<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 414004829
Report Date: 08/23/2023
Date Signed: 08/23/2023 04:53:56 PM


Document Has Been Signed on 08/23/2023 04:53 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:NOTRE DAME PRESCHOOLFACILITY NUMBER:
414004829
ADMINISTRATOR:GIULIANETTI, HAYDETFACILITY TYPE:
850
ADDRESS:1200 NOTRE DAME AVENUETELEPHONE:
(650) 591-2209
CITY:BELMONTSTATE: CAZIP CODE:
94002
CAPACITY:30CENSUS: 21DATE:
08/23/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
02:00 PM
MET WITH:Director, Haydet GuilianettiTIME COMPLETED:
05:15 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 August 23rd, 2023 at approximately 2PM, Licensing Program Analyst (LPA) Tapia-Mandujano conducted an unannounced, annual, required inspection. LPA met with Director, Haydet Guilianetti.
Present in the facility are Director and 3 staff supervising a total of 21 children. Facility is operating within its capacity and is in compliance with staff/child ratio on this day. All adults working at the facility have fingerprint clearance and are associated.

Facility is located on Notre Dame Elementary School campus. Facility operates according to the School year with periodic breaks/holidays throughout the year. Facility operates day care from Monday - Friday 8am-5:30pm. Facility operates in two rooms: Preschool room and TK room.

LPA observed classrooms to be clean and equipped with age appropriate toys and materials. Storage for children's belongings are located inside the classrooms, labeled with each child's individual names. LPA observed facility has an installation of a fire alarm system inside the classrooms as well as a fully charged, fire extinguisher. The classrooms has a smoke and carbon monoxide detector installed as well as emergency kits with first aid materials and emergency contact information. LPA observed that medication is stored appropriately in Directors office, inaccessible to enrolled children and maintained with proper documentation.

All poisons, cleaning solutions and hazardous materials are stored inaccessible to children in off limit areas or facility high shelves. Facility offers snacks and parents bring in their childs' lunch. Filtered water is available to children indoors and outdoors. Outdoor area appears to be clean and orderly. There are a variety of outdoor equipment that are in good working condition. There is also shading area available outside. Children are signed in and out of facility with parents' signatures daily. Facility has license documentation and information properly posted and available for review inside of the Preschool Room.

LPA reviewed facility records that included 5 children's records and 4 staff records. LPA observed children's and staff's records to be complete. All staff have an up to date CPR & First Aid certificate. Director will ensure all staff have up to date Mandated Reporter Certificate. Last emergency drill was conducted 02/2023. Director plans to do an emergency drill before the end of the month. Emergency drills are conducted at least once every six months and are properly logged and documented.

Continued on Page 2..
SUPERVISOR'S NAME: Marie RodriguezTELEPHONE: (650) 732-0619
LICENSING EVALUATOR NAME: Leslit Tapia-MandujanoTELEPHONE: 650-266-8800
LICENSING EVALUATOR SIGNATURE:
DATE: 08/23/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/23/2023
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
SAN BRUNO CC RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME: NOTRE DAME PRESCHOOL
FACILITY NUMBER: 414004829
VISIT DATE: 08/23/2023
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
Page 2 continued...

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.

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.

Director is aware that all staff is 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 director to frequently visit our website at www.ccld.ca.gov for licensing regulations and new updates.

This facility provides Incidental Medical Services – IMS. Director will create an IMS plan and submit to the department. 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-care-centers/.

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.

Based on today's inspection, deficiencies were not observed, according to California Title 22, Health and Safety Code of Regulations.

A notice of site visit was given and must remain posted for 30 days.



Exit interview conducted and report was reviewed with Director, Haydet Guilianetti.
SUPERVISOR'S NAME: Marie RodriguezTELEPHONE: (650) 732-0619
LICENSING EVALUATOR NAME: Leslit Tapia-MandujanoTELEPHONE: 650-266-8800
LICENSING EVALUATOR SIGNATURE:

DATE: 08/23/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/23/2023
LIC809 (FAS) - (06/04)
Page: 3 of 3