384004669-4-12-2024-05-CC-JTSE-D4A26Y-20240412170755

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 384004669
Report Date: 04/12/2024
Date Signed: 04/12/2024 05:08:17 PM

Document Has Been Signed on 04/12/2024 05:08 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
SAN BRUNO CC RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME:	GUIDEPOST MONTESSORI AT FORT MASON		FACILITY NUMBER:	384004669
ADMINISTRATOR/ DIRECTOR:	ZURN, HAYLEE		FACILITY TYPE:	850
ADDRESS:	3741 BUCHANAN STREET		TELEPHONE:	(415) 429-2008
CITY:	SAN FRANCISCO	STATE: CA	ZIP CODE:	94123
CAPACITY: 18	TOTAL ENROLLED CHILDREN: 18	CENSUS: 9	DATE:	04/12/2024
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	02:10 PM
MET WITH:	Head of School, Stephanie Silverman		TIME VISIT/ INSPECTION COMPLETED:	05:20 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 4/12/2024, at approximately 2:10PM, Licensing Program Analyst (LPA) Jonathan Tse conducted an unannounced annual visit at the facility. LPA met with Head of School, Stephanie Silverman (H1). Present during the visit was H1, Director Haylee Zurn (D1), one aide, and nine preschool age children. The facility is in compliance with staffing ratios and requirements on this day. The facility’s operating hours are from 8:30AM to 5:30PM. LPA inspected the facility for any health or safety hazards. The facility is equipped with a fully charged fire extinguisher. There is a fire alarm system running throughout the facility. There is a carbon monoxide detector present. The facility’s first aid kit is complete with all materials necessary for the administration of first aid. LPA observed emergency exit routes to be posted in each classroom. Poisons, detergents, and other chemicals are stored inaccessible to children in care. The facility has two classrooms in use: Children’s House and a Napping Room. LPA observed age-appropriate toys and learning equipment in both classrooms. The surface of the facility’s floor is clean and free of debris. Furniture is age-appropriate and free of rough or sharp edges. The facility provides cots and a cot blanket for children in care. Children may provide extra bedding from home. All bedding is cleaned once a week. The facility provides snacks for children in care. Children bring lunch from home, in addition to water bottles that are refilled at the facility. The facility provides drinking water for children from a water service that is delivered every month. There is no outdoor play area in the facility. The facility has a waiver to use Moscone Park Playground, located at 0469001 San Francisco, CA 94123, as an outdoor play area. The Department had previously inspected the Playground and approved its use for the facility. Per H1, backpacks containing a first aid kit and emergency information are carried during use of the Playground. Continued on Page Two

SUPERVISORS NAME: Ali Zebila
LICENSING EVALUATOR NAME: Jonathan Tse
LICENSING EVALUATOR SIGNATURE:	DATE: 04/12/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/12/2024

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: GUIDEPOST MONTESSORI AT FORT MASON	FACILITY NUMBER: 384004669
	VISIT DATE: 04/12/2024

NARRATIVE

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LPA reviewed three staff files, 12 children’s files, and facility records. There is at least one staff member with current First Aid/CPR certification. LPA discussed requirement to have First Aid/CPR training from the American Red Cross, American Heart Association, or an EMSA certified vendor. H1 stated that they understood. Children’s files contained admission agreements, Consent for Emergency Medical Treatment (LIC627) or equivalent, and Emergency Information and Identification (LIC700). Due to a technical issue with the electronic records, Personal Rights (LIC613A) and Notification of Parents’ Rights (LIC995) were not available to review during the visit. See LIC809-D for deficiency cited today regarding children’s records. LPA observed all required postings to be visible and accessible for review. The facility’s last emergency drill was conducted on 4/9/2024. Drills are properly logged and documented.

LPA reviewed the facility’s lead testing records. There was no lead testing on file. LPA discussed PIN 21-21_1-CCP – Written Directives for Lead Testing with H1. Per H1, the facility currently uses a fixture in the facility kitchen to wash fruits for children. LPA advised that the facility should adjust its menu so that it serves food that does not need to be washed to avoid the use of an untested fixture. LPA discussed possible steps to take regarding lead testing for the facility: test all fixtures and remediate exceedances as needed or submit an attestation showing that the facility does not need to test its fixtures for lead due to receiving water service from a third-party vendor.

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.

Continued on Page Three

SUPERVISORS NAME: Ali Zebila
LICENSING EVALUATOR NAME: Jonathan Tse
LICENSING EVALUATOR SIGNATURE:	DATE: 04/12/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/12/2024

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: GUIDEPOST MONTESSORI AT FORT MASON	FACILITY NUMBER: 384004669
	VISIT DATE: 04/12/2024

NARRATIVE

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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 referred the facility representative to the Department website for lead: Lead Toxicity Prevention and Water Testing Information.

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.

See LIC809-D for deficiencies cited today regarding lead water testing and children’s records. See LIC9102-TA for technical assistance given regarding lead water testing.
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, Stephanie Silverman.

SUPERVISORS NAME: Ali Zebila
LICENSING EVALUATOR NAME: Jonathan Tse
LICENSING EVALUATOR SIGNATURE:	DATE: 04/12/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/12/2024

LIC809 (FAS) - (06/04)

Page: 3 of 5

Document Has Been Signed on 04/12/2024 05:08 PM - It Cannot Be Edited

Created By: Jonathan Tse On 04/12/2024 at 04:46 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: GUIDEPOST MONTESSORI AT FORT MASON	FACILITY NUMBER: 384004669
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 04/12/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

HSC

1597.16(a)(1)

Lead Testing

(1) A licensed child day care center, as defined in Section 1596.76, that is located in a building that was constructed before January 1, 2010, shall have its drinking water tested for lead contamination levels on or after January 1, 2020, but no later than January 1, 2023, and every five years after the date of the initial test. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on interview and record review, the licensee did not comply with the section cited above by not conducting lead water testing 180 days after licensure which poses a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 05/13/2024
	Plan of Correction
1 2 3 4	H1 shall submit a lead water attestation which shall include a description of water services provided and any use or lack thereof of fixtures within the facility for food preparation or consumption in any way by set due date of 5/13/2024.

Type B

Section Cited

CCR

101221(a)

Child's Records

(a) The licensee shall ensure that a separate, complete and current record for each child is maintained in the child care center. 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 by not having LIC613A and LIC995 available for review which poses a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 05/03/2024
	Plan of Correction
1 2 3 4	H1 shall resolve the issue or take steps towards resolving the issue with the facility's record keeping services and update LPA via email. H1 shall obtain three complete children's files and email proof of completion to LPA via email by set due date of 5/3/2024.

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:

Ali Zebila

LICENSING EVALUATOR NAME:

Jonathan Tse

LICENSING EVALUATOR SIGNATURE:

DATE: 04/12/2024

I acknowledge receipt of this form and understand my appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/12/2024

LIC809 (FAS) - (06/04)

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