414002817-6-10-2025-05-CC-JTSE-DHJ299-20250610171135

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 414002817
Report Date: 06/10/2025
Date Signed: 06/10/2025 05:12:31 PM

Document Has Been Signed on 06/10/2025 05:12 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 CC RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME:	WELCOME AMIGOS SPANISH IMMERSION ED.CTR.		FACILITY NUMBER:	414002817
ADMINISTRATOR/ DIRECTOR:	VILLAGOMEZ, ELIZABETH		FACILITY TYPE:	850
ADDRESS:	2825 ALAMEDA DEL LAS PULGAS		TELEPHONE:	(650) 245-7788
CITY:	SAN MATEO	STATE: CA	ZIP CODE:	94403
CAPACITY: 44	TOTAL ENROLLED CHILDREN: 44	CENSUS: 23	DATE:	06/10/2025
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	02:00 PM
MET WITH:	Lead Teacher, Karla Monzalvo		TIME VISIT/ INSPECTION COMPLETED:	05:25 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 6/10/2025, at approximately 2:00PM, Licensing Program Analyst (LPA) Jonathan Tse conducted an unannounced annual visit at the facility. LPA met with Lead Teacher, Karla Monzalvo (S1), and explained the purpose of the visit. Present during the visit was S1, four staff members, and 23 preschool age children. The facility’s operating hours are from 8:00AM to 5:30PM. This facility is located on the premises of Grace Lutheran Church. LPA and S1 inspected the facility for any health or safety hazards. The facility is equipped with a fire alarm system and a fully charged 3A40BC fire extinguisher. There are operational carbon monoxide detectors present. Emergency exits are clearly marked and visible. Poisons, cleaning detergents, and other chemicals are stored inaccessible to children in care. Electrical outlets are covered or blocked when not in use. There are heating and ventilation controls available for the comfort and safety of children in care. LPA observed there to be age-appropriate toys and learning materials present. Furniture is age-appropriate and free of rough or sharp edges. There are cubbies available for each child to use as storage. Children nap on mats and bring bedding from home. Per S1, bedding is taken home once a week for cleaning. Children bring lunch and snacks from home. S1 stated that the facility has extra snacks for children. Children bring water bottles from home and refill them at the facility. Drinking water is provided from a noncontaminating fixture. Toilets and sinks were observed to be operational. LPA advised that handwashing sinks are not required to provide hot water. S1 stated that they understood. Continued on Page Two

NAME OF LICENSING PROGRAM MANAGER: Ali Zebila
NAME OF LICENSING PROGRAM ANALYST: Jonathan Tse
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 06/10/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/10/2025

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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California Health & Human Services Agency

California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:

Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.

Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)

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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 CC RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME: WELCOME AMIGOS SPANISH IMMERSION ED.CTR.	FACILITY NUMBER: 414002817
	VISIT DATE: 06/10/2025

NARRATIVE

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The facility uses two outdoor play areas: Yard 1 and Yard 2. LPA observed the outdoor play areas to be free of debris and other loose materials. Children have access to drinking water while outdoors. Shade is accessible from the building or trees. There are age-appropriate toys and equipment available for use. There is a sandbox in Yard 2 that is covered and checked daily. Per S1, children may be taken outside on neighborhood walks or to nearby parks.

LPA observed the off-limits area of Yard 2 to have an opening in the fence. Although the opening is in an off-limits area, LPA advised that the fence be secured to ensure the safety of children in care. S1 stated that they understood. A hole in the surface of the basketball court was observed and S1 was advised to cover the hole while children use Yard 2.

There are no swimming pools or other similar bodies of water present. Per S1, there are no firearms or weapons stored in the facility.

LPA reviewed five staff files, five children’s files, and facility records. There is at least one staff member with current Pediatric First Aid/CPR training present. LPA advised that Mandated Reporter Training be completed and maintained for all staff.

LPA observed that four out of five staff files did not have a Health Screening Report (LIC503) present. Staff transcripts were also unavailable for review. LPA informed S1 that deficiencies would be cited for staff records. S1 stated that they understood.

All children’s files were observed to be complete. Children are signed in and out of the facility with paper sign-in/out sheets. Children’s rosters are maintained and accessible for review. All required postings are posted and accessible for review upon entry to the facility. The facility last conducted an emergency drill on 5/15/2025. Emergency drills are properly logged and documented. The facility tested its fixtures for lead and found no exceedances. LPA advised that lead testing must be conducted once every five years. S1 stated that they understood.

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NAME OF LICENSING PROGRAM MANAGER: Ali Zebila
NAME OF LICENSING PROGRAM ANALYST: Jonathan Tse
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 06/10/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/10/2025

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 CC RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME: WELCOME AMIGOS SPANISH IMMERSION ED.CTR.	FACILITY NUMBER: 414002817
	VISIT DATE: 06/10/2025

NARRATIVE

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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.

Facility representative 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.

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 21-21.1-CCP).

LPA verified that the lead testing was completed in accordance to the Written Directives outlined in PIN 21-21.1-CCP.

This facility provides Incidental Medical Services – IMS. LPA reviewed storage of “medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. For IMS information see PIN 22-02-CCP. 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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NAME OF LICENSING PROGRAM MANAGER: Ali Zebila
NAME OF LICENSING PROGRAM ANALYST: Jonathan Tse
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 06/10/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/10/2025

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 CC RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME: WELCOME AMIGOS SPANISH IMMERSION ED.CTR.	FACILITY NUMBER: 414002817
	VISIT DATE: 06/10/2025

NARRATIVE

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Facility representative 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.

See LIC809-D for deficiencies cited today regarding staff records. See LIC9102-TV for technical violations issued regarding staff records and physical plant. Appeal rights were provided and explained to S1.

A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with the facility representative, Karla Monzalvo.

NAME OF LICENSING PROGRAM MANAGER: Ali Zebila
NAME OF LICENSING PROGRAM ANALYST: Jonathan Tse
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 06/10/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/10/2025

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 06/10/2025 05:12 PM - It Cannot Be Edited

Created By: Jonathan Tse On 06/10/2025 at 04:48 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: WELCOME AMIGOS SPANISH IMMERSION ED.CTR.	FACILITY NUMBER: 414002817
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 06/10/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

101216(g)(1)

Personnel Requirements

(1) Except as specified in (3) below, good physical health shall be verified by a health screening, including a test for tuberculosis, performed by or under the supervision of a physician not more than one year prior to or seven days after employment or licensure. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on record review, the licensee did not comply with the section cited above by not having health screening reports on file for staff which poses a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 07/10/2025
	Plan of Correction
1 2 3 4	Licensee shall ensure that all staff have a health screening report signed by a physician or other qualified medical personnel and submit completed health screening reports to LPA via email by set due date of 7/10/2025. Please see LIC503 for reference.

Type B

Section Cited

CCR

101216.1(g)

Teacher Qualifications and Duties

(g) A photocopy of the teacher's Child Development Permit as specified in (c)(3) above, or a photocopy of the teacher's transcript(s) documenting successful completion of required course work, shall be maintained at the center. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on record review, the licensee did not comply with the section cited above by not having transcripts available for review which poses a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 06/24/2025
	Plan of Correction
1 2 3 4	Licensee shall submit transcripts to LPA for all staff members at the facility to LPA by set due date of 6/24/2025.

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

	Ali Zebila
NAME OF LICENSING PROGRAM MANAGER:

	Jonathan Tse
NAME OF LICENSING PROGRAM ANALYST:

LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 06/10/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/10/2025

LIC809 (FAS) - (06/04)

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