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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 214005634
Report Date: 06/21/2024
Date Signed: 06/21/2024 01:30:37 PM

Document Has Been Signed on 06/21/2024 01:30 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:GUIDEPOST MONTESSORI AT SAN RAFAELFACILITY NUMBER:
214005634
ADMINISTRATOR/
DIRECTOR:
LIMA, ANAFACILITY TYPE:
850
ADDRESS:11 PROFESSIONAL CENTER PARKWAYTELEPHONE:
(628) 277-1616
CITY:SAN RAFAELSTATE: CAZIP CODE:
94903
CAPACITY: 73TOTAL ENROLLED CHILDREN: 17CENSUS: 18DATE:
06/21/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:22 AM
MET WITH:Ana LimaTIME VISIT/
INSPECTION COMPLETED:
12:45 PM
NARRATIVE
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***Amended Page 3 of the report***

On 6/21/2024, Licensing Program Analyst (LPA) Hanson Leong conducted an unannounced annual visit to the Child Care Center (CCC) listed above. This facility also has an infant program under license # 214005635. LPA met with the Director, Ana Lima, and explained the purpose of the visit. Eighteen preschool-aged children and four staff members were present during the visit. A parent was observed in the classroom with their child. The four staff members present at the CCC received criminal record clearance from the department. The CCC is within its capacity and in accordance with the required ratio of staff to children.

LPA observed that all required documents, such as the facility license, waivers, parental and personal rights notifications, car seat laws, emergency disaster plan, and daily activities schedule, were displayed in a prominent, publicly accessible location.

According to the director, the most recent emergency disaster drill took place on 6/18/2024, and the LPA observed that it was properly documented. LPA reviewed the emergency disaster drill log and found that they were conducted monthly.

LPA conducted an inspection for potential health and safety hazards and found the center’s interior to be clean, safe, and well-maintained. According to the director, the children are required to bring their own food. LPA reminded the director about the importance of the child’s container being labeled with the child’s name and properly stored or refrigerated. Snacks were observed to be available for the children. The CCC was observed to have a first aid kit, functioning smoke and carbon monoxide detectors, and a fully charged fire extinguisher.

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SUPERVISORS NAME: Daniel J Oquendo
LICENSING EVALUATOR NAME: Hanson Leong
LICENSING EVALUATOR SIGNATURE: DATE: 06/21/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/21/2024
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN BRUNO CHILD CARE, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME: GUIDEPOST MONTESSORI AT SAN RAFAEL
FACILITY NUMBER: 214005634
VISIT DATE: 06/21/2024
NARRATIVE
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The classroom was equipped with age-appropriate toys, furniture, and educational materials, and each child had their own designated storage space. Electrical outlets were observed to be properly covered.

The bathrooms were found to be clean and fully operational. The toilets and handwashing facilities were well-kept, safe, and clean.

All accessible cabinets and drawers in the classroom was found to be free of hazardous materials or poisons. Disinfectants, cleaning solutions, poisons, and other items that could pose a danger were stored in the breakroom and were inaccessible to the children.

The outdoor playground was enclosed by a fence, and the play equipment was well-maintained. The areas around and under high climbing equipment, swings, slides, and other similar equipment were observed to be cushioned with material that absorbs falls. No bodies of water, such as pools or spas, were present on site.

The sleeping/resting area was observed to be clean and sanitary. Cots were available for children to use, and each child's cot was identified by the number written on it. According to the director, the parents are required to bring their own sheets to the facility, and the facility asks the parents to have the sheets washed weekly.

LPA observed the CCC records the child's attendance manually on paper and with an electronic app. All parent signatures are accounted for each child from the electronic app. LPA reviewed five children’s files and confirmed that three children have complete files that include their emergency contact and medical information. LPA found that the two children did not have the form LIC 627 in their file. LPA reminded the director that form LIC 627 must be maintained in each child’s files. LPA requested the two children that were missing the form LIC 627 needs to be emailed to the department.

LPA reviewed the files for three staff members and confirmed that two were up to date with their Pediatric First Aid/CPR certifications. LPA found that one of the three staff members had completed the necessary twelve units in Early Childhood Education (ECE), which meets the qualifications required to be classified as a teacher. The second staff member has completed six ECE units and enrolled in two ECE classes. The third staff member has completed six ECE units, qualifying them to be classified as a teacher’s aide.

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SUPERVISORS NAME: Daniel J Oquendo
LICENSING EVALUATOR NAME: Hanson Leong
LICENSING EVALUATOR SIGNATURE:

DATE: 06/21/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/21/2024
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 CHILD CARE, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME: GUIDEPOST MONTESSORI AT SAN RAFAEL
FACILITY NUMBER: 214005634
VISIT DATE: 06/21/2024
NARRATIVE
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***Amended***

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Assembly Bill (AB) 2370, Chapter 676, Statutes of 2018, requires all licensed Child Care Centers (CCCs) constructed before January 1, 2010, to test their water (used for drinking and food preparation) for lead contamination before January 1, 2023, and then every 5-years after the date of the first test.

For child care center licenses issued after July 1, 2022, the licensee shall test their water for lead within 180 days of licensure pursuant to Written Directives section 101700 (PIN 21-21.1CCP).

LPA verified that the lead testing was not completed in accordance to the Written Directives outlined in PIN 21-21.1-CCP.

LPA referred the director to the Department website for lead: Lead Toxicity Prevention and Water Testing


Information.

Director 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.

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-andresources/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.

Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02- CCP. When any IMS is provided, an updated Plan of Operation that includes IMS must be submitted to the Department. 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

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SUPERVISORS NAME: Daniel J Oquendo
LICENSING EVALUATOR NAME: Hanson Leong
LICENSING EVALUATOR SIGNATURE:

DATE: 06/21/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/21/2024
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 CHILD CARE, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME: GUIDEPOST MONTESSORI AT SAN RAFAEL
FACILITY NUMBER: 214005634
VISIT DATE: 06/21/2024
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Director 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.

To improve the quality and value of the new inspection process, a survey may 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 CARE tools, please send email inquiries 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

Please refer to LIC 809D for today’s citation.

A copy of today’s report and the facility’s appeal rights were given to the Director, Ana Lima. A Notice of Site Visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with the Director, Ana Lima.

SUPERVISORS NAME: Daniel J Oquendo
LICENSING EVALUATOR NAME: Hanson Leong
LICENSING EVALUATOR SIGNATURE:

DATE: 06/21/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/21/2024
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 06/21/2024 12:31 PM - It Cannot Be Edited


Created By: Hanson Leong On 06/21/2024 at 12:23 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: GUIDEPOST MONTESSORI AT SAN RAFAEL

FACILITY NUMBER: 214005634

DEFICIENCY INFORMATION FOR THIS PAGE:

VISIT DATE: 06/21/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
HSC
1597.16(a)(1)
Lead Testing
(1) A licensed child day care center, as defined in Section 1596.76, that is located in a building that was constructed before January 1, 2010, shall have its drinking water tested for lead contamination levels on or after January 1, 2020, but no later than January 1, 2023, and every five years after the date of the initial test.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on interview and record review, the licensee did not comply with the section cited above, which poses/posed a potential health, safety or personal rights risk to children in care.
POC Due Date: 07/21/2024
Plan of Correction
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A complete lead water testing report must be submitted to the department by the due date mentioned above, including forms LIC 999, LIC 9275, and LIC 9276.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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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:Hanson Leong
LICENSING EVALUATOR SIGNATURE:
DATE: 06/21/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/21/2024


LIC809 (FAS) - (06/04)
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