414000798-7-21-2022-05-CC-CQUO-CGJSWT-20220721141449

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 414000798
Report Date: 07/21/2022
Date Signed: 07/21/2022 02:15:31 PM

Document Has Been Signed on 07/21/2022 02:15 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
CCLD Regional Office, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME:	SAN MATEO MONTESSORI		FACILITY NUMBER:	414000798
ADMINISTRATOR:	TINA PROZELL		FACILITY TYPE:	850
ADDRESS:	15 - 14TH AVENUE		TELEPHONE:	(650) 571-5095
CITY:	SAN MATEO	STATE: CA	ZIP CODE:	94402
CAPACITY:	21	CENSUS: 21	DATE:	07/21/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	12:10 PM
MET WITH:	Tina Prozell		TIME COMPLETED:	02:30 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 July 21, 2022 at approximately 12:10pm, Licensing Program Analyst (LPA) Catrina Quimbo conducted an unannounced, annual inspection. LPA met with director, Tina Prozell, and explained the purpose of the inspection. Present during inspection included 5 staff members (including director) and 21 enrolled children (preschool age). Facility is operating within capacity limits and ratios at time of LPA's visit. Hours of operation are Monday to Friday 7:30am to 5:30pm. Facility is a multi-level building with two floors. Program operates on first floor only. Second floor is for staff purpose only and is off limits. Facility operates as a Montessori program. LPA inspected day care areas, indoors and outdoors, for health and safety hazards. LPA observed day care areas to be clean, equipped with age appropriate toys, materials and furniture. Day care area includes a fireplace that is properly barricaded and made inaccessible to children in care. Storage for children's belongings are properly labeled with each child's individual names. Facility is equipped with multiple smoke detectors, carbon monoxide detector, fully charged fire extinguisher, and first aid kit. LPA observed all poisons, cleaning solutions and hazardous materials to be stored inaccessible to children behind child safety locked cabinets or stored in facility's high shelves cabinets. LPA observed bathrooms used for day care use to be clean and in proper working condition. Children's sinks do not provide water that is warmer than 120 degrees Fahrenheit. Appropriate sanitation products are properly placed next to accessible sinks. Garbage cans have tight fitting lids. Facility does not currently provide a food service. Enrolled children supply their own food that is packaged and stored in children's cubbies, labeled with each child's individual names. Water is available to children indoors and outdoors with children's water bottles that can be refilled in facility. (Continue Report on Page 2...)

SUPERVISOR'S NAME: Cindy Interiano	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Catrina Quimbo	TELEPHONE: 650-266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 07/21/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/21/2022

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: SAN MATEO MONTESSORI	FACILITY NUMBER: 414000798
	VISIT DATE: 07/21/2022

NARRATIVE

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Outdoor area was observed to be equipped with age appropriate materials that were in good working condition. LPA observed sandbox to be clean and properly maintained. Outdoor area includes age appropriate play structures that have resilient padding underneath. LPA did not observe any pools, spas or bodies of water in the outdoor area. Entire backyard is properly fenced and has sufficient shading.

Children are signed in and out of facility by front entrance. At time of LPA's inspection, all children had been properly signed in. Facility has license documentation and information properly posted and available for review in main entrance of facility.

LPA reviewed facility records that included 10 children's records, 5 staff records (whom were present during inspection). LPA observed children's and staff's records to be complete. Multiple staff members on site have a valid, CPR certificate that will expire 08/2022. Per director, renewal course for CPR will take place prior to expiration date. Last emergency drill was conducted 04/25/2022. Emergency drills are conducted monthly and are properly documented and logged.

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

Director was reminded that all adults 18 and over, including employees and volunteers, 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 up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

To improve the quality and value of the new inspection process, a survey will 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 tools, please send them by email 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.

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SUPERVISOR'S NAME: Cindy Interiano	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Catrina Quimbo	TELEPHONE: 650-266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 07/21/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/21/2022

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: SAN MATEO MONTESSORI	FACILITY NUMBER: 414000798
	VISIT DATE: 07/21/2022

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This facility provides Incidental Medical Services – IMS. LPA reviewed storage of medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. 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

No deficiencies were issued under CCR, Title 22, Division 12.

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

Exit interview conducted and report was reviewed with director, Tina Prozell.

SUPERVISOR'S NAME: Cindy Interiano	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Catrina Quimbo	TELEPHONE: 650-266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 07/21/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/21/2022

LIC809 (FAS) - (06/04)

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