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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 213005248
Report Date: 01/17/2020
Date Signed: 01/17/2020 11:23:54 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:MARIN DAY SCHOOLS - HILLSIDE CAMPUS - PRESCHOOLFACILITY NUMBER:
213005248
ADMINISTRATOR:VANESSA FRANCOFACILITY TYPE:
850
ADDRESS:80 LOMITA DRIVETELEPHONE:
(415) 381-3120
CITY:MILL VALLEYSTATE: CAZIP CODE:
94941
CAPACITY:60CENSUS: 49DATE:
01/17/2020
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
09:25 AM
MET WITH:Director, Vanessa FrancoTIME COMPLETED:
11:30 AM
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Licensing Program Analyst (LPA) Kassandra Medrano met with Director, Vanessa Franco for an unannounced Case Management Inspection. The purpose of the inspection was to discuss an unusual incident that occurred on December 19, 2019; which was reported to the department by the center.

On the day mentioned above, the facility was preparing for nap when a child tripped and bumped their lip. A teacher helped the child up and tended to the wound. When they realized the severity of the wound, they called the director in who took child to office to inform parents. They followed procedures set in place by assessing the wound and situation and ultimately calling parents. The parent came immediately and took child to hospital. Child returned to school January 6th, 2020 with no limitations. LPA observed child at play and seemed happy and in no physical pain.

LPA reviewed facilities recommendations on preventing an incident such as this from occurring again. Facility has moved tripping hazards and created more walking space for children.

SUPERVISOR'S NAME: Ali ZebilaTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Kassandra MedranoTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:

DATE: 01/17/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/17/2020
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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