410503229-6-19-2023-05-CC-CQUO-CSXUK9-20230619153845

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 410503229
Report Date: 06/19/2023
Date Signed: 06/19/2023 03:38:50 PM

Document Has Been Signed on 06/19/2023 03:38 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:	CALIFORNIA MONTESSORI SCHOOL		FACILITY NUMBER:	410503229
ADMINISTRATOR:	HARJIT K. DHILLON		FACILITY TYPE:	850
ADDRESS:	480 N. SAN ANSELMO AVENUE		TELEPHONE:	(650) 589-2237
CITY:	SAN BRUNO	STATE: CA	ZIP CODE:	94066
CAPACITY: 38	TOTAL ENROLLED CHILDREN: 18	CENSUS: 11	DATE:	06/19/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	11:35 AM
MET WITH:	Ravneet "Reenu" Lally		TIME COMPLETED:	04:00 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 June 19, 2023 at approximately 11:35am, Licensing Program Analyst (LPA) Catrina Quimbo conducted an unannounced, annual inspection. LPA met with administrator/assistant director, Ravneet "Reenu" Lally, and explained the purpose of the inspection. Hours of operation are Monday through Friday 8:00am to 5:30pm. Program operates as a Montessori program. Present during LPA's visit included administrator/assistant director, 3 staff and 11 preschool children. Program currently utilizes classrooms, multi-purpose area, kitchen and outdoor area. With administrator/assistant director, LPA inspected facility, indoors and outdoors, for health and safety hazards. Classrooms were observed to be clean and properly ventilated. Classrooms have a variety of toys, furniture and equipment that were observed to be clean and in good working condition. LPA observed flooring in classrooms to be clean. There is multiple areas for children's personal belongings, each labeled with children's individual names. Classroom includes a fire place that is properly barricaded and made inaccessible to children. LPA observed cleaning supplies, poisons and chemicals to be stored in classroom's high shelves. Classroom is equipped with a garbage bin with a tight fitting lid. Facility is equipped with multiple fully charged fire extinguishers and multiple working smoke/carbon monoxide detectors. Facility conducts emergency drills monthly and are properly logged, made available for review. Facility includes both a boys and girls restrooms for children's use. LPA observed bathrooms to be in proper working condition. Sinks do not provide water that is warmer than 120 degrees Fahrenheit. (Continue Report on Page 2...)

SUPERVISORS NAME: Garfield Leung
LICENSING EVALUATOR NAME: Catrina Quimbo
LICENSING EVALUATOR SIGNATURE:	DATE: 06/19/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/19/2023

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 5

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: CALIFORNIA MONTESSORI SCHOOL	FACILITY NUMBER: 410503229
	VISIT DATE: 06/19/2023

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

(Continued, Page 2...)
Program utilizes mats and cots for napping children. Per administrator/assistant director, sheets and blankets are provided by children's families and are sent home weekly. LPA observed mats and cots to be appropriately stored in classroom.

Entire outdoor area is enclosed with an at least 4 ft. high fence. Outdoor area is equipped with a variety of outdoor toys and equipment that were new, and in good working condition. Outdoor area includes a sandbox that is properly covered. There is a play structure that was observed to have resilient padding underneath.

Water is made available to children both indoors and outdoors with children's individual water containers. Facility has completed required lead water testing. Program provides a food service that includes morning and afternoon snacks only. Children's families provide lunches.

Children are signed in and out of facility by authorized representatives' written signatures. LPA observed children to be properly signed in on date of LPA's visit. Facility has license documentation and information properly posted and available for review in classroom.

LPA reviewed facility records that included 8 children's records. Children's files were observed to be complete and have a record of emergency identification information on file and required immunizations. LPA also reviewed staff records that included the staff present. After review, LPA did not observe any of the staff (S1, S2, S3) present to have the required early childhood education/child development units available for review, to qualify staff as teaching staff. Administrator/assistant director stated they will work with staff to qualify as teaching staff. LPA also observed one staff (S3) present, directly working with children, to not have fingerprint clearance on file. Administrator/assistant director stated S3 will go through live scan process as soon as possible.

LPA reminded administrator/assistant director that all staff is required to complete Mandated Reporter training every two years. The training can be obtained online at www.mandatedreporterca.com.

