414004704-12-14-2022-05-CC-CQUO-CM4VB9-20221214151711

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 414004704
Report Date: 12/14/2022
Date Signed: 12/14/2022 03:17:35 PM

Document Has Been Signed on 12/14/2022 03:17 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:	BERESFORD MONTESSORI ACADEMY INC.		FACILITY NUMBER:	414004704
ADMINISTRATOR:	ANA CARDENAS		FACILITY TYPE:	850
ADDRESS:	1051 SOUTH CLAREMONT STREET		TELEPHONE:	(650) 578-8925
CITY:	SAN MATEO	STATE: CA	ZIP CODE:	94402
CAPACITY: 50	TOTAL ENROLLED CHILDREN: 30	CENSUS: 24	DATE:	12/14/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	12:40 PM
MET WITH:	Ana Cardenas & Karina Garcia Barbera		TIME 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 December 14, 2022 at approximately 12:40pm, Licensing Program Analyst (LPA) Catrina Quimbo, conducted an unannounced annual inspection. LPA met with director, Ana Cardenas, and licensee, Karina Garcia Barbera, and explained the purpose of the inspection. Present during LPA's visit included 7 staff members (including director and licensee) and 24 enrolled children (all preschool age). Facility is operating within capacity limits and ratio during LPA's visit. Included in annual inspection, LPA discussed unusual incidents that occurred at facility 11/30/2022, 11/16/2022, and 09/23/2022 with director and licensee. Unusual incidents were previously reported to department with supportive documentation. LPA observed classrooms to be in proper working condition and all children have since returned to facility. LPA did not find facility nor staff to be negligent during unusual incidents. Hours of operation are Monday to Friday 8:30am to 5:00pm. Facility operates as a Montessori program that includes 2 separate classrooms: Watermelon and Blueberry. With licensee, LPA inspected entire facility, indoors and outdoors, for health and safety hazards. LPA observed classrooms to be equipped with a variety of age appropriate toys and materials. Classrooms are designed as a Montessori program with materials that were observed to be in good working condition. Areas in classroom are separated into language, mathematics, sensorial and quiet activities. LPA observed electrical outlets in classrooms to be properly barricaded by child safety covers and/or blocked by furniture. There is a shared bathroom between the classrooms. LPA observed bathroom to be clean and in proper working condition. Garbage bin located in bathroom, classroom and outdoor area were observed to have tight fitting lids. LPA observed poisons, cleaning solutions and hazardous materials inaccessible in facility's high shelves and cabinets. Accessible sinks in classrooms and bathroom do not provide water that is warmer than 120 degrees Fahrenheit. (Continue Report on Page 2...)

SUPERVISORS NAME: Cindy Interiano
LICENSING EVALUATOR NAME: Catrina Quimbo
LICENSING EVALUATOR SIGNATURE:	DATE: 12/14/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/14/2022

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 3

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: BERESFORD MONTESSORI ACADEMY INC.	FACILITY NUMBER: 414004704
	VISIT DATE: 12/14/2022

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

(Continued, Page 2...)
Facility also includes a kitchen, teacher's preparation area and office that are off limits to children. Areas are made inaccessible with child safety locked door handles and/or child safety gate.

Facility provides a food service that includes morning and afternoon snacks only. Lunch is provided by enrolled children's authorized representatives. LPA observed kitchen and food prep area to be clean and orderly. All food is stored and prepared properly to avoid contamination. Water is available to children indoors and outdoors with children's water bottles, labeled with child's individual names that are refilled through accessible water stations.

Entire outdoor area is fully fenced with an at least 5 ft. high fence. Outdoor area was observed to be clean, equipped with materials that were in good working condition. Outdoor area includes a play structure that was observed to have appropriate cushioning underneath. LPA observed garbage bins in outdoor area to have tight fitting lids. Outdoor area includes an additional, accessible sink to children that is equipped with appropriate sanitation products. Facility maintains an outdoor waiver. LPA did not observe any pools, spas or bodies of water in outdoor area.

Storage for children's belongings are located outside the classroom, in facility's lobby area. Children's cubbies are labeled with their individual names. Children are signed in and out of facility via electronic or hand written signatures. LPA observed required licensing documentation to be properly posted, available for review.

Facility has an installation of a fire alarm system throughout entire building. Facility is also equipped with a fully charged fire extinguisher and fully stocked first aid kid. Medication is stored appropriately in kitchen, inaccessible to enrolled children and maintained with proper documentation.

LPA reviewed facility records that included 10 children's records, 6 staff records (whom were present during inspection). LPA observed children's and staff's records to be complete. Multiple staff members present during inspection have valid CPR certificates that will expire in either 2023 or 2024. Emergency drills are conducted at least once every six months and are properly logged and documented. Last emergency drill was conducted 10/27/2022.

Facility was 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.
(Continue Report on Page 3...)

SUPERVISORS NAME: Cindy Interiano
LICENSING EVALUATOR NAME: Catrina Quimbo
LICENSING EVALUATOR SIGNATURE:	DATE: 12/14/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/14/2022

LIC809 (FAS) - (06/04)

Page: 2 of 3

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: BERESFORD MONTESSORI ACADEMY INC.	FACILITY NUMBER: 414004704
	VISIT DATE: 12/14/2022

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

(Continued, Page 3...)
Licensee is aware that all staff hired are required to complete Mandated Reporter Training every two years. The training can be obtained online at www.mandatedreporterca.com. LPA observed the completion certificate on file. LPA encourages the licensee to frequently visit our website at www.ccld.ca.gov for licensing regulations and new updates.

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/inspection-process.

Licensee 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 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.

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 Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226.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

No deficiencies were issued under CCR, Title 22, Division 12.

A 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 licensee, Karina Garcia Barbera.

SUPERVISORS NAME: Cindy Interiano
LICENSING EVALUATOR NAME: Catrina Quimbo
LICENSING EVALUATOR SIGNATURE:	DATE: 12/14/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/14/2022

LIC809 (FAS) - (06/04)

Page: 3 of 3