384001313-5-17-2023-05-CC-HLEG-CRWS7B-20230517133716

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 384001313
Report Date: 05/17/2023
Date Signed: 05/17/2023 01:37:26 PM

Document Has Been Signed on 05/17/2023 01:37 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
SAN BRUNO CHILD CARE, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME:	MONTESSORI CHILDREN'S CENTER		FACILITY NUMBER:	384001313
ADMINISTRATOR:	FLYNN, JUDITH		FACILITY TYPE:	850
ADDRESS:	80 JUAN BAUTISTA CIRCLE		TELEPHONE:	(415) 333-4410
CITY:	SAN FRANCISCO	STATE: CA	ZIP CODE:	94132
CAPACITY:	58	CENSUS: 14	DATE:	05/17/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	10:45 AM
MET WITH:	Jennifer Diaz		TIME COMPLETED:	01:45 PM

NARRATIVE

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On 5/17/2023, Licensing Program Analysts (LPAs) Hanson Leong and Brendon Van, made an unannounced annual visit to the child daycare facility listed above. The LPAs were granted entry by one of the teachers, Jennifer Diaz. The LPAs explained the purpose of the visit to the Ms. Diaz. All the individuals listed on the facility’s roster have been granted permission to work or be present in a childcare facility. The LPAs observed three staff members supervising fourteen preschool aged children. Children's capacity and ratio requirements were observed to be in compliance. The director was not present during today's visit.

LPAs and the Ms. Diaz both performed comprehensive inspections of the facility to look for possible threats to health and safety. The facility offers a first aid kit that is completely loaded with everything that is required for the treatment of wounds and other types of injuries. Toys, furnishings, and learning materials in all classes are age appropriate. The LPAs observed that the playground equipment and outdoor furnishings are in very good shape. The LPAs found that the facility did not have any pools, spas, or other types of bodies of water of any kind. All poisons, cleaning products, and other potentially harmful substances have been stored in a location that is inaccessible to children. The building is equipped with smoke detectors, carbon monoxide detectors, fire extinguishers that are properly charged, centralized smoke alarms, and phones that are in working order.

Ms. Diaz has stated that the facility does not house any firearms or other types of weapons.

The LPAs observed that the facility posted the required documents. (i.e., license, waivers, notification of parental rights, notification of personal rights, car seat law, emergency disaster plan, and daily activities)

The LPAs reviewed the files of five different children. All required forms were in the files of the five children.

The LPAs reviewed the files of three staff members. All required forms were in the files of the three staff members. Review of the training records shows that one staff member is current with their Pediatric First Aid / CPR training. ***See Page 2 for continuation***

SUPERVISOR'S NAME: Daniel J Oquendo	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Hanson Leong	TELEPHONE: 650-266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 05/17/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/17/2023

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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Document Has Been Signed on 05/17/2023 01:37 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN BRUNO CHILD CARE, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME: MONTESSORI CHILDREN'S CENTER	FACILITY NUMBER: 384001313
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 05/17/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

HSC

1597.16(a)(1)

Lead Testing

(1) A licensed child day care center, as defined in Section 1596.76, that is located in a building that was constructed before January 1, 2010, shall have its drinking water tested for lead contamination levels on or after January 1, 2020, but no later than January 1, 2023, and every five years after the date of the initial test. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on interview and record review, the licensee did not comply with the section cited above, which poses a potential health, safety or personal rights risk to children in care.
	POC Due Date: 06/17/2023
	Plan of Correction
1 2 3 4	The director must submit a completed LEAD water report to the department by the above due dare.

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

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: Daniel J Oquendo	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Hanson Leong	TELEPHONE: 650-266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 05/17/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/17/2023

LIC809 (FAS) - (06/04)

Page: 2 of 4

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN BRUNO CHILD CARE, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME: MONTESSORI CHILDREN'S CENTER	FACILITY NUMBER: 384001313
	VISIT DATE: 05/17/2023

NARRATIVE

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Continued, Page 2
The LPAs reviewed the facility's emergency drill log. According to the facility’s emergency drill log, the facility's emergency drills are carried out monthly.

Based on record review, the LEAD water testing was not completed, which is required for all licensed childcare facilities.

The Incidental Medical Services (IMS) policy was discussed with Ms. Diaz. 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 the publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm

Ms. Diaz 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 the 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.

Ms. Diaz was informed about the Mandated Reporter training. In addition to AB1207 training required to complete every two years by all staff hired a one-time General Training is also required. Training can be taken online at www.mandaterreporterca.com. Also, Ms. Diaz was reminded of Pesticide training. Information on the DPR website at: www.cdpr.ca.gov/shoolipm/childcare

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/process.

***See Page 3 for continuation***

SUPERVISOR'S NAME: Daniel J Oquendo	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Hanson Leong	TELEPHONE: 650-266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 05/17/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/17/2023

LIC809 (FAS) - (06/04)

Page: 3 of 4

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN BRUNO CHILD CARE, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME: MONTESSORI CHILDREN'S CENTER	FACILITY NUMBER: 384001313
	VISIT DATE: 05/17/2023

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Continued, Page 3
The following Type B violation (potential health, safety, or personal rights risk to children in care.) was cited for today’s visit:

1. HSC 1597.16(a)(1)- A licensed child day care center, as defined in Section 1596.76, that is located in a building that was constructed before January 1, 2010, shall have its drinking water tested for lead contamination levels on or after January 1, 2020, but no later than January 1, 2023, and every five years after the date of the initial test.

***The department may clear all violations after the review of the facilities’ Plan of Correction***

A copy of this report, the “Notice of Site Visit”, and their appeal rights were given to Jennifer Diaz. A “Notice of Site Visit” must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100. An exit interview was conducted, and the report was reviewed with Jennifer Diaz.

SUPERVISOR'S NAME: Daniel J Oquendo	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Hanson Leong	TELEPHONE: 650-266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 05/17/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/17/2023

LIC809 (FAS) - (06/04)

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