414002467-5-9-2019-05-CC-GSIH-BBZV7L-20190509161120

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 414002467
Report Date: 05/09/2019
Date Signed: 05/09/2019 04:11:25 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:	BERESFORD MONTESSORI		FACILITY NUMBER:	414002467
ADMINISTRATOR:	ANA CARDENAS		FACILITY TYPE:	850
ADDRESS:	1717-1719 GUM STREET		TELEPHONE:	(650) 571-8749
CITY:	SAN MATEO	STATE: CA	ZIP CODE:	94402
CAPACITY:	41	CENSUS: 36	DATE:	05/09/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	01:35 PM
MET WITH:	Karina Garcia-Barbera		TIME COMPLETED:	03:30 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 Analyst (LPA) Singh met with the owner, Karina Garcia-Barbera, for a random annual inspection. Purpose of the inspection was explained. Present, there are 36 children in care with seven teachers, director and the owner. Facility is operating with in the capacity and in compliance with staff child ratio on this day. Facility operates from 8:30 AM to 5 PM. With the owner, LPA inspected the day care areas. There are no pools, spas or other bodies of water at the facility. Facility has smoke detector, carbon monoxide detector, fully charged fire extinguisher and working telephone at the site. All of the cleaning solutions, poisons and other chemicals that are dangerous to the children are stored inaccessible to the children. Facility has age appropriate furniture. All furniture has round corners. Furniture is steady and in good repair. Facility floor is in good repair and free of any hazards. All toilets, hand washing facilities are in working condition with proper sanitation in place. All storage containers for solid waste and in good repair and have proper lid on top. Facility provides the snacks to the children in care. Food preparation area is barricaded and free of any litter. LPA inspected the play yard. Play yard has shaded area and age appropriate play structure. Play structure is steady, free of any loose parts and in good repair. There are cushion pads under the play structure to prevent any fall injury. Per owner, staff members bring the drinking water in a jug while children are present in the play yard. At 2:50 PM, LPA reviewed the facility records. LPA observed that facility has sign in / out record with full legal signatures. LPA reviewed ten random children's and five staff's files. LPA observed facility has record of names, addresses and telephone numbers of each child's authorized representative. Facility has record of immunization of each staff. LPA reviewed the educational qualification of all the teachers. All staff members has valid CPR card until February 2020. LPA observed staff files have record of staff immunization. The facility has fire drill log. Per the log, last drill was conducted on January 17, 2019. See next page for continuation ..............

SUPERVISOR'S NAME: Alma Malig	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Gagandeep Singh	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 05/09/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/09/2019

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: BERESFORD MONTESSORI	FACILITY NUMBER: 414002467
	VISIT DATE: 05/09/2019

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Facility 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 training completion certificates in staff files.

The owner is aware of the update related to the effects of lead exposure. LPA encourages the director to frequently visit our website at www.ccld.ca.gov for licensing regulations and new updates.

No deficiencies are cited today. The copy of this report is reviewed and provided to the owner. Notice of site visit is posted and shall remain posted for next 30 days.

SUPERVISOR'S NAME: Alma Malig	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Gagandeep Singh	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 05/09/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/09/2019

LIC809 (FAS) - (06/04)

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