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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 213002280
Report Date: 10/19/2023
Date Signed: 10/19/2023 02:12:02 PM

Document Has Been Signed on 10/19/2023 02:12 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 CHILD CARE, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME:CORTE MADERA MONTESSORIFACILITY NUMBER:
213002280
ADMINISTRATOR:WEASLER, SHARRALYNFACILITY TYPE:
850
ADDRESS:50 EL CAMINO DRIVETELEPHONE:
(415) 927-0919
CITY:CORTE MADERASTATE: CAZIP CODE:
94925
CAPACITY: 75TOTAL ENROLLED CHILDREN: 75CENSUS: DATE:
10/19/2023
TYPE OF VISIT:Case Management - Lead Testing/ExceedanceUNANNOUNCEDTIME BEGAN:
01:50 PM
MET WITH:Sharralyn Weasler/Daniel SapienTIME COMPLETED:
02:25 PM
NARRATIVE
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On October 19, 2023, Licensing Program Analysts (LPAs) Garcia and Tse conducted an unannounced, case management inspection for the Action Level Exceedance (ALE) of Lead in Child Care Center's water. LPAs met with site director and owner, Sharralyn Weasler and Daniel Sapien. LPAs explained the purpose of the visit.
Present in facility are 48 children, present with 10 staff members.

LPAs discussed the new Assembly Bill (AB) 2370, Chapter 676, Statutes of 2018 requires the Lead Testing of water in the Child Care Center with the site director during the inspection. All Child Care Centers that are located in buildings constructed before January 1, 2010, must have their water tested and post the results by January 1, 2023, and every 5 years after the date of the first testing.

The facility received the ALE report from the Vendor on 09/07/2022. Test results for this facility that exceeded a higher level of parts per billion (ppb) allowed, 5.5 ppb. The facility was proactive in getting facility faucets tested and putting signs indicating that the water fountain/kitchen fixture is not for drinking and or currently out of order. Per director, the affected fixture D (21) has been replaced on 1/20/2023 and the facility got retested on 4/19/23. LPAs reviewed the results for fixture D and it shows below the 5ppb of lead. The facility is also using other sources of water, sinks that passed the tests, for food preparation and water ingestion. Upon arrival of LPAs, the facility's affected fixture had been replaced and retested with results within the allowable threshold. The fixture is now cleared to be utilized for ingestion or used for food preparation.

The facility was not initially cited for the action level exceedance during the lead case management visit on October 2,2023. Due to updated guidance on the written directives in the PIN 21-21.1-CCP, the facility will be cited for the action level exceedance of the fixture. However, the facility has removed the affected fixture before the lead case management visit and the citation given today will be cleared on the same day.

LPA obtained the copies of the External Water Sampler Self-Certification Form (LIC9275), Child Care Center Sampling Checklist (LIC9276), Facility Sketch (LIC999), have been sent in an email to the LPA.

* See next page for deficiencies cited today

This report was reviewed and signed by Site Director/Owner, Sharralyn Weasler/Daniel Weasler.

This notice of Site visit was provided to the licensee and must remain posted for 30 days.

SUPERVISORS NAME: Daniel J Oquendo
LICENSING EVALUATOR NAME: Nathan Garcia
LICENSING EVALUATOR SIGNATURE: DATE: 10/19/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/19/2023
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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Document Has Been Signed on 10/19/2023 02:12 PM - It Cannot Be Edited


Created By: Nathan Garcia On 10/19/2023 at 01:52 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: CORTE MADERA MONTESSORI
FACILITY NUMBER: 213002280

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/19/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
11/20/2023
Section Cited

101700.3

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101700.3 California Lead Action Level at Child Care Centers (b)(1) A result with values of 5.5 ppb or greater shall be deemed an Action Level Exceedance.

This requirement was not met as evidenced by:
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The facility remediated the fixture on 1/20/23 and got retested on 4/19/23 and retest results show below 5ppb of lead in the water. Fixture was remediated prior to both ALE case management visits.
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Based on results received from the certified water samplers, the facility exceeded 5.4 ppb of lead in their water source. Once received, the facility took immediate and proper actions to remediate the fixtures.
This posed a potential health, safety, or personal rights risk to persons in care.
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Deficiency will be cited and cleared on the same visit on 10/19/23.

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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:Daniel J Oquendo
LICENSING EVALUATOR NAME:Nathan Garcia
LICENSING EVALUATOR SIGNATURE:
DATE: 10/19/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/19/2023


LIC809 (FAS) - (06/04)
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