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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 410504655
Report Date: 07/19/2019
Date Signed: 07/19/2019 01:44:50 PM

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:MORNING GLORY MONTESSORI SCHOOL, INC.FACILITY NUMBER:
410504655
ADMINISTRATOR:WISECARVER, JUNEFACILITY TYPE:
850
ADDRESS:2750 ADELINE DRIVETELEPHONE:
(650) 343-9627
CITY:BURLINGAMESTATE: CAZIP CODE:
94010
CAPACITY:30CENSUS: 21DATE:
07/19/2019
TYPE OF VISIT:Required - 3 YearUNANNOUNCEDTIME BEGAN:
11:45 AM
MET WITH:Jacqueline WisecarverTIME COMPLETED:
02:00 PM
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Licensing Program Analyst (LPA) Faye Bremer conducted an unannounced Annual Required inspection. LPA met with Teacher Jacqueline Wisecarver and explained purpose of inspection. This center is located on the Mercy High School Campus, on the ground floor of the high school. There were 21 children present and participating in circle time with 2 teachers during LPA's arrival. LPA inspected the playground with Teacher Jacqueline and observed a post of the fence to have come undone. Teacher Jacqueline informed LPA that the playground will be getting new tan-bark on August 5th, and that the post had come undone yesterday. Teacher Jacqueline puts the post back in as a temporary fix, but informs LPA that it will be fully repaired in August at the same time that the they will be receiving new tan-bark. LPA inspected the physical classroom area with Teacher Jacqueline and observed the facility to be clean, safe and orderly. Carbon monoxide detector, smoke detector, and fully charged fire extinguisher was present. Program provides snacks, but children bring their lunches. This is a half-day program, with the center open during the summer from 9am-1pm. Children do not take naps at the center. Disaster Drills are conducted and logged, last conducted April 29, 2019. The center discipline policy is redirection and communication.

LPA reviewed staff files and children's files. Children's files have all required assessments, agreements, and medical records. No children are taking medications. Staff files are current and complete, with all required trainings. Staff are all fingerprint cleared and associated to the program. Teacher Jacqueline informs LPA that she is currently working on becoming the Director of the program. LPA informs Teacher Jacqueline to submit copies of all documentation to CCL within 30 days of the change.

LPA received copies of the updated lease agreement, and facility sketch.

Continued on following page.
SUPERVISOR'S NAME: Alma MaligTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Faye BremerTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:

DATE: 07/19/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/19/2019
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: MORNING GLORY MONTESSORI SCHOOL, INC.
FACILITY NUMBER: 410504655
VISIT DATE: 07/19/2019
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Continued from previous page.

Facility is not currently providing Incidental Medical Services. 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.

No Deficiencies cited during today's inspection.
Report reviewed, discussed and copy provided.
SUPERVISOR'S NAME: Alma MaligTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Faye BremerTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:

DATE: 07/19/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/19/2019
LIC809 (FAS) - (06/04)
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