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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 384004643
Report Date: 03/20/2025
Date Signed: 03/20/2025 03:09:33 PM

Document Has Been Signed on 03/20/2025 03:09 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:POTRERO HILL MONTESSORI SCHOOLFACILITY NUMBER:
384004643
ADMINISTRATOR/
DIRECTOR:		YANG, LIUFACILITY TYPE:
850
ADDRESS:1701 17TH STREETTELEPHONE:
(650) 476-3015
CITY:SAN FRANCISCOSTATE: CAZIP CODE:
94103
CAPACITY: 54TOTAL ENROLLED CHILDREN: 50CENSUS: 46DATE:
03/20/2025
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
11:33 AM
MET WITH:Janice Cunanan / (Jessica) Liu Yang TIME VISIT/
INSPECTION COMPLETED:
03:10 PM
NARRATIVE
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On March 20, 2025, at approximately 9:00am, Licensing Program Analysts (LPAs) Tso and Badger made an unannounced required visit to the child care center listed above. The LPAs were granted entry by the head teacher of the toddler classroom 1, Janice Cunanan (Head Teacher). The Director, (Jessica) Liu Yang (facility representative) was not at the facility and arrived at approximately 9.55am. The Head Teacher and the facility representative was informed of the reason for today's visit by the LPAs. Present in the center included 13 staff members and 46 children (22 toddlers and 24 preschool-aged). All individuals listed on the facility’s roster have been granted permission to work or be present in a childcare center. The center is operating within its capacity and in accordance with the required ratio of staff to children. Hours of operation are Monday- Friday, 8:30 am- 5:30 pm.

LPAs assessed the Center for Health and Safety Hazards with the facility representative. The Center also maintains a carbon monoxide detector (tested under working conditions during the visit), centralized smoke alarm, fully charged fire extinguisher, and First Aid kit. The Center also provided age-appropriate toys, furnishings, and equipment. Designated cubbies are available for children to store their belongings. There is sufficient sleeping equipment and cots for each child, and all mats and bedding are kept in the appropriate location. The facility maintains an electronic record of sign-in/out for children, and all parent sign in records were accounted for and matched the number of children present. The children’s classroom environment appeared clean and organized, with appropriate heating, lighting, and ventilation. LPAs did not observe any pools, spas, or other bodies of water at the facility. According to the facility representative, no firearms or weapons are present at the Center, and all cleaning materials and potentially hazardous objects are kept out of reach of children. Personnel restrooms are separate from the children, and all solid waste storage containers have tightly fitted lids. Per the Director, the meals for the children were provided by their parents. The facility provided the snacks only. LPAs also observed that the food preparation site is clean, organized, and inaccessible to children.
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Garfield Leung
Man Tso
DATE: 03/20/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/20/2025
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: POTRERO HILL MONTESSORI SCHOOL
FACILITY NUMBER: 384004643
VISIT DATE: 03/20/2025
NARRATIVE
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(Continued, page 2 …)
The facility has an outdoor waiver approved by the Department that allows the facility to use the nearby playground.

LPAs checked the personnel and children's records at the facility. A sample of children's files was found to contain comprehensive information such as medical assessments, needs, services, and feeding plans. However, LPA reviewed that 2 children's immunization records were not found at the facility (refer to LIC9102). LPA reviewed that 4 staff's immunizations records and mandated reporter training certificated were not found at the facility or expired respectively (refer to LIC9102).

The staff files were also well-organized and thorough, with Mandated Reporter Training Certificate (AB1207) valid until 05/25. A staff member was observed to have valid CPR/First Aid cards. Multiple staff members were observed vaccine proofs for Measles and Pertussis in their files. Additionally, the facility had posted the required documents, including the license, waivers, Notification of Parental Rights, Notification of Personal Rights, Car Seat Law, and Emergency Disaster Plan. The last emergency drill was conducted on 5/7/2024 (refer o LIC9102).

LPAs discussed the safe sleep regulations with the facility representative and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed the facility representative 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.

LPAs reminded the facility representative that as of September 1, 2016. A person may not be employed or volunteer at a childcare facility unless he or she has been immunized against influenza, pertussis, and measles.

The Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02-CCP. 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) 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-care-centers/. (Continued on page 3…)
SUPERVISOR'S NAME: Garfield Leung
LICENSING EVALUATOR NAME: Man Tso
LICENSING EVALUATOR SIGNATURE:

DATE: 03/20/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/20/2025
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: POTRERO HILL MONTESSORI SCHOOL
FACILITY NUMBER: 384004643
VISIT DATE: 03/20/2025
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The 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).

The facility representative was informed about Mandated Reporter training available on the CCLD website. In addition to AB1207 training required to be completed every two years by all staff hired a one-time General Training is also required. Training can be taken online at www.mandaterreporterca.com. Also, the facility representative was reminded of Pesticide training. Information on the DPR website at: www.cdpr.ca.gov/shoolipm/childcare

The 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.

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.

There were no deficiencies cited at this time under CCR, Title 22, Div. 12, Chapter 3. A copy of today’s report was given to the facility representative.Notice of site visit was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.Exit interview conducted and report was reviewed with the facility representative, (Jessica) Liu Yang.
SUPERVISOR'S NAME: Garfield Leung
LICENSING EVALUATOR NAME: Man Tso
LICENSING EVALUATOR SIGNATURE:

DATE: 03/20/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/20/2025
LIC809 (FAS) - (06/04)
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