213005257-9-21-2021-05-CC-KMEO-C73TUK-20210921150227

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 213005257
Report Date: 09/21/2021
Date Signed: 09/21/2021 03:02:49 PM

Document Has Been Signed on 09/21/2021 03:02 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:	MARIN DAY SCHOOLS - OLD MILLS CAMPUS		FACILITY NUMBER:	213005257
ADMINISTRATOR:	PISETSKY, CAROL		FACILITY TYPE:	840
ADDRESS:	352 THROCKMORTON		TELEPHONE:	(415) 383-1308
CITY:	MILL VALLEY	STATE: CA	ZIP CODE:	94941
CAPACITY: 47	TOTAL ENROLLED CHILDREN: 0	CENSUS: 13	DATE:	09/21/2021
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	01:40 PM
MET WITH:	Director, Beth Conroy		TIME COMPLETED:	03:10 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	On September 21st, 2021, at 1:40pm An annual comprehensive inspection was conducted today. The facility is located at a operating public school site: Old Mill School. At 2:12pm, Director returned to classroom with 6 children. At 2:50pm 7 children arrived to classroom door. Licensing Program Analyst (LPA) Kassandra Medrano inspected the facility building and grounds, conducted an evaluation of the physical plant, and reviewed children, and facility records. Currently, director is the only staff supervising children due to staffing shortage. Director states that facility never exceeds 14 children. The program operates 9:30 am-6:30pm, the first children arrive around 2 PM. The following was observed today: Facility has a mandated reporter waiver, staff complete training through bright horizons. Current facility director Elizabeth Conroy, director states she has sent in documentation, LPA to follow up. Current rooms used for care is the Old Mill EDS room. The following items were reviewed as part of today's visit: Care and Supervision of the Children, Child Discipline Procedures, Emergency Evacuation Procedures (smoke and carbon monoxide detectors present and in working order), Medication Policies, Isolation of Sick Children, Food Service, Transportation, Parents Rights, and Reporting Requirements. Bathroom for school age children is located within the classroom. The outdoor play area is located outside of classroom, facility has access to entire lower level playground. Children are signed in to the facility by staff and out of the facility by parents or guardians. Parents are not currently entering classroom, they sign outside of the classroom door. Posting requirements for site visits were discussed. Current forms and Title 22 Regulations can be obtained through the internet at www.ccld.ca.gov. Staff immunization are on file. Director was reminded that as of September 1, 2016

SUPERVISORS NAME: Ali Zebila
LICENSING EVALUATOR NAME: Kassandra Medrano
LICENSING EVALUATOR SIGNATURE:	DATE: 09/21/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/21/2021

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, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME: MARIN DAY SCHOOLS - OLD MILLS CAMPUS	FACILITY NUMBER: 213005257
	VISIT DATE: 09/21/2021

NARRATIVE

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A person may not be employed or volunteer at a child care 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. Influenza Declarations were also reviewed. Director was advised of the required annual pesticides training. For More information about changes to the Healthy Schools Act, templates, or articles, you can inspect the DPR website at: https://apps.cdpr.ca.gov/schoolipm/childcare/training/main.cfm . Director was informed about the Provider Information Notices (PINs) on CCLD website. This facility provides IMS. A review of storage of medications, equipment and supplies, and reviewed children, personnel and administrative records.

"NOTICE OF SITE VISIT" DOCUMENT WAS POSTED ADJACENT TO THE MAIN ENTRY DOORWAY AND VISIBLE TO PARENTS.

SUPERVISORS NAME: Ali Zebila
LICENSING EVALUATOR NAME: Kassandra Medrano
LICENSING EVALUATOR SIGNATURE:	DATE: 09/21/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/21/2021

LIC809 (FAS) - (06/04)

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