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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 414002467
Report Date: 01/28/2026
Date Signed: 01/28/2026 03:52:10 PM

Document Has Been Signed on 01/28/2026 03:52 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:BERESFORD MONTESSORIFACILITY NUMBER:
414002467
ADMINISTRATOR/
DIRECTOR:		REGINA MASLOGFACILITY TYPE:
850
ADDRESS:1717-1719 GUM STREETTELEPHONE:
(650) 571-8749
CITY:SAN MATEOSTATE: CAZIP CODE:
94402
CAPACITY: 41TOTAL ENROLLED CHILDREN: 40CENSUS: 35DATE:
01/28/2026
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:10 PM
MET WITH:Karina Garcia, Veronica GarciaTIME VISIT/
INSPECTION COMPLETED:
04:05 PM
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On 1/28/2026 at 12:10PM., Licensing Program Analyst (LPA), Luis Gomez met with Teacher, Veronica Garcia. The purpose of today's visit was explained and was for an unannounced- annual random inspection. Present was the director, and 6 staff supervising 35 children. The licensee, Karina Garcia arrived during today’s inspection. The facility’s day and hours of operation are Monday- Friday, 8:30AM- 5:00PM. The program utilizes two classrooms: Daisy and Sunflower; and the shared outdoor play yard. LPA inspected facility, indoors and outdoors, for health and safety hazards.

At 12:25PM., LPA observed the following: classrooms were neat and orderly, with age-appropriate playthings and learning materials available for the children. The doorways, floors, and accessible surfaces were clean and clear of any obstructions. The furniture and inspected was in good repair. LPA observed labeled cubbies in entry way for storage of belongings.

The facility is equipped with different activity areas, and several cabinets/ shelves for supplies. LPA observed tables and chairs, scaled to the appropriate size. The books and manipulative inspected were in like-new condition. The trash bins used for disposal of solid waste had been covered.

For nap/ scheduled rest, several mats, made from a cleanable plastic material are available for children. Per licensee, napping supplies are washed weekly by families. The classrooms had adequate ventilation, lighting, and a comfortable temperature. Facility had a functioning telephone service; carbon monoxide detector; and fire extinguisher (2A10BC). (REFER TO 809C, FOR CONT.)

NAME OF LICENSING PROGRAM MANAGER: Marie Rodriguez
NAME OF LICENSING PROGRAM ANALYST: Luis Gomez
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 01/28/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/28/2026
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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California Health & Human Services Agency
California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:
  • Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.
  • Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)
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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: BERESFORD MONTESSORI
FACILITY NUMBER: 414002467
VISIT DATE: 01/28/2026
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(Page 2)
The food preparation/ kitchen area was reviewed. The area was observed clean, free of debris or rubbish. The food inspected (dry snacks) was current and had been properly stored.

During inspection, LPA reviewed the outdoor play yard. LPA observed area was completely enclosed with a tall fence. The play structure was properly anchored, and absorbent material (tanbark) had been installed. For water services, refillable bottles are brought by the families, and available for children to drink as they wish.

LPA reminded licensee to remove building material from the accessible outside play yard.

At 1:30PM., LPA reviewed facility records including 5 children and 7 personnel files. The staff files contained the: Proof of Teacher Qualification; Personnel Record (LIC501); Proof of completed Mandated Reporter Training Course (AB1207); and Health Screenings/ TB Assessments (LIC503).

The children’s files were reviewed and included the: Consent for Medical Treatment (LIC627); Identification of Emergency Information (LIC700); Immunization Record; Personal Rights (LIC613A); and The Notification of Parents Rights (LIC995A).

The staff’s Cardiopulmonary Resuscitation/ First Aid Certification was current: expiring: 6/2026. The facility emergency disaster drill (Fire and Earthquake) was completed on: 10/16/2025.


The required posting were observed posted in the facility, and include the: License; Emergency Disaster Plan (LIC610); Seat Beat Safety Laws; Notification of Parent’s Rights (LIC995A); Snack Menu; and Personal Rights. (REFER TO 809C, FOR CONT.)
NAME OF LICENSING PROGRAM MANAGER: Marie Rodriguez
NAME OF LICENSING PROGRAM ANALYST: Luis Gomez
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 01/28/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/28/2026
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: BERESFORD MONTESSORI
FACILITY NUMBER: 414002467
VISIT DATE: 01/28/2026
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Assembly Bill (AB) 2370, chapter 676, statues 2018 requires all licensed childcare centers (CCC’s) constructed before January 1, 2010, to test their water (used for drinking and food preparation) for lead contamination before January 1, 2023, and every five years after the date of the first test. LPA has verified that lead testing procedure was completed in accordance with the Written Directives outlined in PIN 21-21- CCP.

Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manuel – Regulations Interpretations and Procedures for Child Care Centers Section 101173 and 101226. When an IMS is provided, an updated Plan of Operations that includes IMS must be submitted to the Department. Following information regarding ADA was provided: US Department of Justice (USDOJ) toll- free ADA information line at (800) 514- 0382 (TTY) and link to publications: Commonly asked questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm

The Licensee, Karia Garcia 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 Child Care Center. A civil penalty of $100.00 minimum/ day for maximum of 5 days or, if the penalty is repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.

Based on today's inspection, no deficiencies were observed in the areas evaluated according to Title 22, Division 12, Chap. 1 Ca. Health and Safety Code of Regulations. An exit interview and facility evaluation report
(FER) was discussed with Licensee, Karina Garcia. The licensee's signature of this form acknowledges receipt of these documents.

This report and rights to comment were discussed. This report must be available in the facility file for public review. The Notice of site visit was provided and must remain posted for 30 days. The licensee was advised any additional questions to call Office, M-F, 8:00am-5:00pm, 650-266-8800 or 1-844-538-8766. Website: www.ccld.ca.gov

NAME OF LICENSING PROGRAM MANAGER: Marie Rodriguez
NAME OF LICENSING PROGRAM ANALYST: Luis Gomez
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 01/28/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/28/2026
LIC809 (FAS) - (06/04)
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