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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 410503311
Report Date: 09/20/2023
Date Signed: 09/20/2023 04:01:08 PM


Document Has Been Signed on 09/20/2023 04:01 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 CC RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066



FACILITY NAME:MILLBRAE NURSERY SCHOOL, INCFACILITY NUMBER:
410503311
ADMINISTRATOR:BOGNI-RODRIGUEZ, BRIGIDANFACILITY TYPE:
850
ADDRESS:86 CENTER ST.TELEPHONE:
(650) 589-3028
CITY:MILLBRAESTATE: CAZIP CODE:
94030
CAPACITY:44CENSUS: 29DATE:
09/20/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
11:10 AM
MET WITH:Director, Brigidan Bogni-Rodriguez and SIte Supervisor, Megan Bogni-RodriguezTIME COMPLETED:
04:20 PM
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On September 20th, 2023 at approximately 11:10AM, Licensing Program Analyst (LPA) Tapia-Mandujano conducted an unannounced, annual, required inspection, as well as Case Management-licensee initiated inspection. LPA was granted entrance by Site Supervisor, Megan Bogni-Rodriguez. Facility has requested to add a toddler option to the preschool license. During today's inspection, LPA received an updated licensing application. Facility has requested to have a group of 12 toddlers.

Present in the facility are Site Supervisor, 7 staff and 3 parent volunteer supervising a total of 29 preschool age children. Facility is operating within its capacity and is in compliance with staff/child ratio on this day. All adults working at the facility have fingerprint clearance and are associated.

Facility is approved to operate in two classrooms, which are separated by age. Facility has designated outdoor area. Outdoor areas that require an adult supervision will be the chicken coop, gated swing area, and the bunny hutch. Facility operates according to the School year with periodic breaks/holidays throughout the year. Facility operates day care from Monday - Friday 8am-6pm.

Once the toddler option is approved, facility will have the smaller room be dedicated for the toddler room to not exceed 12 children ages 18 months to 36 months. The bigger classroom will be designated for the preschool age children. There are two bathrooms with two sink available for children in each classroom. Outdoor area will be used in rotation so there is no comingling of toddler and preschool age children. During toddler use of the outdoor area, toddlers will be allowed to use the "grass area", "bike trail/cement area", and the left of the outdoor yard which contains age-appropriate materials. LPA measured the small room to measure 540.691sqft. allowing for 15 children, and the bigger room to measure 1,065.780 allowing for 30 children.

LPA observed classrooms to be clean and equipped with age appropriate toys and materials. Storage for children's belongings are located inside the classrooms, labeled with each child's individual names. LPA observed facility has an installation of a fire alarm system inside the classrooms as well as a fully charged, fire extinguisher. The classrooms has a smoke and carbon monoxide detector installed as well as emergency kits with first aid materials and emergency contact information. LPA observed that medication is stored appropriately, inaccessible to enrolled children and maintained with proper documentation.

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SUPERVISOR'S NAME: Marie RodriguezTELEPHONE: (650) 732-0619
LICENSING EVALUATOR NAME: Leslit Tapia-MandujanoTELEPHONE: 650-266-8800
LICENSING EVALUATOR SIGNATURE:
DATE: 09/20/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/20/2023
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 CC RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME: MILLBRAE NURSERY SCHOOL, INC
FACILITY NUMBER: 410503311
VISIT DATE: 09/20/2023
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All poisons, cleaning solutions and hazardous materials are stored inaccessible to children in off limit areas or facility high shelves. Facility offers all food for children. Filtered water is available to children indoors and outdoors. Outdoor area appears to be clean and orderly. There are a variety of outdoor equipment that are in good working condition. There is also shading area available outside. Children are signed in and out of facility with parents' signatures daily through Brightwheel. Facility has license documentation and information properly posted and available for review in the entryway.

LPA reviewed facility records that included 5 children's records and 5 staff records. LPA observed children's and staff's records to be complete. There is at least one staff that have an up to date CPR & First Aid certificate. All staff have Mandated Reporter Certificate. Last emergency drill was conducted 07/2023. Emergency drills are conducted at least once every six months and are properly logged and documented.

Facility representative was reminded that all adults 18 and over, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a Child Care Center. A civil penalty of $100.00 minimum/day for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.

Facility was 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.

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 certificate on file. LPA encourages the director to frequently visit our website at www.ccld.ca.gov for licensing regulations and new updates.

LPA discussed the safe sleep regulations with facility representative and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed licensee [or facility representative] of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

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SUPERVISOR'S NAME: Marie RodriguezTELEPHONE: (650) 732-0619
LICENSING EVALUATOR NAME: Leslit Tapia-MandujanoTELEPHONE: 650-266-8800
LICENSING EVALUATOR SIGNATURE:

DATE: 09/20/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/20/2023
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
SAN BRUNO CC RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME: MILLBRAE NURSERY SCHOOL, INC
FACILITY NUMBER: 410503311
VISIT DATE: 09/20/2023
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Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02-CCP. 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) or (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA are available at: https://www.ada.gov/resources/child-care-centers/. Facility will be submitting an IMS plan to the department.

Assembly Bill (AB) 2370, Chapter 676, Statutes of 2018, requires all licensed Child Care Centers (CCCs) constructed before January 1, 2010, to test their water (used for drinking and food preparation) for lead contamination before January 1, 2023, and then every 5-years after the date of the first test. LPA verified that the lead testing was completed in accordance to the Written Directives outlined in PIN 21-21.1-CCP. LPA received copies of lead results and LIC forms during this inspection.

Facility representative was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

Prior to approval of toddler option, the following must be completed and reviewed by the department:
*Fire Clearance Approval
*Form that acknowledges parents that child would be enrolled in toddler program
*Toddler room set up with age appropriate toys and materials

Based on today's inspection, deficiencies were not observed, according to California Title 22, Health and Safety Code of Regulations.

A notice of site visit was given and must remain posted for 30 days.



Exit interview conducted and report was reviewed with Director, Brigidan Bogni-Rodriguez and Site Supervisor, Megan Bogni-Rodrigiez.
SUPERVISOR'S NAME: Marie RodriguezTELEPHONE: (650) 732-0619
LICENSING EVALUATOR NAME: Leslit Tapia-MandujanoTELEPHONE: 650-266-8800
LICENSING EVALUATOR SIGNATURE:

DATE: 09/20/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/20/2023
LIC809 (FAS) - (06/04)
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