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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 414002817
Report Date: 11/02/2022
Date Signed: 11/02/2022 02:25:02 PM

Document Has Been Signed on 11/02/2022 02:25 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
CCLD Regional Office, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME:WELCOME AMIGOS SPANISH IMMERSION ED.CTR.FACILITY NUMBER:
414002817
ADMINISTRATOR:VILLAGOMEZ, ELIZABETHFACILITY TYPE:
850
ADDRESS:2825 ALAMEDA DEL LAS PULGASTELEPHONE:
(650) 455-5330
CITY:SAN MATEOSTATE: CAZIP CODE:
94403
CAPACITY: 44TOTAL ENROLLED CHILDREN: 39CENSUS: 37DATE:
11/02/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
11:40 AM
MET WITH:Elizabeth VillagomezTIME COMPLETED:
02:30 PM
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On November 2, 2022 at approximately 11:40am, Licensing Program Analyst (LPA) Catrina Quimbo, conducted an unannounced, annual inspection. LPA met with teacher's assistant, T1, and explained the purpose of the visit. At start of LPA's visit, director was not present due to a pre-scheduled appointment. T1 alerted director of LPA's presence via mobile phone. LPA spoke with director on mobile phone, explaining the purpose of LPA's visit.

Present during LPA's visit included 37 enrolled children (all preschool age) and 4 staff members. Facility is operating within capacity limits and ratios during LPA's visit. Hours of operation are Monday to Friday from 8:00am to 5:30pm.

LPA inspected day care areas, inside and outside, for health and safety hazards. Program operates at Grace Lutheran Church and School in Preschool and Kindergarten classrooms only.

At approximately 12:00pm, director arrived to facility. LPA continued inspection with director. Classrooms are equipped with working telephones, first aid kits, and working carbon monoxide detectors. Entire facility has a smoke, fire alarm system and fully charged fire extinguisher implemented by Grace Lutheran School. LPA observed cleaning solutions, poisons and other chemicals to be made inaccessible behind child safety locked cabinets. Storage for children's belongings are located inside each classroom, labeled with children's individuals names.

LPA observed classrooms to have age appropriate furniture, toys and materials that were clean and in good working condition. Program uses school bathroom and has exclusive use over school bathrooms. LPA observed bathrooms to be in working condition with appropriate sanitation products. Sinks in bathroom do not provide water that is warmer than 120 degrees Fahrenheit.
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SUPERVISORS NAME: Cindy Interiano
LICENSING EVALUATOR NAME: Catrina Quimbo
LICENSING EVALUATOR SIGNATURE: DATE: 11/02/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/02/2022
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 3
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME: WELCOME AMIGOS SPANISH IMMERSION ED.CTR.
FACILITY NUMBER: 414002817
VISIT DATE: 11/02/2022
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LPA observed electrical outlets in classrooms to be made inaccessible, blocked by furniture or to have child safety covers. Children are signed into and out of program with parent's written signatures. LPA observed all children present to be properly signed into program. All licensing documentation is properly posted outside of classrooms, available for review.

Water is made accessible to children, indoors and outdoors, with children's individual water containers. Preschool program has exclusive use of an outdoor area that is made separate from entire school's outdoor play area. LPA observed play area utilized for preschool program to be fully enclosed and fenced with an at least 4 ft. high fence. LPA observed outdoor area to have age appropriate materials that are in good working condition. Playground also includes a play structure that is made off limits to enrolled children by safety cones.

Program does not provide a food service. Children bring their own food that is stored in children's backpacks with individually labeled hooks. Classrooms have sufficient amount of sleeping cots that are utilized for nap time.

LPA reviewed 10 children's files and 6 staff files. Children's files were complete and have a record of emergency identification information on file. At least one staff member on site has a valid and current CPR certificate that will expire 12/2023.

Director is aware that all staff hired are required to complete Mandated Reporter Training every two years. The training can be obtained online at www.mandatedreporterca.com. LPA encourages director to frequently visit our website at www.ccld.ca.gov for licensing regulations and new updates.

Director was informed that as of September 1, 2016, a person may not be employed or volunteer at a child care facility unless he or she has been immunized against influenza, pertussis, and measles or qualifies for an exemption pursuant to Health and Safety code 1596.7995 and 1597.662.

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.
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SUPERVISORS NAME: Cindy Interiano
LICENSING EVALUATOR NAME: Catrina Quimbo
LICENSING EVALUATOR SIGNATURE:

DATE: 11/02/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/02/2022
LIC809 (FAS) - (06/04)
Page: 2 of 3
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME: WELCOME AMIGOS SPANISH IMMERSION ED.CTR.
FACILITY NUMBER: 414002817
VISIT DATE: 11/02/2022
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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

No deficiencies were issued under CCR, Title 22, Division 12.

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 director/licensee, Elizabeth Villagomez.
SUPERVISORS NAME: Cindy Interiano
LICENSING EVALUATOR NAME: Catrina Quimbo
LICENSING EVALUATOR SIGNATURE:

DATE: 11/02/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/02/2022
LIC809 (FAS) - (06/04)
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