414004560-11-29-2023-05-CC-CQUO-CY2RCM-20231129115435

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 414004560
Report Date: 11/29/2023
Date Signed: 11/29/2023 11:54:40 AM

Document Has Been Signed on 11/29/2023 11:54 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:	AMIGOS DE SF		FACILITY NUMBER:	414004560
ADMINISTRATOR:	ZECENA, DALILA		FACILITY TYPE:	850
ADDRESS:	1020 SULLIVAN AVENUE		TELEPHONE:	(650) 218-1555
CITY:	DALY CITY	STATE: CA	ZIP CODE:	94015
CAPACITY: 22	TOTAL ENROLLED CHILDREN: 21	CENSUS: 18	DATE:	11/29/2023
TYPE OF VISIT:	Required - 3 Year	UNANNOUNCED	TIME BEGAN:	08:25 AM
MET WITH:	Paola Ramirez		TIME COMPLETED:	12:15 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 November 29, 2023 at approximately 8:25am, Licensing Program Analysts (LPAs) Catrina Quimbo and Yasha Nasiripour conducted an unannounced, annual inspection. LPAs met with lead teacher, Paola Ramirez (T1), and explained the purpose of the inspection. Upon LPAs' arrival, children were being dropped off to the center. Hours of operation are Monday through Friday 7:30am to 5:30pm. LPAs inspected facility, indoors and outdoors, for health and safety hazards. Classroom was observed to be clean and properly ventilated. LPAs observed classroom to be sectioned into multiple areas that include a dramatic play, fine motor skill development, art and eating area. LPA observed each section to be clean, free of any hazards or poisons. Children's toys and materials were observed to be age appropriate. Furniture for children's use was also age appropriate and in good condition. Carpets in classroom were free of stains and were secure to floor. After all children arrived, present during LPAs' visit included 3 staff (T1, TA1, and A1) and 18 preschool children. Per T1, facility does not currently have a fully qualified director on site during operating hours. Storage for children's personal belongings is in classroom, labeled with children's individual names. LPA observed poisons, cleaning supplies and other hazardous materials to be stored inaccessible to children, in bathroom's high shelves and/or in an off limit area. Classroom is equipped with a fully charged fire extinguisher, fire alarm system and working smoke and carbon monoxide detectors. LPAs tested carbon monoxide detector near eating area and observed detector to be working. LPAs observed electrical outlets in classrooms to be made inaccessible with child safety covers. Bathroom for children's use was observed to be clean and in proper working condition, equipped with appropriate sanitation and toileting materials. Sinks accessible to children do not provide water that is warmer than 120 degrees Fahrenheit. LPAs observed garbage bins in classroom and in bathroom to have tight fitting lids. (Continue Report on Page 2...)

SUPERVISORS NAME: Marie Rodriguez
LICENSING EVALUATOR NAME: Catrina Quimbo
LICENSING EVALUATOR SIGNATURE:	DATE: 11/29/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/29/2023

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 4

Document Has Been Signed on 11/29/2023 11:54 AM - It Cannot Be Edited

Created By: Catrina Quimbo On 11/29/2023 at 11:03 AM

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: AMIGOS DE SF	FACILITY NUMBER: 414004560
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 11/29/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

101215.1(b)

Child Care Center Director Qualifications and Duties

(b) All child care centers shall have a director. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on observation, interview, record review, the licensee did not comply with the section cited above. There was no fully qualified director on site, which poses a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 12/15/2023
	Plan of Correction
1 2 3 4	Facility must have a fully qualified director on site during all hours of operation. A director packet of a fully qualified director must be submitted to department by POC due date.

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:

Marie Rodriguez

LICENSING EVALUATOR NAME:

Catrina Quimbo

LICENSING EVALUATOR SIGNATURE:

DATE: 11/29/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/29/2023

LIC809 (FAS) - (06/04)

Page: 2 of 4

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: AMIGOS DE SF	FACILITY NUMBER: 414004560
	VISIT DATE: 11/29/2023

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 cots for napping children. Per T1, sheets and blankets are provided by children's families and are sent home weekly or as needed.

Entire outdoor area is entirely enclosed with an at least 4 ft. high fence. Outdoor area is equipped with a variety of outdoor toys and equipment that were in good working condition. There is a play structure in the outdoor area that has resilient padding underneath. LPAs observed a sandbox in outdoor area without a cover. LPAs advised T1 to maintain sandbox with full cover.

Water is made available to children both indoors and outdoors with children's individual water containers that can be refilled on site. 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.

LPA verified that the lead testing was completed in accordance to the Written Directives
outlined in PIN 21-21.1-CCP. Facility has completed required lead water testing. Water fixtures tested were within time frame of testing and were below the 5.5. ppb threshold.

Program does not currently provide a food service. Children's families provide children's meals including snack and lunch. Children are signed in and out of facility by authorized representative's written signatures, located in the classroom. LPA observed children to be properly signed in on date of visit. Facility has license documentation and information properly posted and available for review in classroom. Emergency disaster drills are conducted and are properly logged and documented. Last emergency disaster drill was conducted 11/07/2023.

LPA reviewed facility records that included 6 children's records. Children's files have record of emergency identification information on file and required immunizations. LPA also reviewed staff records that included the teaching staff present. All staff on site have current their required immunizations and Mandated Reporter training certifications. 2 out of the 3 staff present have current CPR/First Aid certifications. Staffs' required immunizations were also made available for review.

LPAs reminded T1 that all staff is required to complete Mandated Reporter Training every two years. The training can be obtained online at www.mandatedreporterca.com.
(Continue Report on Page 3...)

SUPERVISORS NAME: Marie Rodriguez
LICENSING EVALUATOR NAME: Catrina Quimbo
LICENSING EVALUATOR SIGNATURE:	DATE: 11/29/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/29/2023

LIC809 (FAS) - (06/04)

Page: 3 of 4

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: AMIGOS DE SF	FACILITY NUMBER: 414004560
	VISIT DATE: 11/29/2023

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...)
LPA discussed the safe sleep regulations with facility representative and
discussed the Child Care Licensing Safe Sleep webpage at
https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-andresources/safe-sleep as an additional resource. LPA also informed facility representative of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

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-carecenters/

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.

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.

Facility was cited a Type B citation for not having a fully qualified director on site. A plan of correction was discussed. Appeal Rights were provided.

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

Exit interview conducted and report was reviewed with the T1, Paola Ramirez.

SUPERVISORS NAME: Marie Rodriguez
LICENSING EVALUATOR NAME: Catrina Quimbo
LICENSING EVALUATOR SIGNATURE:	DATE: 11/29/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/29/2023

LIC809 (FAS) - (06/04)

Page: 4 of 4