<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 384004021
Report Date: 04/25/2023
Date Signed: 04/25/2023 01:51:48 PM


Document Has Been Signed on 04/25/2023 01:51 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:CREATIVE MONTESSORI PRESCHOOLFACILITY NUMBER:
384004021
ADMINISTRATOR:CHAN, MARYFACILITY TYPE:
850
ADDRESS:3101 VICENTE STREETTELEPHONE:
(415) 661-2828
CITY:SAN FRANCISCOSTATE: CAZIP CODE:
94116
CAPACITY:52CENSUS: 51DATE:
04/25/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:45 AM
MET WITH:Mary Chan and Nicole OlsenTIME COMPLETED:
02:00 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 April 25, 2023., Licensing Program Analyst (LPA) Van conducted an unannounced random annual inspection in conjunction with delivering the complaint findings. LPA met with Senior Directors Nicole Olsen and Mary Chan. The purpose of the inspection was explained to both Directors. This facility is a preschool program. Nine teachers, including the two Directors, supervised 51 children at the Center. The facility complies with the staff-children ratios today. The Hours of operation are Monday to Friday, 7:30 am to 6:00 pm.
LPA toured and inspected the physical plant with the Directors for potential health and safety hazards. The facility has an electronic sign-in /out for parents or authorized representatives; sign-in/out codes are provided to the parents. The Center operates on a large open floor partitioned into smaller pods/classrooms using book/storage shelves at waist height. Staff members are always able to see and hear children. LPA observed that each child has their cubbies available with their name labeled. The facility is in good repair and has proper temperature and ventilation. Classrooms have age-appropriate toys and learning materials. The furniture appears steady and in good repair. The facility has a carbon monoxide & smoke detector, fully charged fire extinguishers, and working telephones. First aid supplies are fully stocked and available for children's use. All cleaning solutions, poisons, and other dangerous chemicals are inaccessible to children. All toilets and handwashing sinks are in good working condition with proper sanitation. LPA observed no bodies of water on the premises.
The facility presently has an outdoor waiver granted by the Department to use the outdoor space allows no more than 23 preschool children at the time, and the rotational schedule is required.
Continued on page 2...
SUPERVISOR'S NAME: Garfield LeungTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Brendon VanTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:
DATE: 04/25/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/25/2023
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 3


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: CREATIVE MONTESSORI PRESCHOOL
FACILITY NUMBER: 384004021
VISIT DATE: 04/25/2023
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
26
27
28
29
30
31
32
 The outdoor play area is maintained clean and free of debris. The outdoor play area is completely fenced, clean, and in good repair. Outdoor play structures are in good condition, and free of loose parts, and soft cushioning is underneath all play structures to absorb accidental falls. LPA reminded the Director that the staff must ensure the playground is cleared of debris or harmful material before use.
Children's records and personnel records were reviewed during the inspection. The Center maintained thorough records of each child. Records include each child's authorized representative's names, addresses, and telephone numbers. In addition, each child's immunization record, medical assessment, and admission agreement can be located in each child's file. Staff records indicate that all staff or individuals requiring caregiver background checks have received criminal records and child abuse index clearances or exemptions. Multiple staff members have a record of valid CPR and Mandated Reporter training. All staff maintained immunization records. The Director stated that the Center conducts fire and earthquakes monthly and adequately documented; the last drills were completed on 4/24/2023.
The facility had posted the required forms. (i.e., License, waivers, Notification of Parent's Rights, Notification of Personal Rights, Car Seat Law, Emergency Disaster Plan, and Daily activities). The Center offers breakfast, lunch, and afternoon snacks to children. Waters are readily available for children indoors and outdoors. All storage containers for solid waste within the Center have a proper tight-fitting cover. 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 the publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm
Continued on page 3...
SUPERVISOR'S NAME: Garfield LeungTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Brendon VanTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:

DATE: 04/25/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/25/2023
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
SAN BRUNO CHILD CARE, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME: CREATIVE MONTESSORI PRESCHOOL
FACILITY NUMBER: 384004021
VISIT DATE: 04/25/2023
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
26
27
28
29
30
31
32
 The Director 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.
The Director was informed about 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, the Director 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.
No deficiencies were cited today. An exit interview was conducted, and the report was reviewed with the Directors, Mary Chan and Nicole Olsen. Today's report and site visit notice were provided to the Director. LPA informed the Director that the site visit notice must be posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.
SUPERVISOR'S NAME: Garfield LeungTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Brendon VanTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:

DATE: 04/25/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/25/2023
LIC809 (FAS) - (06/04)
Page: 3 of 3