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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 384002968
Report Date: 10/07/2022
Date Signed: 10/07/2022 03:23:34 PM


Document Has Been Signed on 10/07/2022 03:23 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:SAN FRANCISCO MONTESSORI ACADEMYFACILITY NUMBER:
384002968
ADMINISTRATOR:KLEIN, ISABELLFACILITY TYPE:
850
ADDRESS:1283 22ND AVETELEPHONE:
(415) 759-5710
CITY:SAN FRANCISCOSTATE: CAZIP CODE:
94122
CAPACITY:23CENSUS: 19DATE:
10/07/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Isabell KleinTIME COMPLETED:
11:45 AM
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On October 07, 2022 at approximately 9:30am, Licensing Program Analyst (LPA) Winnie Ly conducted an Unannounced Required - 1 Year Visit at the and met with Site Director, Isabell Klein during the visit. Purpose of the inspection was explained. There were 4 staff including the Director caring for 19 children. Teacher to child ratios were met on this day. The facility has fully charged fire extinguishers that meet the minimum requirements, smoke detectors, and a carbon monoxide detector. The center uses a clip board with children's names for parents to sign children in and out.

LPA and Site Director inspected the center for Health and Safety Hazards. There are no pools, spas or other bodies of water on the premises. Per the Site Director, there are no firearms or weapons in the center. Adequate first aid supplies are available. All cleaning supplies and other potentially harmful items are stored inaccessible to the children. Per Director, currently no children in care need medication. If there were, medications are stored in the cupboard inaccessible to children. Furniture and equipment are in good condition, free from loose, sharp or pointed parts. Children's toilets are in working order with adequate supplies. There is separate bathroom on site for adults. The food preparation area is clean and orderly. The center provides morning snack, lunch and afternoon snacks. Lunch is cater from outside vendor. Menus are posted in the center. All solid waste storage containers have tight fitting lids. Drinking water is provided with cups and filter water fountain.

LPA and Site Director also toured the outdoor play area for Health and Safety Hazards. LPA observed outdoor equipment is in good condition, free from loose, sharp or pointed parts. The play structure appears to be age appropriate for children in care. Areas under slides and other climbing equipment is adequately cushioned. Last Emergency Drill was conducted on 07/07/2022 and properly logged.

At 10:15am, A random sample of children's and staff’s files were reviewed and found to be complete. At least one staff have current Pediatric First Aid and CPR. Facility has posted all the required licensing forms in a prominent visible location.

CONTINUED>>>
SUPERVISOR'S NAME: Garfield LeungTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Winnie LyTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:
DATE: 10/07/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/07/2022
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: SAN FRANCISCO MONTESSORI ACADEMY
FACILITY NUMBER: 384002968
VISIT DATE: 10/07/2022
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This facility provides Incidental Medical Services-IMS. LPA reviewed storage of medication Per Director, currently no children in care need medication. Facility also has Incidental Medical Services Plan (IMS) on file. 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

Facility was also 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.

LPA discussed Child Abuse Mandated Training AB1207 with the Director. As of January 1, 2018 all staff will be required to complete Mandated Reporter Training every two years. The training can be obtained online at www.mandatedreporterca.com.

Pesticide regulations were discussed with the Director. In accordance with the Healthy Schools Act, California law requires that anyone using any pesticide must be trained every year in integrated pest management and the safe use of pesticides around children. The director was advised that a free one hour online course is available on the Department of Pesticide Regulation's Web site: www.cdpr.ca.gov/schoolipm/training. For questions, email ccipmlist@cdpr.ca.gov.

Director was also advised to reach out to San Bruno Regional Office for concern or questions. Desk Duty is available M-F, 8a.m.-5p.m. (650) 266-8800. Website for forms and regulations updates: www.cdss.cs.gov/inforesources/Community-Care-Licensing

An Exit Interview was conducted with Director. No deficiencies were issued today under Title 22 Division 12 of the California Code of Regulations. A copy of this report and appeal rights were discussed and left with Director whose signature on this form confirm receipt of these reports. Notice of Site Visit was provided. Notice to remain posted for 30 days. For updates on Licensing information, go to CCL website: www.ccld.ca.gov. For Provider Information Notice: ccld.ca.gov/PG5098.htm
SUPERVISOR'S NAME: Garfield LeungTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Winnie LyTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:

DATE: 10/07/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/07/2022
LIC809 (FAS) - (06/04)
Page: 2 of 2