414001981-10-18-2022-05-CC-MROZ-CKC27L-20221018170855

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 414001981
Report Date: 10/18/2022
Date Signed: 10/18/2022 05:09:03 PM

Document Has Been Signed on 10/18/2022 05:09 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:	KINDER ACADEMY MONTESSORI		FACILITY NUMBER:	414001981
ADMINISTRATOR:	MA, SOPHIA SHAN		FACILITY TYPE:	850
ADDRESS:	300 E. SANTA INEZ AVENUE		TELEPHONE:	(650) 340-8819
CITY:	SAN MATEO	STATE: CA	ZIP CODE:	94401
CAPACITY:	24	CENSUS: 7	DATE:	10/18/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	02:00 PM
MET WITH:	Sophia Ma		TIME COMPLETED:	05:30 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	Licensing Program Analysts (LPAs) Marie Rodriguez and Maria Olguin-Leon conducted an unannounced annual inspection. LPAs met with Licensee and Director Sophia Ma and explained purpose of inspection. Present at the facility were the Director, two teachers, and seven preschool aged children. Center is operating within capacity limits and in compliance with staff to child ratio. Hours of operation are Monday to Friday from 8:30am to 5:30pm. Center provides a half day and a full day program. LPAs inspected indoor and outdoor areas of school with Director. There are no bodies of water, firearms, or weapons on the premises. Both classrooms in center are in good condition with proper temperature and ventilation and are free of any hazards. Furniture in classrooms are in good repair. Classrooms have age appropriate toys and equipment. Each classroom has a wall heater that is properly barricaded. Napping mats are in good condition and are properly stored in main classroom. There are two bathrooms adjacent to main classroom. The boys bathroom has one toilet, urinal, and sink. The girls bathroom has one toilet and sink. Bathrooms appear to be clean, in good repair, and free of any hazards. There is a separate bathroom for staff usage in the adjoining church. The outdoor play area is fenced for supervision with age appropriate toys and equipment in good condition. The play structure is age appropriate and in good condition with sufficient cushioning underneath. All required postings and waiver are posted on the bulletin board by the main classroom. Menu is posted for the month. Center only provides morning and afternoon snacks. Children bring their own lunch. Drinking water is available for children indoors and outdoors. Food preparation area is clean and free of any toxins or contamination. All food is properly stored to avoid contamination. All storage containers for solid waste have a proper lid. All cleaning products, chemicals, and toxins are inaccessible to children.

SUPERVISOR'S NAME: Daniel J Oquendo	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Marie Rodriguez	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 10/18/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/18/2022

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
CCLD Regional Office, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME: KINDER ACADEMY MONTESSORI	FACILITY NUMBER: 414001981
	VISIT DATE: 10/18/2022

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
26
27
28
29
30
31
32

Last emergency drill was conducted on September 30, 2022. Emergency drills are conducted every other month and are properly logged. Paper sign-in/out sheets are located inside a binder at the entrance of the school. The center has a complete paper record of sign-in/out sheets by authorized pickup person. There is a working fire alarm and sprinkler system throughout the center. A carbon monoxide detector and a fully charged fire extinguisher is in each classroom and a working telephone is available on-site.

Seven children records reviewed were complete. All children have a record of emergency identification information on file. Three staff records reviewed were complete. All staff have a criminal record clearance on file. Staff have a current pediatric first aid/CPR certificate that expires March 2024.

No deficiencies cited today under California Code of Regulations, Title 22, Division 12.

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 (US DOJ) 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.

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.

Licensee 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.

SUPERVISOR'S NAME: Daniel J Oquendo	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Marie Rodriguez	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 10/18/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/18/2022

LIC809 (FAS) - (06/04)

Page: 2 of 3

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: KINDER ACADEMY MONTESSORI	FACILITY NUMBER: 414001981
	VISIT DATE: 10/18/2022

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
26
27
28
29
30
31
32

LPAs discussed the safe sleep regulations with Licensee 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. LPAs also informed 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.

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 was conducted and report was reviewed with Licensee Sophia Ma.

SUPERVISOR'S NAME: Daniel J Oquendo	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Marie Rodriguez	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 10/18/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/18/2022

LIC809 (FAS) - (06/04)

Page: 3 of 3