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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 380501318
Report Date: 10/28/2019
Date Signed: 10/28/2019 02:30:14 PM

COMPREHENSIVE INSPECTION
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 HOUSE OF CHILDRENFACILITY NUMBER:
380501318
ADMINISTRATOR:DIANA GUSTAFSONFACILITY TYPE:
850
ADDRESS:1187 FRANKLIN STREETTELEPHONE:
(415) 441-7691
CITY:SAN FRANCISCOSTATE: CAZIP CODE:
94109
CAPACITY:110CENSUS: 49DATE:
10/28/2019
TYPE OF VISIT:Required - 3 YearUNANNOUNCEDTIME BEGAN:
11:50 AM
MET WITH:Diana Gustafson and Lauren PayumoTIME COMPLETED:
03:00 PM
NARRATIVE
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Licensing Program Analyst (LPA) Mok conducted an unannounced required inspection today. LPA met with the Site Director, Diana Gustafson and Assistant Site Director, Lauren Payumo. The purpose of the inspection was explained to them. There were 49 children with 10 staff present. The facility is a Preschool Center. The facility is located in back of the First Unitarian Universalist Church. Parents have to go through the courtyard to the main entrance of the facility. Gate was installed at the main entrance to prevent daycare children access to the off-limit areas. The facility operation hours are Monday to Friday from 7 AM to 6 PM. The preschool program is run in the classrooms A, B, C, D, and E. Per Lauren, Classroom E is not used for the program during the current school year because they don't t have the TK children this year The classrooms A & B are on the upper level, and rest of the classrooms are on the lower level. There is a upper play yard available for the children from Classroom A & B. The facility also has a play yard on the lower level that is shared by the children from Classrooms C, D, and E. The outdoor play yards are completely fenced. LPA toured and inspected the facility for health and safety hazard. The facility was clean and in order. The temperature and lighting were adequate. All toxins and harmful objects were either locked or made inaccessible to children. Classroom A and B had its own children bathroom with 1 sink and 1 toilet in each class. There were 2 children bathrooms with 4 toilets, 2 urinals, and 3 sinks available for the children from Classrooms C, D, and E. There were plenty of age-appropriate toys, books, learning, and children furniture available in each classroom. The children furniture were in good condition and repair. All the lower cabinets and drawers in each classroom were free of hazard. All electrical outlets were covered. Mats were used for napping. Tap water was available in each classroom. Cubbies were available for the children to store their own belonging outside each classroom. Children bring their own water bottle and lunch to school daily. Facility provides AM/PM snacks to the children only. The outdoor play yards were inspected during the inspection. There were some outdoor toys, play house , and ride-on toys and a play structure with soft cushioning underneath available for the children in the upper yard. The lower yard also had a play structure with soft cushioning underneath, and some ride-on toys available for children as well. At least one staff had a valid CPR/First AId training available for review during the inspection. The training will be expired on 8/18/2020. Fire drill is conducted at least 2 times a year. The latest drill was conducted 10/4/2019. Per Lauren, there were 2 children on special medication. This facility provides Incidental Medical Services - IMS. LPA reviewed storage of medication and equipment/supplies, and reviewed children's, personnel, and administrative record. For IMS Information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. 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. All required postings were posted. Children files and roster were reviewed during the inspection. LPA also obtained a copy of the roster from licensee during the inspection. Most of the teachers completed the Mandated Reporter Training (AB1207). The certificates were reviewed during the inspection.

This report and notice of site visit were discussed with the licensee and must be made available to the public upon request. For quarterly update on Licensing information, go to CCL website: www.ccld.ca.gov. For Provider Information Notice: ccld.ca.gov/PG5098.htm.
SUPERVISOR'S NAME: Alma MaligTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Cindy MokTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:

DATE: 10/28/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/28/2019
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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