Administrator/assistant 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.
(Continue Report on Page 3...)

SUPERVISORS NAME: Garfield Leung
LICENSING EVALUATOR NAME: Catrina Quimbo
LICENSING EVALUATOR SIGNATURE:	DATE: 06/19/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/19/2023

LIC809 (FAS) - (06/04)

Page: 2 of 5

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: CALIFORNIA MONTESSORI SCHOOL	FACILITY NUMBER: 410503229
	VISIT DATE: 06/19/2023

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

(Continued, Page 3...)
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.

Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. 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)/ (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

Facility was cited a Type A citation for having an un-fingerprinted adult (S3) work directly with children. Facility was also cited a Type B citation for the staff present (S1, S2, S3) during LPA's visit to not have the required early childhood education/child development units to qualify as teaching staff. Appeal Rights were provided to administrator/assistant director.

During visit, LPA received an updated LIC200A from administrator/assistant director, with updated operating hours.

A notice of site visit was given and must remain posted for 30 days. Failure to maintain posting requirements shall result in an immediate civil penalty of $100.

Exit interview conducted and report was reviewed with administrator/assistant director, Ravneet "Reenu" Lally.

SUPERVISORS NAME: Garfield Leung
LICENSING EVALUATOR NAME: Catrina Quimbo
LICENSING EVALUATOR SIGNATURE:	DATE: 06/19/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/19/2023

LIC809 (FAS) - (06/04)

Page: 3 of 5

Document Has Been Signed on 06/19/2023 03:38 PM - It Cannot Be Edited

Created By: Catrina Quimbo On 06/19/2023 at 02:43 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: CALIFORNIA MONTESSORI SCHOOL	FACILITY NUMBER: 410503229
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 06/19/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type A

Section Cited

CCR

101170(e)(1)

Criminal Record Clearance

(e) All individuals subject to a criminal record review pursuant to Health and Safety Code Section 1596.871 shall prior to working, residing or volunteering in a licensed facility: (1) Obtain a California clearance or a criminal record exemption as required by the Department or This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on observation, interview and record review, S3 (whom was present during LPA's visit), did not have fingerprint clearance prior to working with the children on site, which poses an immediate health, safety or personal rights risk to persons in care.
	POC Due Date: 06/20/2023
	Plan of Correction
1 2 3 4	Administrator/assistant director stated S3 will complete live scan process as soon as possible. Administrator/assistant director understands S3 cannot work with children until they have received fingerprint clearance.

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

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:

Garfield Leung

LICENSING EVALUATOR NAME:

Catrina Quimbo

LICENSING EVALUATOR SIGNATURE:

DATE: 06/19/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/19/2023

LIC809 (FAS) - (06/04)

Page: 4 of 5

Document Has Been Signed on 06/19/2023 03:38 PM - It Cannot Be Edited

Created By: Catrina Quimbo On 06/19/2023 at 02:43 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: CALIFORNIA MONTESSORI SCHOOL	FACILITY NUMBER: 410503229
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 06/19/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

101216.1(b)(1)

Teacher Qualifications and Duties

(b) Prior to employment, a teacher shall meet the requirements of (b)(1) or (b)(2) below: (1) A teacher shall have completed, with passing grades, at least six postsecondary semester or equivalent quarter units of the education requirement specified in (c)(1) below; or shall have obtained a Child Development Assistant Permit issued by the California Commission on Teacher Credentialing. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on observation, interview and record review, the licensee did not comply with the section cited above due to S1, S2, and S3 not having the required early childhood education (ECE)/child development units to be a teacher which poses a potential health, safety or personal rights risk to children in care.
	POC Due Date: 07/19/2023
	Plan of Correction
1 2 3 4	Administrator/assistant director stated they will work with staff to qualify them as teaching staff. Administrator/assistant director is aware staff without qualifications cannot be left alone with the children nor count towards teacher/student ratio.

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

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:

Garfield Leung

LICENSING EVALUATOR NAME:

Catrina Quimbo

LICENSING EVALUATOR SIGNATURE:

DATE: 06/19/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/19/2023

LIC809 (FAS) - (06/04)

Page: 5 of 5