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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 414002690
Report Date: 05/07/2025
Date Signed: 05/08/2025 06:00:43 PM

Document Has Been Signed on 05/08/2025 06:00 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:MSD GEOKIDS (INFANT)FACILITY NUMBER:
414002690
ADMINISTRATOR/
DIRECTOR:		BOURNE, KIMFACILITY TYPE:
830
ADDRESS:345 MIDDLEFIELD RD., M/S 204TELEPHONE:
(650) 329-4236
CITY:MENLO PARKSTATE: CAZIP CODE:
94025
CAPACITY: 35TOTAL ENROLLED CHILDREN: 35CENSUS: 20DATE:
05/07/2025
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:48 AM
MET WITH:Chae MarshallTIME VISIT/
INSPECTION COMPLETED:
12:45 PM
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On May 7, 2025 at approximately 8:30AM, Licensing Program Analyst (LPA) Katie Krenn conducted an unannounced annual visit. During today’s visit, LPA met with Director, Chae Marshall and explained the purpose of the visit to her. During today's inspection LPA observed eight infants, 11 toddlers, and seven teachers. LPA reviewed the sign in sheet where parents sign their children in and out of the facility. LPA confirmed that all seven teachers present had obtained criminal record clearances. The facility remains within its capacity limits and meets the required ratios for today’s visit.

The facilities hours of operation are Monday - Friday from 8:00AM - 6:00PM. At this time all the children in care are full-time. The facility currently does not take drop-ins.

LPA observed that all required documents: such as the facility license, notification of parents’ rights, and emergency disaster plan, were displayed and visible to the public. LPA notified the director that the notice for car seat laws should be posted. The director found the notice with the car seat laws, printed it, and posted it during the visit.

The most recent emergency disaster drill was conducted on 3/20/2025, and the LPA observed that it was documented. LPA reviewed the emergency disaster drill log and found that drills were conducted at least once every six months.

Each of the classrooms in the facility had a first aid kit, a smoke detector, a charged fire extinguisher, and an emergency disaster backpack kit. LPA did not test the smoke detectors, because they are a part of an integrated system. LPA tested the carbon monoxide detector that was in the hall outside the classrooms and found it to be functioning.

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NAME OF LICENSING PROGRAM MANAGER: Daniel J Oquendo
NAME OF LICENSING PROGRAM ANALYST: Katie Krenn
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 05/07/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/07/2025
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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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: MSD GEOKIDS (INFANT)
FACILITY NUMBER: 414002690
VISIT DATE: 05/07/2025
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The LPA inspected the indoor and outdoor areas for health and safety hazards. The facility was clean, safe, and well-maintained. Disinfectants, cleaning solutions, and poisons were securely stored out of children's reach, and all accessible cabinets and drawers in the classrooms were free of hazardous materials.

LPA observed that the two classrooms had age-appropriate toys, furniture, educational materials, and designated storage space for each child, which included hooks, bins, and cabinet space, all of which were clearly labeled for each child. LPA did not observe any accessible electrical outlets. Each classroom had a diaper-changing table within arm’s reach of a sink. The bathrooms were clean, fully operational, and equipped with suitable toileting equipment and sanitation products.

The outdoor playground has a fence that is at least four feet tall. The play equipment is in good condition and does not have sharp, loose, or pointed parts. The areas around and under climbing equipment are cushioned with tanbark. There are no pools, spas, or bodies of water on the property. Each child has there own water bottle which is filled at the facility from a carbon filter pitcher. The water bottles are brought outside during outdoor play and accessible to the children.

The preschool program does not currently provide lunch for the children. The families provide lunches for their children. LPA observed that each child had lunch boxes or bins in their designated storage space. The facility provides snacks for the children. LPA observed healthy snack option such as fresh fruits. Several of the children have documented allergies. This information is posted on the wall in each classroom, which a photo of each child by their listed allergies. An Epi-pen is kept in the emergency backpack kit in each classroom. Other medications are stored in the office, LPA observed them to be clearly labeled with appropriate instructions and not expired.

The facility offers different options for children to rest or nap, including mats and cribs. LPA observed that clean sheets and bedding was available for the children. Infant mattresses are firm and equipped with appropriately sized sheets. All cribs are well-maintained and free of loose items that could pose safety risks. Per the director, the facility provides the sheets and washes them daily.

LPA reviewed the files of five children, confirming that their emergency contact and medical information were complete and in order. LPA also reviewed the 15-minute sleep records for infants under two years old and confirmed that they were complete.

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NAME OF LICENSING PROGRAM MANAGER: Daniel J Oquendo
NAME OF LICENSING PROGRAM ANALYST: Katie Krenn
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 05/07/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/07/2025
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: MSD GEOKIDS (INFANT)
FACILITY NUMBER: 414002690
VISIT DATE: 05/07/2025
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LPA reviewed five staff files and confirmed that all necessary forms were complete and in order. LPA verified that four of the five staff members held current Pediatric First Aid and CPR certifications. During a review of the staff transcripts, LPA found that all five staff members had successfully completed twelve units in Early Childhood Education (ECE), which qualifies them to serve as teachers. LPA found that all the teachers had current Mandated Reporter Training, complete vaccination records, and all other required paperwork in the reviewed files.

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.



Director 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.

LPA discussed the safe sleep regulations with director 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 director 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.

No deficiencies were issued during today's visit.

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 the director Chae Marshall.
NAME OF LICENSING PROGRAM MANAGER: Daniel J Oquendo
NAME OF LICENSING PROGRAM ANALYST: Katie Krenn
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 05/07/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/07/2025
LIC809 (FAS) - (06/04)
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