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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 214005417
Report Date: 01/15/2020
Date Signed: 01/15/2020 11:55:26 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:HAMILTON MONTESSORI SCHOOLFACILITY NUMBER:
214005417
ADMINISTRATOR:ACKER, CINDYFACILITY TYPE:
850
ADDRESS:600 PALM DRIVETELEPHONE:
(510) 798-7429
CITY:NOVATOSTATE: CAZIP CODE:
94949
CAPACITY:90CENSUS: 17DATE:
01/15/2020
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
10:20 AM
MET WITH:Neringa WillisTIME COMPLETED:
12:10 PM
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A annual inspection was made to the facility by Licensing Program Analyst (LPA) Kevin O'Connell. The facility file was reviewed prior to this visit. A review of the personnel report on 01/15/20 indicates that all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions.
This program operates Monday - Friday; 7:00 am to 6:00 pm in three classrooms. The facility was toured with the Assistant Director at 10:25am and the floor and yard plan submitted by the licensee were verified. This facility is licensed for 90 children. 3 teachers were supervising 17 children during today's inspection and were operating within the licensed capacity and ratio requirements.
The items which could pose a danger to children (such as detergents, cleaning compounds and medications) were observed to be inaccessible to children. The Assistant Director states that there are no poisons but knows to lock them. The toys, floors, desks and other equipment and surfaces are clean, toxic free, safe and in good condition. There is uncontaminated drinking water available to children both indoors and outdoors on the playground. The children's bathrooms are in safe and sanitary condition. Food prep areas are clean. Children bring their own lunch. Snacks are served and menus were posted. Garbage containers containing solid waste have tight fitting lids. The LPA observed a working carbon monoxide detector and there were multiple charged fire extinguishers of at least 2A 10: BC or larger.
The playground was free of hazards. The playground equipment was in safe condition. There is bark for cushioning underneath the climbing structures to absorb falls. The Assistant Director stated that there are no bodies of water and none were observed except for a fountain in the large courtyard which is a "off limits" area. The Assistant Director stated no weapons are stored on site and none were observed. At least two teachers had current Pediatric CPR and First Aid certifications on file.
SUPERVISOR'S NAME: Leslie LeporiTELEPHONE: (707) 588-5060
LICENSING EVALUATOR NAME: Kevin O'ConnellTELEPHONE: (707) 588-5047
LICENSING EVALUATOR SIGNATURE:

DATE: 01/15/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/15/2020
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC809 (FAS) - (06/04)
Page: 1 of 2
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: HAMILTON MONTESSORI SCHOOL
FACILITY NUMBER: 214005417
VISIT DATE: 01/15/2020
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The sign-in/sign-out procedure was reviewed and in compliance. Four staff records were reviewed at 11:00am for immunizations, Mandated Reporter Certificates and education transcripts and all were complete. Ten children’s records were reviewed at 10:50am, and contained signed admission agreements.
Incidental Medical Services (IMS) policy was discussed. There is not a need for administering any IMS at this time. 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

This report, as well as the AAP Guide to Safe Sleep, Safe Sleep in Childcare brochure, What does a Safe Sleep Environment Look Like brochure & Safe Sleep Concepts handout, were reviewed and discussed with the Assistant Director. The Effects of Lead Exposure brochure has been reviewed with and discussed with the Assistant Director. All licensing reports are public information and must be made available upon request for at least three years. No deficiencies were cited today.


Notice of Site Visit shall be posted for 30 days from today's visit.
SUPERVISOR'S NAME: Leslie LeporiTELEPHONE: (707) 588-5060
LICENSING EVALUATOR NAME: Kevin O'ConnellTELEPHONE: (707) 588-5047
LICENSING EVALUATOR SIGNATURE:

DATE: 01/15/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/15/2020
LIC809 (FAS) - (06/04)
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