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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 214005604
Report Date: 01/18/2022
Date Signed: 01/18/2022 12:05:21 PM

Document Has Been Signed on 01/18/2022 12:05 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:GUIDEPOST MONTESSORI AT MILL VALLEYFACILITY NUMBER:
214005604
ADMINISTRATOR:MILLER, LISAFACILITY TYPE:
850
ADDRESS:40 RIDGE AVENUETELEPHONE:
(949) 354-2259
CITY:MILL VALLEYSTATE: CAZIP CODE:
94941
CAPACITY: 25TOTAL ENROLLED CHILDREN: 25CENSUS: 0DATE:
01/18/2022
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Director, Ilsa MillerTIME COMPLETED:
12:15 PM
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On January 18th, 2022 at 9:30am, Licensing Program Analyst (LPA) Kassandra Medrano met with Center Director, Ilsa Miller and Assistant Director, Criselda Thomas, for a pre-licensing inspection. On 10/25/2022, the facility was hit by a mud slide, which lead to temporary closure, facility has requested temporary operation at this site until they can return to original site. At this time, facility has been notified by the Muir woods park community association that they must relocate by or before summer.This is subject to change depending community center.The facility will operate as a combination center with preschool (ages 2 years to entry into first grade), toddlers (ages 18-36 months) and infants (ages 6 weeks preschool children (ages 2 years to entry into first grade). The facility was inspected today, indoor and outdoor for health and safety hazards. Indoor: The preschool classroom measures a total of 900 square feet allowing for a capacity of 25 children. The facility is equipped with a fire extinguisher, smoke and carbon monoxide detectors. There is a separate bathroom for staff. Isolation of ill children will be in bathroom B until parent arrives for pick up. There will be drinking water readily available for children indoors. Outdoor: The outdoor area is below and fenced, facility plans to allow 12 to 15 children down at once. LPA has requested cushioning below slide. Facility is aware that there needs to be direct supervision at all times for structures. This facility plans to provide Incidental Medical Services – IMS. LPA reviewed location of storage for medication and equipment/supplies. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. 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. Facility representative was reminded that all adults 18 and over responsible for administration or direct supervision of staff, persons who provides care and supervision to children, and staff who have contact with children, including employees and volunteers, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a Child Care Center.
SUPERVISORS NAME: Ali Zebila
LICENSING EVALUATOR NAME: Kassandra Medrano
LICENSING EVALUATOR SIGNATURE: DATE: 01/18/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/18/2022
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: GUIDEPOST MONTESSORI AT MILL VALLEY
FACILITY NUMBER: 214005604
VISIT DATE: 01/18/2022
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A civil penalty of $100.00 minimum/day up to $500.00 maximum per day/per person will be assessed if this regulation is violated. The fire inspection has been conducted and approved as of November 30, 2021. A copy of the STD 850 was received prior to inspection on 12/8/2021.The fire inspection has been conducted and approved as of November 30, 2021. A copy of the STD 850 was received prior to inspection on 12/8/2021. At this time the fire inspector has given facility two week time frame to install fire system into facility. After the fire system is installed, inspector will come out to reinspect.
LPA is requesting photo documentation of cushioning within the outdoor play area.

A copy of this report will be emailed to Director. This report will be kept in the facility file and will be made available for public review upon request. Desk Duty is available M-F, 8a.m.-5p.m. (650) 266-8800. Website for forms and Regulations: www.ccld.ca.gov

Applicant will be recommended for Licensure effective today, January 18, 2021.

A copy of this report will be emailed to Director. This report will be kept in the facility file and will be made available for public review upon request. Desk Duty is available M-F, 8a.m.-5p.m. (650) 266-8800. Website for forms and Regulations: www.ccld.ca.gov
SUPERVISORS NAME: Ali Zebila
LICENSING EVALUATOR NAME: Kassandra Medrano
LICENSING EVALUATOR SIGNATURE:

DATE: 01/18/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/18/2022
LIC809 (FAS) - (06/04)
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