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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 414002467
Report Date: 05/09/2019
Date Signed: 05/09/2019 04:23:03 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 MONTESSORIFACILITY NUMBER:
414002467
ADMINISTRATOR:ANA CARDENASFACILITY TYPE:
850
ADDRESS:1717-1719 GUM STREETTELEPHONE:
(650) 571-8749
CITY:SAN MATEOSTATE: CAZIP CODE:
94402
CAPACITY:41CENSUS: 36DATE:
05/09/2019
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
03:30 PM
MET WITH:Karina Garcia-BarberaTIME COMPLETED:
04:30 PM
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Licensing Program Analyst (LPA) Singh met with the owner, Karina Garcia-Barbera, for a case management inspection for an incident. 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.

The facility self reported that a parent had a nanny assigned to bring the child to the facility. The nanny informed that the child had ache. On April 29, 2019, the child was not present at the facility, but the parent was informed by the nanny that child attended the day care. During today’s inspection, the owner stated that the child did not attended the day care on that specific day. Per the owner, facility had meeting with parents and the class teachers of the child. Per owner, it was informed the parents that the child was not present at the facility and sign in / sign out sheet was presented. Per owner, parents have terminated employment of the nanny and parents are bringing the child to the facility since then.

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 MaligTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Gagandeep SinghTELEPHONE: (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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