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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 414005194
Report Date: 09/11/2025
Date Signed: 09/11/2025 03:42:10 PM

Document Has Been Signed on 09/11/2025 03:42 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:NEO IMMERSION MONTESSORI SCHOOLFACILITY NUMBER:
414005194
ADMINISTRATOR/
DIRECTOR:		ELINA CHENFACILITY TYPE:
860
ADDRESS:830 ROSITA ROAD #C-18TELEPHONE:
(650) 898-8468
CITY:PACIFICASTATE: CAZIP CODE:
94044
CAPACITY: 25TOTAL ENROLLED CHILDREN: 25CENSUS: 0DATE:
09/11/2025
TYPE OF VISIT:PrelicensingANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:40 AM
MET WITH:Elina ChenTIME VISIT/
INSPECTION COMPLETED:
03:55 PM
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On 09/11//2025, Licensing Program Analyst (LPA) Andrea Medlin met with applicant representative,Elina Chen. The purpose of the visit was a scheduled pre-licensing inspection at the facility to ensure the health, safety, and personal rights as required by Title 22 and Health and Safety Regulations governing California Child Care Centers will be met. This is an application for 21 preschool aged children (ages 2.5-6 years old) in classroom #C-18 at the Linda Mar Learning Center owned through the Pacifica School District. The childcare center will operate Monday-Friday 8:00AM-5:30PM. The fire inspection was conducted and approved on 1/6/2025 by the North County Fire Department. No children are present during this inspection.

LPA toured and measured the on-limits areas and classroom located at the facility. The facility has a total of one classroom and outside hallway where children's cubbies are located.

Preschool Classroom measurements are:
The Indoor total measurements contain a total of 842.67 square feet, which will accommodate applicant's request for 21 preschool children.

Preschool Outdoor measurements are:
The outdoor total measurements contain a total of 9808.44 square feet, which will accommodate applicant's request for 21 preschool children. The outdoor garden area will not be used at this time due to not meeting health and safety standards due to debris needing to be removed, weeds cleaned up, etc. However LPA meausred the area and it contained 1500 square feet.

(Continued on next page LIC-809-C)
NAME OF LICENSING PROGRAM MANAGER: Deborah Lowe
NAME OF LICENSING PROGRAM ANALYST: Andrea Medlin
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 09/11/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/11/2025
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: NEO IMMERSION MONTESSORI SCHOOL
FACILITY NUMBER: 414005194
VISIT DATE: 09/11/2025
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LPA observed classroom to be clean, safe, sanitary, and in good repair. A comfortable temperature for children shall be maintained at all times. Furniture and equipment were observed to be maintained in good condition, free of sharp, loose, or pointed parts. All materials and surfaces accessible to children including toys, shall be free of toxic substances. All play equipment and materials used by children were observed to be age-appropriate. LPA observed a fully charged fire extinguisher, carbon monoxide, and smoke detectors in the facility. Children will have access to a total of 4 sinks, 2 toilets, and 3 urinals. LPA observed children's cubbies directly outside the classroom in the hallway. Staff have a separate bathroom that can be utilized by sick children if needed. Sick children will be isolated outside the classroom in the hallway with staff supervision. LPA advised that applicant maintains first-aid supplies in a location accessible to staff but inaccessible to children.

All outdoor and indoor passageways and other areas of potential hazard were observed to be free of obstruction. The child care center was observed to be clean, safe, sanitary and in good repair. Per applicant representative, parents/legal guardians will provide the meals and snacks for their child. Applicant was advised that full-day programs shall ensure that each child has a lunch and children shall be free to drink water as they wish. Drinking water is readily available via filtered water dispenser.

Drinking water from a non-contaminating fixture or container shall be readily available both indoors and in the outdoor activity area. LPAs advised per Health and Safety Code 1597.16(a)(1) Lead Testing and PIN-21-21-CCP Assembly Bill (AB) 2370, Chapter 676, Statutes of 2018, requires all licensed Child Care Centers (CCCs) constructed before January 1, 2010 to test their drinking water for lead contamination between January 1, 2020 and January 1, 2023, and then every 5 years after the date of the first test. Per Written Directive 100700(c)(1) Written Directives for Lead Testing (1) For a license issued on or after July 1, 2022, initial testing results shall be received and posted within 180 days of licensure.

Per Written Directive 100700(c)(1) for Lead Testing (1). For a license issued on or after July 1, 2022, initial testing results shall be received and posted within 180 days of licensure.


(Continued on next page 809-C)
NAME OF LICENSING PROGRAM MANAGER: Deborah Lowe
NAME OF LICENSING PROGRAM ANALYST: Andrea Medlin
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 09/11/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/11/2025
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: NEO IMMERSION MONTESSORI SCHOOL
FACILITY NUMBER: 414005194
VISIT DATE: 09/11/2025
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LPA advised applicant of licensing requirement of 35 square feet per child for indoor space; one toilet and hand washing fixture requirement for every 15 children.

Outdoor areas for preschool children were free of hazards including, holes, broken glass dry grasses, and other debris that pose a fire hazard. Shade was provided by use of overhead tarp. The areas around and under high climbing equipment was cushioned with soft rubber material to absorbs falls. Playground area is enclosed by a fence that is at least four feet high to protect children and to to keep them in the outdoor activity area. Any construction or equipment that could pose a hazard in the outdoor activity area shall be made inaccessible to children in care. LPA observed no bodies of water.

LPA observed the following postings in a prominent, publicly accessible location in the center. LIC 613A(9/96), PUB 393 (8/02), Child Care Center Notification of Parents' Rights and LIC 610 Disaster Plan. The license shall be posted when received; applicant reminded of the requirements to ensure license number is included in all advertisements in accordance with Health and Safety Code Section 1596.861.

Applicant was reminded that all adults 18 and over responsible for administration, direct supervision of staff, persons who provides care and supervision to children, and staff who have contact with children, 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 in violation.

LPA discussed the safe sleep regulations with applicant and discussed the Child Care Licensing Safe Sleep webpage at: https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep, as an additional resource. LPA also informed applicant 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.

(Continued on next page 809-C)
NAME OF LICENSING PROGRAM MANAGER: Deborah Lowe
NAME OF LICENSING PROGRAM ANALYST: Andrea Medlin
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 09/11/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/11/2025
LIC809 (FAS) - (06/04)
Page: 4 of 5
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: NEO IMMERSION MONTESSORI SCHOOL
FACILITY NUMBER: 414005194
VISIT DATE: 09/11/2025
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LPA reviewed with applicant the LIC 311A, Records to Be Maintained At The Facility, for child’s records, personnel records, administrative records, and documents to be posted.

Applicant was informed of the MyChildCarePlan.org site, 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.

Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update News letters and other important information communication platforms. To receive important licensed related information regarding licensed facilities,visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-care-licensing/subscribe and select the Child Care option to receive email communication.


The following corrections are needed before licensure will be considered. Corrections are due by September 24, 2025:
  • For designated director Nora Lacayo: Criminal Record Clearance status with community care licensing and association to this facility license number
  • For designated director Nora Lacayo: Verification of negative TB test results and measels (MMR) immunization.
  • Final review of application packet by LPM



Final licensure approval will be determined by review of the Centralized Application Bureau (CAB) Licensing Program Manager.

Exit interview conducted and reviewed with facility representative, Elina Chen, and a copy of this report must be made available for public review upon request.
NAME OF LICENSING PROGRAM MANAGER: Deborah Lowe
NAME OF LICENSING PROGRAM ANALYST: Andrea Medlin
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 09/11/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/11/2025
LIC809 (FAS) - (06/04)
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