by the Director, Elizabeth Costelo. The LPA explained the purpose of the visit to the director. All the individuals listed on the facility’s roster have been granted permission to work or be present in a childcare facility. The LPA observed three staff members supervising seventeen preschool age children. Children's capacity and ratio requirements were observed to be in compliance,

LPA and the director both performed comprehensive inspections of the facility to look for possible threats to health and safety. The facility offers a first aid kit that is completely loaded with everything that is required for the treatment of wounds and other types of injuries. Toys, furnishings, and learning materials in all classes are age appropriate. The LPA observed that the playground equipment and outdoor furnishings are in very good shape. The LPA noted that there were no bodies of water present at the facility. All poisons, cleaning products, and other potentially harmful substances have been stored in a location that is inaccessible to children. The building is equipped with smoke detectors, carbon monoxide detectors, fire extinguishers that are properly charged, centralized smoke alarms, and phones that are in working order.

The director has stated that the facility does not house any firearms or other types of weapons.

The LPA observed that the facility posted the required documents. (i.e., license, waivers, notification of parental rights, notification of personal rights, car seat law, emergency disaster plan, and daily activities).

Five different children's files were reviewed by the LPA. All required forms were in the files of the five children.

Three staff members' files were reviewed by the LPA. All required forms were in the files of the three staff members. Review of the training records shows that all three staff members are current with their Pediatric First Aid / CPR certifications. ***See Page 2 for continuation***

SUPERVISOR'S NAME: Daniel J Oquendo	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Hanson Leong	TELEPHONE: 650-266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 02/21/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/21/2023

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
SAN BRUNO CHILD CARE, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME: ABBEY MONTESSORI CHILDREN'S CENTER - PRESCHOOL	FACILITY NUMBER: 213004840
	VISIT DATE: 02/21/2023

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Continued, Page 2
According to the director, the facility satisfies the requirements by carrying out simulations of fire and earthquake drills every three to four months, as well as by documenting their results.

The following reminders were discussed with the director:

1. All adults 18 and over living or working in a licensed childcare facility, 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 licensed childcare facility.
2. Incidental Medical Services (IMS) policy
3. 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. \

No deficiencies were issued today

A copy of this report, and the “Notice of Site Visit” were given to Lourdes Anca

A “Notice of Site Visit” must remain posted for 30 days.

Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

An exit interview was conducted, and the report was reviewed with Lourdes Anca

SUPERVISOR'S NAME: Daniel J Oquendo	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Hanson Leong	TELEPHONE: 650-266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 02/21/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/21/2023

LIC809 (FAS) - (06/04)

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