410503311-2-21-2020-05-CC-JSAI-BLZQ9R-20200221105847

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 410503311
Report Date: 02/21/2020
Date Signed: 02/21/2020 10:58:53 AM

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:	MILLBRAE NURSERY SCHOOL, INC		FACILITY NUMBER:	410503311
ADMINISTRATOR:	BOGNI-RODRIGUEZ, BRIGIDAN		FACILITY TYPE:	850
ADDRESS:	86 CENTER ST.		TELEPHONE:	(650) 589-3028
CITY:	MILLBRAE	STATE: CA	ZIP CODE:	94030
CAPACITY:	44	CENSUS: 7	DATE:	02/21/2020
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	08:15 AM
MET WITH:	Bogni- Rodrigues, Brigidan		TIME COMPLETED:	11:10 AM

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

Licensing Program Analyst( LPA) Jyoti Saini met with Director Brigidan Bogni Rodriguez . The purpose of the visit was explained and is for an annual inspection. Program operates year-round and uses 2 classrooms, and outdoor play areas. Hours of operation are Monday- Friday 8:00am- 5:30pm. At 8:20am, LPA observed, Director and 3 staff supervising 7 children. Children continued to be dropped off during the visit. LPA Saini observed licensing forms are posted next to the main door. At 8:25am, LPA and Director of the Facility inspected indoor areas for Health and Safety hazards. Classrooms clean, orderly and equipped with age appropriate toys, puzzles, blocks, books and equipment that are in good repair. Each classroom has an art area and child size tables and chairs available for the children. There are children’s bathroom located in each of the two classes. Each of the children’s restroom is equipped with 2 child size toilets and 2 child size sinks and diaper changing station. Bathrooms are maintained clean, in good repair, and with adequate supplies. Staff uses a separate restroom and maintained inaccessible to the children in the care. Hooks and Cubbies are available for children's belongings. Facility is equipped with a smoke detector, carbon monoxide detector and a fire extinguisher. Facility has first aid kit and emergency supplies that are properly maintained and kept inaccessible to children. All cleaning products, detergents and toxins are maintained inaccessible to children.Emergency drills are done monthly, with the last drill conducted on 12-04-2019 @ 12:30pm, properly logged. At 8:40am, LPA Saini inspected outdoor play areas for safety hazards and dangerous conditions. Entire outdoor area is enclosed with gated fencing. Drinking water is readily available indoors and outdoors children.

At 9:15am, LPA Saini reviewed, Children’s files during today’s inspection. LPA Saini observed children's files are complete and up-to date. At 9:45am. LPA reviewed staff files. As per record review, Teachers working in the classroom have current certification of CPR /1st aid, expiring in 08/2020. Staff have documentation of required immunization (measles, pertussis and influenza). Each staff member have completed Mandated reporter training and Pest management training certification.

SUPERVISOR'S NAME: Alma Malig	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Jyoti Saini	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 02/21/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/21/2020

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: MILLBRAE NURSERY SCHOOL, INC	FACILITY NUMBER: 410503311
	VISIT DATE: 02/21/2020

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

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

Director was reminded 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.

Director was informed about the Provider Information Notices (PINs) on CCLD website.

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

This report and rights to comment and appeal were discussed with director Bogni. This report must be available in the facility for public review.
Notice of site visit posted and shall remain posted for 30 days.

SUPERVISOR'S NAME: Alma Malig	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Jyoti Saini	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 02/21/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/21/2020

LIC809 (FAS) - (06/04)

Page: 2 of 2