<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 384000667
Report Date: 11/15/2022
Date Signed: 11/15/2022 04:08:25 PM

Document Has Been Signed on 11/15/2022 04:08 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:MONTESSORI SCHOOL OF THE BAY AREA INC. - INFANTFACILITY NUMBER:
384000667
ADMINISTRATOR:DAVID THATHIAHFACILITY TYPE:
830
ADDRESS:1550 EDDY STREETTELEPHONE:
(415) 292-7970
CITY:SAN FRANCISCOSTATE: CAZIP CODE:
94115
CAPACITY: 18TOTAL ENROLLED CHILDREN: 18CENSUS: 12DATE:
11/15/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
01:20 PM
MET WITH:Vilma Galdamez & Sandra HernandezTIME COMPLETED:
03:45 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 November 15, 2022, at approximately 1:20pm, Licensing Program Analysts (LPA) Winnie Ly conducted a Unannounced Required - 1 Year inspection and met with Teachers Vilma Galdamez and Sandra Hernandez. The purpose of the inspection was explained. There are 12 infants and 4 staff present today. Staff to child ratio is met today. The facility has fully charged fire extinguishers, smoke detectors, and a carbon monoxide (CO) detector that meet the minimum requirements. The program uses clipboard for parents to sign their children in and out of the program.

There are no bodies of water on the premises. Per staff, there are no firearms or weapons at the center. All cleaning supplies and toxins were locked or inaccessible to the children. All solid waste storage bins are secured with tight fitting lids. There is a variety of age appropriate toys and materials, including cribs. LPA did not observe any baby walkers present in the center. Changing tables are within arms reach of a sink. Parents provide all diapers/milk/formula and food. All bottles were labeled with the child's name and date. Per staff, parents wash/sterilize the bottles at home at the end of each day. LPA observed outdoor equipment is in good condition, free from loose, sharp or pointed parts. Outdoor equipment appears to be age appropriate for children in care. Last Emergency Drill was conducted on 10/30/2022 and properly logged.

A random sample of children's files were reviewed and found infants' files were missing LIC 9227 Individual Sleeping Plan and Infants' 15 Minutes Sleeping Log. Missing Sleeping Plan (LIC 9227) and Sleeping Logs pose a potential health and safety risks to children in care. Type B deficiencies are cited on this day in accordance with the California Code of Regulations, Title 22, see LIC 809D.

In the staff files reviewed, all staff files are missing renewal of Pediatric CPR/First Aid. Therefore, facility does not meet the requirement of having one staff member on site certified for CPR/First Aid. Furthermore, staff are also missing renewal of Child Abuse Mandated Reporter Training. Missing renewal of Pediatric CPR/First Aid and missing renewal of Child Abuse Mandated Reporter Training pose pose a potential health and safety risks to children in care. Type B deficiencies are cited on this day in accordance with the California Code of Regulations, Title 22, see LIC 809D.

CONTINUED>>>
SUPERVISORS NAME: Garfield Leung
LICENSING EVALUATOR NAME: Winnie Ly
LICENSING EVALUATOR SIGNATURE: DATE: 11/15/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/15/2022
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 4
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: MONTESSORI SCHOOL OF THE BAY AREA INC. - INFANT
FACILITY NUMBER: 384000667
VISIT DATE: 11/15/2022
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
26
27
28
29
30
31
32
PAGE 2....

Facility does not have children that need IMS at this time. Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. When any IMS is provided, an updated Plan of Operation that includes 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

Facility was also informed that as of September 1, 2016, 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. All staff have proof of Immunization.

LPA discussed Child Abuse Mandated Training AB1207 with Facility Representatives. As of January 1, 2018 all staff will be required to complete Mandated Reporter Training every two years. The training can be obtained online at www.mandatedreporterca.com.

Pesticide regulations were discussed with the Facility Representatives. In accordance with the Healthy Schools Act, California law requires that anyone using any pesticide must be trained every year in integrated pest management and the safe use of pesticides around children. The director was advised that a free one hour online course is available on the Department of Pesticide Regulation's Web site: www.cdpr.ca.gov/schoolipm/training. For questions, email ccipmlist@cdpr.ca.gov.

