414004105-7-15-2025-05-CC-JTSE-DJLTW9-20250715150509

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 414004105
Report Date: 07/15/2025
Date Signed: 07/15/2025 03:05:42 PM

Document Has Been Signed on 07/15/2025 03:05 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:	A+ IMMERSION PRESCHOOL II		FACILITY NUMBER:	414004105
ADMINISTRATOR/ DIRECTOR:	WONG, SHARON LAU		FACILITY TYPE:	850
ADDRESS:	30 W. 39TH AVENUE		TELEPHONE:	(650) 292-0817
CITY:	SAN MATEO	STATE: CA	ZIP CODE:	94403
CAPACITY: 90	TOTAL ENROLLED CHILDREN: 90	CENSUS: 66	DATE:	07/15/2025
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	11:35 AM
MET WITH:	Director, Sharon Wong		TIME VISIT/ INSPECTION COMPLETED:	03:20 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 7/15/2025, at approximately 11:35AM, Licensing Program Analyst (LPA) Jonathan Tse conducted an unannounced annual visit at the facility. LPA met with Director, Sharon Wong, and explained the purpose of the visit. Present during the visit was Director, eight staff members, and 66 preschool age children. The facility is operating within staffing and ratio requirements on this day. The facility’s operating hours are from 7:30AM to 6:00PM. LPA and Director inspected the facility for any health or safety hazards. There is a fully charged fire extinguisher that is at least size 2A10BC. There is a fire alarm system running throughout the facility. Per Director, there are combination smoke and carbon monoxide detectors installed in addition to the fire alarm system. Emergency exits are clearly marked and visible. Evacuation routes are posted and accessible for review. LPA advised that poisons, cleaning detergents, and other chemicals be placed inaccessible to children in care. This can include placing them high on a shelf so that children cannot reach them, or by placing a childproof lock on a cabinet. Director stated that they understood. Electrical outlets were observed to be covered or blocked by furniture when not in use. Passageways were observed to be free of obstructions. There are four classrooms in the facility. 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 children to use for storage. Children nap on cots and bring bedding from home. Bedding is brought home once a week for cleaning. Per Director, cots are wiped down once a week. Continued on Page Two

NAME OF LICENSING PROGRAM MANAGER: Ali Zebila
NAME OF LICENSING PROGRAM ANALYST: Jonathan Tse
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 07/15/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/15/2025

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: A+ IMMERSION PRESCHOOL II	FACILITY NUMBER: 414004105
	VISIT DATE: 07/15/2025

NARRATIVE

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Children bring water bottles from home and the facility refills bottles from a non-contaminating fixture. All meals and snacks are provided from home. LPA advised that the facility should maintain extra snacks just in case children do not bring their own. Director stated that they understood.

There are refrigerators present in each classroom. LPA observed the back of a refrigerator in Classroom 4 to be stained. LPA advised that the part be cleaned or replaced. Medication was observed to be stored in central locations and inaccessible to children in care. Medication was observed to be stored in its original packaging and with physician’s instructions as needed.

LPA observed the outdoor play area to be free of debris and other loose materials. The facility has an outdoor rotation waiver that allows for up to 85 children to be present at a time. The facility was in compliance with the waiver during the visit. There are age-appropriate toys and equipment present. There is shade available from nearby buildings, trees, or canopies.

Supervision of the outdoor play area was discussed. The outdoor play area is enclosed by a fence that is at least four feet high. There is a sandbox present that is checked prior to use by children. Drinking water is readily accessible for children during outdoor play. There are no swimming pools or other bodies of water present. There are no firearms or weapons stored in the facility.

LPA observed an electric utility box in the outdoor play area that had signage posted indicating that there must be 8 feet of clearance in front of it, and 3 feet of clearance on its sides. LPA observed that the facility had blocked off the immediate space around the box with gates and had blocked the space with unused toys and equipment. The utility box is inaccessible to children in care. However, LPA advised that the facility must comply with the signage posted on the utility box. Director stated that they understood.

LPA reviewed nine staff records, twelve children’s files, and facility records. All staff members present have current Pediatric First Aid/CPR and Mandated Reporter training on file. LPA advised that updated transcripts for teachers should be printed upon completion or enrollment in courses. Director 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: 07/15/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/15/2025

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: A+ IMMERSION PRESCHOOL II	FACILITY NUMBER: 414004105
	VISIT DATE: 07/15/2025

NARRATIVE

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All children’s files were observed to be complete. Children are signed in and out of the facility with paper sign-in/out sheets. LPA verified that all children present were signed in during the visit. All required postings were observed to be posted and accessible for review in the main entrance of the facility.

Based on review of the facility’s lead water testing records, the facility tested its water fixtures for lead on 1/20/2024, past the deadline of 1/1/2023. There were no exceedances of lead in any of the fixtures tested. LPA advised that lead testing results must be posted and accessible for review. LPA informed Director that a deficiency would be cited and cleared during today’s visit for not testing prior to the deadline of 1/1/2023. The facility must test its fixtures again for lead by 1/20/2029.

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.

Licensee 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 referred licensee to the Department website for lead: Lead Toxicity Prevention and Water Testing Information.
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NAME OF LICENSING PROGRAM MANAGER: Ali Zebila
NAME OF LICENSING PROGRAM ANALYST: Jonathan Tse
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 07/15/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/15/2025

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: A+ IMMERSION PRESCHOOL II	FACILITY NUMBER: 414004105
	VISIT DATE: 07/15/2025

NARRATIVE

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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/.

Licensee 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 deficiency cited and cleared during regarding lead water testing. See LIC9102-TV for technical violation issued today regarding the facility’s physical plant (outdoor play area).

A notice of site visit was given and must remain posted for 30 days. Appeal rights were provided and explained.

Exit interview conducted and report was reviewed with the Licensee, Sharon Wong.

NAME OF LICENSING PROGRAM MANAGER: Ali Zebila
NAME OF LICENSING PROGRAM ANALYST: Jonathan Tse
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 07/15/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/15/2025

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 07/15/2025 03:05 PM - It Cannot Be Edited

Created By: Jonathan Tse On 07/15/2025 at 02:52 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: A+ IMMERSION PRESCHOOL II	FACILITY NUMBER: 414004105
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 07/15/2025

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
1 2 3 4	Based on record review, the licensee did not comply with the section cited above by testing after the deadline of 1/1/2023 which posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 07/29/2025
	Plan of Correction
1 2 3 4	The facility tested its fixtures for lead and had no exceedances of lead in any of the fixtures tested.

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.

	Ali Zebila
NAME OF LICENSING PROGRAM MANAGER:

	Jonathan Tse
NAME OF LICENSING PROGRAM ANALYST:

LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 07/15/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/15/2025

LIC809 (FAS) - (06/04)

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