410502913-12-19-2019-05-CC-ACON-BK22KE-20191219162750

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 410502913
Report Date: 12/19/2019
Date Signed: 12/19/2019 04:28:02 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 SCHOOL OF LINDA MAR, INC.		FACILITY NUMBER:	410502913
ADMINISTRATOR:	ROSALES, M. DOLORES		FACILITY TYPE:	850
ADDRESS:	1666 HIGGINS		TELEPHONE:	(650) 355-7272
CITY:	PACIFICA	STATE: CA	ZIP CODE:	94044
CAPACITY:	75	CENSUS: 55	DATE:	12/19/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	02:30 PM
MET WITH:	Kirk Rosales		TIME COMPLETED:	04:50 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 12-19-19 at 2:30, Licensing Program Analyst (LPA) April Cowan met with school administrator for a random annual inspection. Purpose of the inspection was explained. Present, in the facility are school administrator, 5 staff, and 55 children in care. Facility is operating within the capacity and is in compliance with staff / child ratio on this day. Facility operates day care from Monday to Friday from 07:30 AM to 05:30 PM. With school administrator, LPA inspected the day care rooms and play yard. LPA observed facility has 2 carbon monoxide detector, 2 fully charged fire extinguisher, and working telephone on site. At 3:00, smoke alarms were unable to be tested. LPA observed that it was unclear how to test smoke detectors. All cleaning solutions, poisons and other chemicals dangerous to the children are stored inaccessible to the children. Facility has age appropriate furniture. Furniture is steady and in good repair. Facility has a sufficient amount of cribs and sleeping matts available. Facility floor is in good repair and free of any hazards. There are first aid supplies available in the center. All hand washing facilities are in working condition with proper sanitation in place. See next page for continuation .........

SUPERVISOR'S NAME: Garfield Leung	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: April Cowan	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 12/19/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/19/2019

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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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: MONTESSORI SCHOOL OF LINDA MAR, INC.	FACILITY NUMBER: 410502913
	VISIT DATE: 12/19/2019

NARRATIVE

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All storage containers for solid waste are in good repair and have proper lids. All food is stored in a properly manner and has lids to avoid contamination. Bottles and other items provided by the parents are labeled and stored appropriately. Food preparation area is free of litter. Food is stored adequately to prevent contamination. Play yard is free of hazards. There is a sufficient amount of cushion material in the play yard to help absorb the impact of falls.
At 3:30 PM, LPA reviewed the facility records. LPA observed that facility is using electronic sign in / out and has waiver posted. LPA obtained a print out of Sign-in/Sign-out information. Facility has license and all of the other required documents posted and visible for the public. LPA reviewed 5 random children's and 3 random staff's files. There are menus posted at least one week in advance and are visible to the child's authorized representative. Director is aware that all staff is required to complete Mandated Reporter Training every two years. The training can be obtained online at www.mandatedreporterca.com. LPA observed the completion certificates on file. LPA encourages the director to frequently visit our website at www.ccld.ca.gov for licensing regulations and new updates.
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. 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
See next page for continuation .........

SUPERVISOR'S NAME: Garfield Leung	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: April Cowan	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 12/19/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/19/2019

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: MONTESSORI SCHOOL OF LINDA MAR, INC.	FACILITY NUMBER: 410502913
	VISIT DATE: 12/19/2019

NARRATIVE

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>No deficiencies were cited today under CCR, Title 22, Division 12, Chapter 3.

This report must be available in the facility for public review. Notice of site visit was observed being posted. Director was advised any additional questions to call Office, M-F, 8am-5pm, 650-266-8800 or 1-844-538-8766. Website: www.cdss.ca.gov

The copy of this report is reviewed and provided to the director. Notice of site visit is posted and shall remain posted for next 30 days.

SUPERVISOR'S NAME: Garfield Leung	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: April Cowan	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 12/19/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/19/2019

LIC809 (FAS) - (06/04)

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