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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 213005121
Report Date: 07/24/2019
Date Signed: 07/24/2019 12:48:11 PM

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 CENTRAL MARIN-P/S, THEFACILITY NUMBER:
213005121
ADMINISTRATOR:BARBIERI, DORISFACILITY TYPE:
850
ADDRESS:317 AUBURN STREETTELEPHONE:
(415) 456-1748
CITY:SAN RAFAELSTATE: CAZIP CODE:
94901
CAPACITY:72CENSUS: 45DATE:
07/24/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Administrator, Maeve RuddyTIME COMPLETED:
01:00 PM
NARRATIVE
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Licensing Program Analyst, Luis J. Gomez Site met with Administrator Maeve Ruddy. Administrator stated that the current director is away from the facility. The purpose of the visit was explained to Site Administrator and is for an annual inspection. The Prek Montessori Themed program operates year-round and uses 3 primary classrooms (Prek #1 , Prek #2 and Toddler #3). Program also operates enrichment activities in room #4 and uses 2 outdoor play areas for the children. Hours of operation are Monday- Friday 7:00am- 6:00pm. Present are site administrator and 8 staff supervising 45 children. LPA Gomez observed a volunteer helping in daycare without fingerprint clearance. Facility was inspected indoors and outdoors for Health and Safety hazards. For children who take naps, folded mats and covers are available in room 3. All classrooms have age appropriate wooden toys, puzzles, blocks, books and equipment that are in good repair. Classrooms have acceptable ventilation and ample lighting. Each classroom is equipped with a smoke and carbon monoxide detectors and a fire extinguisher. First Aid Kit and Emergency supplies are properly maintained and kept inaccessible to children. All cleaning products and toxins are maintained inaccessible to children and locked in a hallway closet. Emergency drills are done monthly, with the last drill conducted on 05/08/2019 and properly logged in each classroom. Facility has 2 children's bathrooms located in the main hallway. Each restroom is equipped with 3 toilets and 2 sinks. Restrooms are maintained clean, in good repair, and with adequate supplies. Staff use a separate restroom located outside the office. Program utilizes 2 outdoor play areas for the daycare children. LPA Gomez inspected outdoor play area for safety hazards and dangerous conditions. LPA Gomez observed each play area is equipped with toys and bikes for children in care. Each out door area is completely enclosed with wooden fencing. Drinking water is readily available indoors and outdoors children with the use of pitchers. LPA Gomez inspected the children’s medication and observed all medication is current. Program provides a daily morning and afternoon snacks. Children bring their own lunch time meals to the facility from home. All required Licensing information is properly posted in the front next to the main door.

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SUPERVISOR'S NAME: Alma MaligTELEPHONE: (650) 266-8832
LICENSING EVALUATOR NAME: Luis GomezTELEPHONE: (650) 393-9134
LICENSING EVALUATOR SIGNATURE:

DATE: 07/24/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/24/2019
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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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: MONTESSORI SCHOOL OF CENTRAL MARIN-P/S, THE
FACILITY NUMBER: 213005121
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/24/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
07/25/2019
Section Cited
CCR
101170(e)(1)
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101170(e)(2) Criminal Record Clearance. Prior to working or volunteering in a licensed child care facility, all individuals subject to a criminal record review shall obtain a criminal record clearance or criminal record exemption.
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Facility will have volunteer finger printed and associated to the daycare center by the due date: 7/25/2019.

Facility will submit proof of correction to licensing.
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This requirement is not met as evidenced by; LPA Gomez observed a volunteer helping in daycare without fingerprint clearance. This is an immediate health and safety risk to children 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.
SUPERVISOR'S NAME: Alma MaligTELEPHONE: (650) 266-8832
LICENSING EVALUATOR NAME: Luis GomezTELEPHONE: (650) 393-9134
LICENSING EVALUATOR SIGNATURE:

DATE: 07/24/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/24/2019
LIC809 (FAS) - (06/04)
Page: 3 of 3
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: MONTESSORI SCHOOL OF CENTRAL MARIN-P/S, THE
FACILITY NUMBER: 213005121
VISIT DATE: 07/24/2019
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LPA Gomez review facility Personnel Files and Children’s Files during todays inspection. LPA Gomez observed all files are current and up-do-date. Designated staff’s CPR/ 1st Aid Certification is current, expiring in 10/2019.

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

Site Administrator 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.

Site Administrator was informed about the Provider Information Notices (PINs) on CCLD website. Site Supervisor was reminded to make sure to renew all staff's Mandated Reporter Training certificate before the expiration date.


>See attached deficiencies page for deficiencies issued today under Title 22 Division 12 of the Ca. Code of Regulations.


This report and a Notice of Site Visit are provided to Administrator. .>This report and rights to comment and appeal were discussed with Site Administrator. This report must be available in the facility for public review. Notice of site inspection was posted.

Site Supervisor was advised any additional questions to call Office, M-F, 8am-5pm, 650-266-8800 or 1-844-538-8766. Website: www.ccld.ca.gov

SUPERVISOR'S NAME: Alma MaligTELEPHONE: (650) 266-8832
LICENSING EVALUATOR NAME: Luis GomezTELEPHONE: (650) 393-9134
LICENSING EVALUATOR SIGNATURE:

DATE: 07/24/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/24/2019
LIC809 (FAS) - (06/04)
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