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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 384004290
Report Date: 01/19/2023
Date Signed: 01/19/2023 12:27:42 PM

Document Has Been Signed on 01/19/2023 12:27 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:GERMAN INTERNATIONAL SCHOOL OF SILICON VALLEYFACILITY NUMBER:
384004290
ADMINISTRATOR:MARIE-LOUISE NASTKEFACILITY TYPE:
850
ADDRESS:117 DIAMOND STREETTELEPHONE:
(650) 254-0748
CITY:SAN FRANCISCOSTATE: CAZIP CODE:
94114
CAPACITY: 44TOTAL ENROLLED CHILDREN: 44CENSUS: 28DATE:
01/19/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
08:45 AM
MET WITH:Marie-Louise NastkeTIME COMPLETED:
12:45 PM
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On January 19, 2023., Licensing Program Analyst (LPA) Van met with Director Marie-Louise Nastke for an unannounced annual random inspection. The purpose of the inspection was explained, and the Center's staff granted LPA entry to the facility. This facility is a preschool program. Three teachers and the Site Director supervised 15 children at the Center, and the second group of 13 children was on a field trip supervised by two teachers. The facility complies with the staff-children ratios today. The Hours of operation are Monday to Friday, 7:30 am to 5:00 pm.

LPA toured and inspected the physical plant with the Director for any potential health and safety hazards. The facility utilizes a Nemborn GISSV parent's app for sign-in /out for parents or authorized representatives; sign-in/out codes are provided to the parents. LPA observed that each child has their cubbies available with their name labeled. The facility is in good repair and has proper temperature and ventilation. Classrooms have age-appropriate toys and learning materials. The furniture appears steady and in good repair. The facility has a carbon monoxide & smoke detector, fully charged fire extinguishers and working telephones. First aid supplies are fully stocked and available for children's use. All cleaning solutions, poisons, and other dangerous chemicals are inaccessible to children. Medications are stored and inaccessible to children, and all medications have proper labeling, unaltered, and parental consent. All toilets and handwashing sinks are in good working condition with proper sanitation. LPA observed no bodies of water on the premises.
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SUPERVISORS NAME: Garfield Leung
LICENSING EVALUATOR NAME: Brendon Van
LICENSING EVALUATOR SIGNATURE: DATE: 12/19/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/19/2022
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: GERMAN INTERNATIONAL SCHOOL OF SILICON VALLEY
FACILITY NUMBER: 384004290
VISIT DATE: 01/19/2023
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The facility presently has an outdoor waiver granted by the Department to use the outdoor space shared with the school-age. The waiver allows no more than 21 preschool children at the time and the rotational schedule required. The outdoor play area is maintained clean and free of debris. The outdoor play area is completely fenced, clean, and in good repair. Outdoor play structures are in good condition and free of loose parts, and soft cushioning is underneath all play structures to absorb accidental falls. LPA reminded the Director that the staff must ensure that the playground is cleared of debris or harmful material before use. An updated outdoor waiver will be reassessed with the management, and the new waiver will be sent out to reflect the current License capacity.

Children's records and personnel records were reviewed during the inspection. Records review showed the facility has records of each child's authorized representative's names, addresses, and telephone numbers. In addition, each child's immunization record, medical assessment, and admission agreement can be located in each child's file. Staff records indicate that all staff or individuals requiring caregiver background checks have received criminal records and child abuse index clearances or exemptions. Multiple staff members have a record of valid CPR. All staff maintained immunization records. The Director stated that the Center conducts fire and earthquakes at least once every six months; the last drill was on December 5, 2022.

The facility had posted the required forms. (i.e., License, waivers, Notification of Parent's Rights, Notification of Personal Rights, Car Seat Law, Emergency Disaster Plan, and Daily activities). Per the Director, the Center does not provide food to children. However, the facility has lunch services, which children are required to pay or children can also bring their lunch and snacks. Waters are readily available for children indoors and outdoors. All storage containers for solid waste within the Center have a proper tight-fitting cover.
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SUPERVISORS NAME: Garfield Leung
LICENSING EVALUATOR NAME: Brendon Van
LICENSING EVALUATOR SIGNATURE:

DATE: 01/19/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/19/2023
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: GERMAN INTERNATIONAL SCHOOL OF SILICON VALLEY
FACILITY NUMBER: 384004290
VISIT DATE: 01/19/2023
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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 the publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm
The Director was reminded that all adults 18 and over, including employees and volunteers, must obtain a criminal record clearance or exemption or transfer their existing clearance or exemption prior to the initial presence in a Child Care Center. 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 Director was informed about Mandated Reporter training. In addition to AB1207 training required to complete every two years by the Licensee and all staff hired, a one-time General Training is also required. Training can be taken online at www.mandaterreporterca.com. Also, the Director was reminded of Pesticide training. Information on the DPR website at: www.cdpr.ca.gov/shoolipm/childcare

To improve the quality and value of the new inspection process, a survey will 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 tools, please send them by email 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/process.

No deficiencies were cited today. An exit interview was conducted, and the report was reviewed with the Director, Marie-Louise Nastke. Today's report and notice of the site visit were provided to the Director. LPA informed the Director that the site visit notice must be posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.
SUPERVISORS NAME: Garfield Leung
LICENSING EVALUATOR NAME: Brendon Van
LICENSING EVALUATOR SIGNATURE:

DATE: 01/19/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/19/2023
LIC809 (FAS) - (06/04)
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