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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 213005570
Report Date: 04/23/2024
Date Signed: 04/23/2024 03:59:06 PM

Document Has Been Signed on 04/23/2024 03:59 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
SAN BRUNO CC RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME:OLD FIREHOUSE SCHOOL MILL VALLEY-PRESCHOOLFACILITY NUMBER:
213005570
ADMINISTRATOR/
DIRECTOR:		GARRETT O'BRIENFACILITY TYPE:
850
ADDRESS:10 OLIVE STREETTELEPHONE:
(415) 388-1417
CITY:MILL VALLEYSTATE: CAZIP CODE:
94941
CAPACITY: 40TOTAL ENROLLED CHILDREN: 35CENSUS: 28DATE:
04/23/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:40 PM
MET WITH:Director, Garrett O'BrienTIME VISIT/
INSPECTION COMPLETED:
04:15 PM
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On 4/23/2024, at approximately 1:40PM, Licensing Program Analyst (LPA) Jonathan Tse conducted an unannounced annual visit at the facility. LPA met with Director, Garrett O’Brien (D1). LPA explained the purpose of the visit. Present during the visit was D1, seven staff members, and 28 preschool age children. The facility is in compliance with staffing and ratio requirements on this day. The facility’s operating hours are from 8:00AM to 5:30PM.

LPA inspected the facility for any health or safety hazards. LPA observed there to be fully charged fire extinguishers throughout the facility that are at least size 2A10BC. LPA observed carbon monoxide detectors to be present in the classrooms that are operational. Electrical outlets are covered or obstructed by furniture to be inaccessible to children in care.

The facility operates in three classrooms: Red, Yellow, and Green classrooms. LPA observed the facility to be in clean and orderly condition. LPA observed age-appropriate toys and learning materials to be present. Cots are available and labeled for each child. Bedding is brought from home and cleaned once a week. The facility has bedding available if needed. Children bring lunch from home and the facility provides AM/PM snacks. Children bring water bottles from home and water is provided from a non-contaminating fixture. Allergy lists are posted in each classroom and medication is kept out of reach of children in care. First aid kits are stored in each classroom and are maintained with band-aids, gauze, and scissors. There are cubbies available for each child that are labeled with their names. Off-limits areas are secured by childproof gates. Per D1, there are no firearms or weapons stored in the facility.

LPA observed the outdoor play are to be free of debris and other loose articles. The facility has a waiver for the use of the outdoor play area that allows for only 26 children outside at a time. LPA observed the facility to be in compliance with the waiver during the visit. There is a play structure that is cushioned by resilient padding in the form of woodchips. There is a sandbox that has a cover and is checked every other day. There are age-appropriate toys and equipment available. There are no pools or other bodies of water in the facility.
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SUPERVISORS NAME: Ali Zebila
LICENSING EVALUATOR NAME: Jonathan Tse
LICENSING EVALUATOR SIGNATURE: DATE: 04/23/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/23/2024
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
SAN BRUNO CC RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME: OLD FIREHOUSE SCHOOL MILL VALLEY-PRESCHOOL
FACILITY NUMBER: 213005570
VISIT DATE: 04/23/2024
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LPA reviewed six staff files, six children’s files, and facility records. There is at least one staff member with valid First Aid/CPR training. LPA discussed Mandated Reporter Training requirements with D1. D1 stated that they understood. All staff present during today’s visit are fully qualified teachers and have their qualifications and immunization records available for review. LPA observed all children’s files to be complete. LPA observed all required postings to be posted and accessible for review. The facility uses the website Cura Cubby for parents to sign their children in and out of the facility. LPA verified the sign-in/out sheets on the website during the visit. The facility tested its fixtures for lead on 9/30/2022 and there were no exceedances.

To improve the quality and value of the new inspection process, a survey may 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 CARE tools, please send email inquiries 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/inspection-process.

Facility representative was reminded that all adults 18 and over, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, 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 for a maximum of 5 days or, if the penalty is for a repeat violation, for a
maximum of 30 days per person will be assessed if this regulation is violated.

Assembly Bill (AB) 2370, Chapter 676, Statutes of 2018, requires all licensed Child Care Centers (CCCs) constructed before January 1, 2010, to test their water (used for drinking and food preparation) for lead contamination before January 1, 2023, and then every 5-years after the date of the first test. For child care center licenses issued after July 1, 2022, the licensee shall test their water for lead within 180 days of licensure pursuant to Written Directives section 101700 (PIN 21-21.1-CCP).

LPA verified that the lead testing was completed in accordance to the Written Directives outlined in PIN 21-21.1-CCP.


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SUPERVISORS NAME: Ali Zebila
LICENSING EVALUATOR NAME: Jonathan Tse
LICENSING EVALUATOR SIGNATURE:

DATE: 04/23/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/23/2024
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
SAN BRUNO CC RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME: OLD FIREHOUSE SCHOOL MILL VALLEY-PRESCHOOL
FACILITY NUMBER: 213005570
VISIT DATE: 04/23/2024
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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 PIN 22-02-CCP. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice) or (800) 514-0383 (TTY) and link to publication. Commonly Asked Questions about Child Care Centers and the ADA are available at: https://www.ada.gov/resources/child-carecenters/.

Facility representative was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

No deficiencies were cited during today’s visit on 4/23/2024.
A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with the facility representative, Garrett O’Brien.
SUPERVISORS NAME: Ali Zebila
LICENSING EVALUATOR NAME: Jonathan Tse
LICENSING EVALUATOR SIGNATURE:

DATE: 04/23/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/23/2024
LIC809 (FAS) - (06/04)
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