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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 414002663
Report Date: 07/26/2024
Date Signed: 08/23/2024 11:00:47 AM

Document Has Been Signed on 08/23/2024 11:00 AM - 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:IMMACULATE HEART OF MARY (PRESCHOOL)FACILITY NUMBER:
414002663
ADMINISTRATOR/
DIRECTOR:		ARBAN, ERSIEFACILITY TYPE:
850
ADDRESS:1000 ALAMEDA DE LAS PULGASTELEPHONE:
(650) 593-4265
CITY:BELMONTSTATE: CAZIP CODE:
94002
CAPACITY: 36TOTAL ENROLLED CHILDREN: 5CENSUS: 3DATE:
07/26/2024
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:30 AM
MET WITH:Ersie ArbanTIME VISIT/
INSPECTION COMPLETED:
11:20 AM
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Licensing Program Analyst (LPA) Kassandra Medrano met with Ersie Arban, Director, for the purpose of conducting a Case Management Inspection. The facility submitted an application to add a room to their license that had not been previously added. The preschool is located on campus of Immaculate Heart of Mary School, a private school. Present today in the facility is the director, with 3 children. It was observed that the teacher/child ratio was in compliance during today's inspection. Prior to todays inspection, fire clearance was approved by San Mateo Consolidated Fire Department on July 2nd, 2024. The Preschool Program is currently operating Monday through Friday from 7:30AM to 4 PM, serving children ages 2 years old to entry to first grade. LPA observed that the Facility is clean, safe, sanitary, and in good repair for children, staff, and visitors.

School Gym: 56.6 x 88.9 = 5031.74 sq. feet (not including stage) divided by 35 = 143 children

LPA toured the facility during today's inspection as well as measured the space available for the children. The facility has requested to maintain the same capacity. LPA advised that room is approved for use as of today, 08/23/2024. LPA also advised that being that this is a school site, that the space not be used while other programs are present.

A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with the Director, Ersie.
SUPERVISORS NAME: Ali Zebila
LICENSING EVALUATOR NAME: Kassandra Medrano
LICENSING EVALUATOR SIGNATURE: DATE: 07/26/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/26/2024
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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