434415538-7-16-2021-52-CC-MOTI-C4YS64-20210716133519

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 434415538
Report Date: 07/16/2021
Date Signed: 07/16/2021 01:35:24 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612

FACILITY NAME:	GUIDEPOST MONTESSORI AT PALO ALTO		FACILITY NUMBER:	434415538
ADMINISTRATOR:	AARON BAILEY		FACILITY TYPE:	850
ADDRESS:	930 EMERSON STREET		TELEPHONE:	(650) 382-0550
CITY:	PALO ALTO	STATE: CA	ZIP CODE:	94301
CAPACITY:	48	CENSUS: 33	DATE:	07/16/2021
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	09:23 AM
MET WITH:	Yingjiao "Yogi" Kang		TIME COMPLETED:	01:40 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	(1) On 7/16/2021, Licensing Program Analyst (LPA) Melanie Otsuji arrived to the facility unannounced to conduct a Required 1 Year inspection. LPA was met by Interim Director Yingjiao "Yogi" Kang. Present during today's visit were 7 staff members and 33 preschool aged children. LPA conducted a health and safety inspection of the facility. There are no pools, spas or other bodies of water accessible to children in care. Disinfectants and other dangerous items are kept inaccessible. Furniture and equipment were observed to be in good condition, free of sharp, loose, or pointed parts. Playground equipment was observed to be in good repair and free of hazards. Areas under high climbing equipment are cushioned with material that absorbs a fall. Toilets, hand washing stations are kept in safe and sanitary operating conditions. Kitchen and food prep areas were kept clean, free of litter and rubbish. Storage containers for solid waste have tight-fitting covers that are kept on and in good repair. Drinking water was available for children inside and outside. Facility has an operable carbon monoxide detector. Fire/Evacuation Drill was last conducted on June 17, 2021. LPA obtained the current sign in/out sheet and the number of children signed in matches current census. It also records the time of day and full legal signature of the authorized representative. Facility utilizes the Director's office and staff bathroom for isolation should a child fall ill while in care. LPA reviewed 6 children files and 4 staff files. Files were all kept electronically with the ability to print paper copies as necessary. Children's files contained the appropriate Emergency Identification Form, and required medical assessment. Staff files contained a health screening, proof of mandated reporter and immunizations. LPA observed a menu posted showing at least one week of meals. Facility provides AM/PM snacks with either lunch being brought from home.

SUPERVISOR'S NAME: Wynn Norona	TELEPHONE: (510) 622-2593
LICENSING EVALUATOR NAME: Melanie Otsuji	TELEPHONE: (510) 341-5559
LICENSING EVALUATOR SIGNATURE:	DATE: 07/16/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/16/2021

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, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612

FACILITY NAME: GUIDEPOST MONTESSORI AT PALO ALTO	FACILITY NUMBER: 434415538
	VISIT DATE: 07/16/2021

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Individual Medical Services (IMS) policy was discussed. When any IMS is provided, a Plan for Providing IMS must be submitted to the Department. 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

There are no deficiencies cited during today's visit. The Center was provided a copy of their appeal rights (LIC 9058 01/16) and the signature on this form acknowledges receipt of these rights. This report must be available for public review for 3 years. LPA provided Notice of Site visit and staff posted visit notice in LPA presence.

SUPERVISOR'S NAME: Wynn Norona	TELEPHONE: (510) 622-2593
LICENSING EVALUATOR NAME: Melanie Otsuji	TELEPHONE: (510) 341-5559
LICENSING EVALUATOR SIGNATURE:	DATE: 07/16/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/16/2021

LIC809 (FAS) - (06/04)

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