384000740-11-30-2022-05-CC-CQUO-CLNRNN-20221130121037

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 384000740
Report Date: 11/30/2022
Date Signed: 11/30/2022 12:10:56 PM

Document Has Been Signed on 11/30/2022 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
CCLD Regional Office, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME:	GLEN PARK MONTESSORI		FACILITY NUMBER:	384000740
ADMINISTRATOR:	ROSEMARY RAE		FACILITY TYPE:	850
ADDRESS:	647 CHENERY STREET		TELEPHONE:	(415) 585-7701
CITY:	SAN FRANCISCO	STATE: CA	ZIP CODE:	94131
CAPACITY:	36	CENSUS: 12	DATE:	11/30/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	09:50 AM
MET WITH:	Ana Padilla		TIME COMPLETED:	12:20 PM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	On November 30, 2022 at approximately 9:50am, Licensing Program Analyst (LPA) Catrina Quimbo conducted an unannounced, annual inspection. LPA met with site supervisor, Ana Padilla, and explained the purpose of the inspection. Present during LPA's visit included site supervisor, 2 staff members and 12 enrolled children (all preschool age). Facility is operating within capacity limits and ratio during LPA's visit. Licensee/Director was not present on site due to personal reasons. Facility is a multi-level, 2 classroom facility that operates as a Montessori program. There is one classroom on the first floor and a classroom on the second floor (currently not in use). Program is currently operating on the first floor of the facility only. Hours of operation are Monday to Friday 8:00am to 6:00pm. LPA inspected day care areas currently in use, with site director, for health and safety hazards. LPA observed classroom to be equipped with a variety of age appropriate toys and materials. Classrooms are designed as a Montessori program with materials that were observed to be in good working condition. Areas in classroom are separated into language, mathematics, sensorial, and quiet activities. During inspection, LPA observed a small dog (pug) in classroom. LPA reminded site supervisor children are not to have access to used and/or touched materials by animals or pets in facility. Facility contains stairs that leads to classroom on second floor. LPA observed stairs to be barricaded. Storage for children's belongings are located both inside and outside the classroom. Children's cubbies, lockers, and shelves are labeled with their individual names. LPA observed poisons, cleaning solutions and hazardous materials inaccessible by locked cabinets or stored on facility's high shelves. Bathroom was observed to be in clean, working condition. LPA observed garbage bins located in bathroom, classroom and outdoor area to have tight fitting lids. (Continue Report on Page 2...)

SUPERVISOR'S NAME: Cindy Interiano	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Catrina Quimbo	TELEPHONE: 650-266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 11/30/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/30/2022

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: GLEN PARK MONTESSORI	FACILITY NUMBER: 384000740
	VISIT DATE: 11/30/2022

NARRATIVE

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Facility is equipped with a fire alarm system, working smoke and carbon monoxide detectors and multiple fully charged fire extinguishers. Facility is also equipped with emergency supplies located inside the classroom and in outdoor area.

Outdoor area was observed to be clean, equipped with materials that were in good working condition. Outdoor area includes stairs that are properly fenced and gated when not in use. Facility maintains an outdoor waiver. There were no pools, spas or bodies of water in outdoor area.

Drinking water is available to children, indoors and outdoors, with children's individually, labeled water bottles. Per site supervisor, children's water bottles can be refilled on site through filtered water station.

Children are signed in and out of facility by parents' written signatures. At time of LPA's visit, all children were properly signed in. Parents are currently entering facility through back, outdoor exit, through outdoor area. All other outside visitors and guests enter through main front door. Facility has license documentation and information properly posted and available for review in both classrooms.

LPA reviewed facility records that included 7 children's records and 3 staff records. Children's files were observed to be complete. Children's files have a record of emergency identification information on file. Current children's roster was also made available for review.

LPA observed staff records to also be complete. All staff on site have a current, valid CPR certification that will expire 12/2023. Staff also have current, Mandated Reporter certificates and required immunizations that were made available for review.

Last emergency drill was conducted 11/15/2022. Emergency drills are conducted monthly and are properly logged and documented.

Facility was informed 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.
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SUPERVISOR'S NAME: Cindy Interiano	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Catrina Quimbo	TELEPHONE: 650-266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 11/30/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/30/2022

LIC809 (FAS) - (06/04)

Page: 2 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: GLEN PARK MONTESSORI	FACILITY NUMBER: 384000740
	VISIT DATE: 11/30/2022

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To improve the quality and value of the new inspection process, a survey will be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or tools, please send them by email to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/inspection-process.

Site supervisor was reminded that all adults 18 and over, 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 Child Care Center. A civil penalty of $100.00 minimum/day up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

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

No deficiencies were issued under CCR, Title 22, Division 12.

A notice of site visit was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

Exit interview conducted and report was reviewed with site supervisor, Ana Padilla.

SUPERVISOR'S NAME: Cindy Interiano	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Catrina Quimbo	TELEPHONE: 650-266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 11/30/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/30/2022

LIC809 (FAS) - (06/04)

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