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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 414001945
Report Date: 05/15/2023
Date Signed: 05/15/2023 04:26:45 PM


Document Has Been Signed on 05/15/2023 04:26 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 CHILD CARE, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066



FACILITY NAME:LAKEVIEW MONTESSORIFACILITY NUMBER:
414001945
ADMINISTRATOR:BRAMHE, SHEILAFACILITY TYPE:
850
ADDRESS:1950 BEACH PARK BLVD.TELEPHONE:
(650) 578-9532
CITY:FOSTER CITYSTATE: CAZIP CODE:
94404
CAPACITY:42CENSUS: 25DATE:
05/15/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
11:32 AM
MET WITH:Maria ArandaTIME COMPLETED:
04:50 PM
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On May 15, 2023, Licensing Program Analyst (LPA)Olguin-Leon conducted an unannounced annual inspection at Lakeview Montessori. LPA met with lead teacher, Maria Aranda and purpose of visit was explain. Facility is a preschool program center with a toddler option. During today’s visit there are 25 children with lead teacher and 4 staff. Director Sheila Bramhe arrived at approximate 12:30 PM. Children's capacity and ratio requirements were observed to be in compliance. Hours of operation are Monday-Friday 8:30 AM- 5:30 PM

LPA and site director toured the facility for health and safety hazards. Facility is composed of two main classrooms: one is a preschool classroom and the other the toddler classroom. Facility is clean with proper ventilation. There are plenty of age-appropriate toys, furniture and learning materials all in good repair. Cubbies are available for children to store personal items and belongings. There is one restroom with three toilets and three sinks available for washing hands. There is no hot water in children’s sinks. There is a changing table outside restrooms for diaper changing. There is a separate bathroom for staff usage on the premises. Facility has sufficient sleeping mats for all children. The outdoor play area is fenced for supervision with age-appropriate toys and equipment in good condition. Outdoor flooring consists of square rubber mats to cushion falls. At approx. 12:10, LPA observed the square mats to have gaps between mats, which can be a tripping hazard. At approx. 12:20 PM, LPA observed broken wood trim on building with sharp edges, which is a safety hazards, two technical violations were issued. LPA reminded Director to clean and remove broken toys outdoors. Playground is surrounded with a 5 ft. fence. There are no pools or bodies of water. Per Director, there are no weapons or firearms on the premises.

The facility provides Lunch and 2 snacks to the children. The food is prepared on site. Kitchen is clean and inaccessible to children. Food is stored properly for freshen and non-contamination. Menu is posted in kitchen and all the classrooms. Children have their own labeled water bottles to use inside or outside.

Cont. page 2
SUPERVISOR'S NAME: Ali ZebilaTELEPHONE: (650) 266-8817
LICENSING EVALUATOR NAME: Maria Olguin-LeonTELEPHONE: 650-266-8800
LICENSING EVALUATOR SIGNATURE:
DATE: 05/15/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/15/2023
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 CHILD CARE, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME: LAKEVIEW MONTESSORI
FACILITY NUMBER: 414001945
VISIT DATE: 05/15/2023
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LPA reminded Director of keeping sleeping logs for children under the age of 2 yrs. old. No record of water lead testing was available. Director will complete water testing, LPA emailed Director PINs with directives and certified testers. Type B deficiency issued today.

Incidental Medical Services were discussed per Site Director they are not currently providing these services, as no children are on medications. There are first aid kits available in the classroom with plenty of medical supplies. Isolation area for sick children is in the office/reception area. All storage containers for solid waste have a proper lid. All cleaning products, chemicals, and toxins are inaccessible to children. LPA observed parent sign in/out sheet for complete signatures. A fully charged fire extinguisher, smoke detector, carbon monoxide detector, and a working telephone available on site.

LPA reviewed 5 children’s records and 5 staff records. All the children's records were complete. Facility has posted the required forms (i.e., License, menus, Notification of Parent's Rights, Notification of Personal Rights, Car Seat Law (updated), and Emergency Disaster Plan). There is a least one staff current with First Aid/CPR certification. Site Director states Fire and Earthquake drills are done each month, last drill was conduct 04/17/2023.

Director was reminded that all adults 18 and over living or working in the home, 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 licensed Family Child Care Home. 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.

The Director was reminded about the Provider Information Notices (PINs) on the CCLD website. Director was informed that as of September 1, 2016, a person may not be employed or volunteer at a childcare 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.

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SUPERVISOR'S NAME: Ali ZebilaTELEPHONE: (650) 266-8817
LICENSING EVALUATOR NAME: Maria Olguin-LeonTELEPHONE: 650-266-8800
LICENSING EVALUATOR SIGNATURE:

DATE: 05/15/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/15/2023
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 CHILD CARE, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME: LAKEVIEW MONTESSORI
FACILITY NUMBER: 414001945
VISIT DATE: 05/15/2023
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As of January 1, 2018, all staff must complete Mandated Reporter Training every two years. The training can be obtained online at www.mandatedreporterca.com.

LPA encouraged the Director to frequently visit our website at www.ccld.ca.gov for licensing regulations and new updates.

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/process.

The following Type B violations (potential health, safety, or personal rights risk to children in care.) was cited for today’s visit:

1. Health and Safety Code 1597.16(a)(1)- A licensed child day care center, as defined in Section 1596.76, that is located in a building that was constructed before January 1, 2010, shall have its drinking water tested for lead contamination levels on or after January 1, 2020, but no later than January 1, 2023, and every five years after the date of the initial test.

**The department may clear all violations after the review of the facilities’ Plan of Correction**

A notice of site visit was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.



Exit interview conducted and report was reviewed with the Site Director, Sheila Bramhe.

SUPERVISOR'S NAME: Ali ZebilaTELEPHONE: (650) 266-8817
LICENSING EVALUATOR NAME: Maria Olguin-LeonTELEPHONE: 650-266-8800
LICENSING EVALUATOR SIGNATURE:

DATE: 05/15/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/15/2023
LIC809 (FAS) - (06/04)
Page: 3 of 11
Document Has Been Signed on 05/15/2023 04:26 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN BRUNO CHILD CARE, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066


FACILITY NAME: LAKEVIEW MONTESSORI
FACILITY NUMBER: 414001945

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/15/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
HSC
1597.16(a)(1)
Lead Testing
(1) A licensed child day care center, as defined in Section 1596.76, that is located in a building that was constructed before January 1, 2010, shall have its drinking water tested for lead contamination levels on or after January 1, 2020, but no later than January 1, 2023, and every five years after the date of the initial test.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on interview, the licensee did not comply with the section cited above ,which poses a potential health, safety or personal rights risk to children in care.
POC Due Date: 06/15/2023
Plan of Correction
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Director will provide a complete LEAD water report from an approved vendor by the above due date.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME: Ali ZebilaTELEPHONE: (650) 266-8817
LICENSING EVALUATOR NAME: Maria Olguin-LeonTELEPHONE: 650-266-8800
LICENSING EVALUATOR SIGNATURE:
DATE: 05/15/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/15/2023
LIC809 (FAS) - (06/04)
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