410509651-6-7-2024-05-CC-ZBAK-D5ZRQP-20240607131351

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 410509651
Report Date: 06/07/2024
Date Signed: 06/07/2024 01:14:13 PM

Document Has Been Signed on 06/07/2024 01:14 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 MONTESSORI SCHOOL, INC.		FACILITY NUMBER:	410509651
ADMINISTRATOR:	PERRY, C. & PERRY, N.		FACILITY TYPE:	850
ADDRESS:	797 SANTA MARGARITA AVENUE		TELEPHONE:	(650) 588-2229
CITY:	MILLBRAE	STATE: CA	ZIP CODE:	94030
CAPACITY:	60	CENSUS: 17	DATE:	06/07/2024
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	10:30 AM
MET WITH:	Nichole Perry		TIME COMPLETED:	01:30 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 June 7, 2024, Licensing Program Analysts (LPAs) Basak and Ly met with the director, Nicholle Perry, for an unannounced, annual inspection. The purpose of the inspection was explained, and the director granted LPAs entry to the facility. Upon entering the facility, LPAs observed 3 teachers supervising 17 preschool children. The facility is within the capacity and complies with the staff-child’s ratios today. LPAs verified the staff members' criminal records during the inspection with the CDSS Guardian Background Check site. The Center uses only one large classroom during the time inspection conducted. There are hooks by the classroom entrance for children's belonging. The classroom using book/storage shelves at waist height. Staff members are always able to see and hear children. The hours of operation are Monday through Friday from 8:00 a.m. to 3:00 p.m. LPAs and the director thoroughly examined the physical plant to identify potential health and safety hazards. The center has sign-in and out binder for parents. Upon review, the record showed that all parents' signatures matched and accounted for the number of children present. The facility was observed in good shape, and the temperature and ventilation levels appear appropriately maintained. Each classroom is furnished with age-appropriate toys and educational materials. The furniture looks sturdy and well-maintained. LPAs did not observe any hazardous item or chemical in children's reach. See Page 2

SUPERVISOR'S NAME: Daniel J Oquendo	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Zeynep Basak	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 06/07/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/07/2024

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
SAN BRUNO CC RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME: MILLBRAE MONTESSORI SCHOOL, INC.	FACILITY NUMBER: 410509651
	VISIT DATE: 06/07/2024

NARRATIVE

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LPA's observed the facility has multiple fully charged fire extinguishers with 2A 10 BC specifications and a functioning telephone. The Center also has a smoke alarm and a carbon monoxide detector. Emergency supplies are stored in locked storage, and first aid supplies are fully stocked and available for children's use.

LPA's observed all hazardous materials, including cleaning solutions and disinfectants, are stored in a locked storage room, which is inaccessible to children. There were no child required medications at that time.
LPA's observed all toilets and handwashing sinks are in good working condition and have proper sanitation. LPAs observed no bodies of water on the premises.

The facility presently has an outdoor waiver granted by the Department allowing to share and rotate with the other facility. The outdoor waiver was observed posted.

During the inspection, LPA's reviewed records of children and personnel. The records for each child were complete in the file, including emergency cards and immunization records. Each child's file also contains the medical assessment and admission agreement. LPA's reviewed the qualifications of the staff members and confirmed that everyone had completed the required ECE units, mandated reporter training, and valid Pediatric First Aid CPR.
LPA's confirmed with the Director, that the Center conducts its fire and earthquake drills at least once in six months. The most recent drill was completed on April 2024.

LPA observed the facility had posted the required forms. (i.e., License, Notification of Parent's Rights, Notification of Personal Rights, Car Seat Law, Emergency Disaster Plan, and Daily activities). The director stated that the center provides morning snacks to children. The facility also has a filter water pitcher for children to refill indoors and outdoors. All storage containers for solid waste within the center have a proper tight-fitting cover.
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SUPERVISOR'S NAME: Daniel J Oquendo	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Zeynep Basak	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 06/07/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/07/2024

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 MONTESSORI SCHOOL, INC.	FACILITY NUMBER: 410509651
	VISIT DATE: 06/07/2024

NARRATIVE

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The Director 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.

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

The Director was informed about Mandated Reporter training AB 1207. The Mandated Reporter AB 1207 training must be completed every two years by the Licensee and for all staff hired. 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
The Director was informed of the MyChildCarePlan.org website, a consumer education website that helps families obtain childcare by connecting them to childcare providers and Resource and Referral Agencies (R&Rs) throughout California.

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.

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SUPERVISOR'S NAME: Daniel J Oquendo	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Zeynep Basak	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 06/07/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/07/2024

LIC809 (FAS) - (06/04)

Page: 3 of 4

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 MONTESSORI SCHOOL, INC.	FACILITY NUMBER: 410509651
	VISIT DATE: 06/07/2024

NARRATIVE

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To improve the quality and value of the new inspection process, a survey may 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 CARE tools, please send email inquiries 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/inspection-process

A notice of site visit was given to the director, and it must remain posted on, or immediately adjacent to, the interior side of the main door for 30 days.

SUPERVISOR'S NAME: Daniel J Oquendo	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Zeynep Basak	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 06/07/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/07/2024

LIC809 (FAS) - (06/04)

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