LPA discussed the safe sleep regulations with licensee and discussed the Child Care Licensing Safe Sleep webpage athttps://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed licensee of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

An exit interview was conducted and Plans of Corrections (POC) were developed and reviewed with Licensee. A copy of this report and appeal rights were discussed and left with Licensee whose signature on this form confirm receipt of these reports. Notice of Site Visit was posted. Notice to remain posted for 30 days. For updates on Licensing information, go to CCL website: www.ccld.ca.gov. For Provider Information Notice: ccld.ca.gov/PG5098.htm
SUPERVISORS NAME: Garfield Leung
LICENSING EVALUATOR NAME: Winnie Ly
LICENSING EVALUATOR SIGNATURE:

DATE: 11/15/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/15/2022
LIC809 (FAS) - (06/04)
Page: 2 of 4
Document Has Been Signed on 11/15/2022 04:08 PM - It Cannot Be Edited


Created By: Winnie Ly On 11/15/2022 at 02:51 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME: MONTESSORI SCHOOL OF THE BAY AREA INC. - INFANT
FACILITY NUMBER: 384000667

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/15/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
101429(a)(2)(B)
Responsibility for Providing Care and Supervision for Infants
(B) Staff shall physically check on sleeping infant(s) every 15 minutes and document the following:

This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
Based on record review, the licensee did not comply with the section cited above in infants in care which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 11/29/2022
Plan of Correction
1
2
3
4
Director will start having sleeping logs for infant in care and email proof of the log to LPA by 11/29/2022.
Type B
Section Cited
CCR
101430(a)(3)(A)(4)
Infant Care Activities
(A) Staff shall place infants up to 12-months of age on their backs for sleeping. (4) Infants with an Individual Infant Sleeping Plan [LIC 9227 (3/20)] that have Section C of the form completed and signed by an authorized representative shall be placed on their back when first laid down to sleep. In the event the infant changes position, the infant may remain in the alternative position.

This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
Based on record review, the licensee did not comply with the section cited above in infants in care which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 11/29/2022
Plan of Correction
1
2
3
4
Director will work with families to have LIC 9227 fill out email proof of completion to LPA by 11/29/2022.
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Garfield Leung
LICENSING EVALUATOR NAME:Winnie Ly
LICENSING EVALUATOR SIGNATURE:
DATE: 11/15/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/15/2022


LIC809 (FAS) - (06/04)
Page: 4 of 4
Document Has Been Signed on 11/15/2022 04:08 PM - It Cannot Be Edited


Created By: Winnie Ly On 11/15/2022 at 02:51 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME: MONTESSORI SCHOOL OF THE BAY AREA INC. - INFANT
FACILITY NUMBER: 384000667

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/15/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
HSC
1596.8662(b)(1)
Administration of Child Day Care Licensing
(1) On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child day care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training provided pursuant to paragraphs (2) and (3) of subdivision (a), and shall complete renewal mandated reporter training every two years following the date on which he or she completed the initial mandated reporter training.

This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
Based on record review, the licensee did not comply with the section cited above in all staff in infant program did not renew Child Abuse Mandated Reporter Training which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 11/29/2022
Plan of Correction
1
2
3
4
Staff will take the online course to renew and Director will email proof of completion to LPA by 11/29/2022.
Type B
Section Cited
CCR
101216(f)
Personnel Requirements
(f) At least one staff member who is trained in pediatric cardiopulmonary resuscitation and pediatric first aid pursuant to Health and Safety Code Section 1596.866 shall be present when children are at the child care center or offsite for center activities.

This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
Based on record review, the licensee did not comply with the section cited above in staff in infant program did not renew Pediatric CPR/First Aid which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 11/29/2022
Plan of Correction
1
2
3
4
Staff will need to renew Pediatric CPR/First Aid and email proof of completion to LPA by 11/29/2022.
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Garfield Leung
LICENSING EVALUATOR NAME:Winnie Ly
LICENSING EVALUATOR SIGNATURE:
DATE: 11/15/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/15/2022


LIC809 (FAS) - (06/04)
Page: 3 of 4