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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 380505725
Report Date: 01/06/2020
Date Signed: 01/06/2020 12:31:16 PM

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:ST. NICHOLAS DAY CARE AND PRESCHOOL-INFANTFACILITY NUMBER:
380505725
ADMINISTRATOR:TUWAI, KATHYFACILITY TYPE:
830
ADDRESS:5200 DIAMOND HEIGHTS BLVD.TELEPHONE:
(415) 550-1536
CITY:SAN FRANCISCOSTATE: CAZIP CODE:
94131
CAPACITY:39CENSUS: 30DATE:
01/06/2020
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
11:30 AM
MET WITH:Director, Kathy TuwaiTIME COMPLETED:
12:45 PM
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Licensing Program Analyst, (LPA) Luis J. Gomez and (LPM) Garfield Leung met with director Kathy Tuwai. Purpose of the inspection was explained and is for plan of correction inspection. Present is director and 9 staff supervising 30 children. All children present are Infant age. LPA and LPM inspected the facility with director for health and safety hazards. LPA Gomez and LPM Leung reviewed the following deficiencies issued on 11/19/2019:

On December 2, 2019, director submitted an updated weekly personnel schedule with required break to the licensing office.

At 11:13pm, on January 6, 2020 LPA Gomez and LPM Leung inspected the infant classroom for health and safety hazards. Infant classroom is operating within the required staff- child ratio. Director stated, qualified teacher who was out sick has now returned.

Deficiency issued on 11/19/2019 have been cleared. 'Cleared POC Letter' was given to director.

**No deficiencies were cited against the facility today under CCR,Title 22, Div. 12, Chapt. 1**

This report and rights to comment and appeal were discussed with Licensee. This report must be kept in the facility available for public review. Notice of site visit was observed being posted.
SUPERVISOR'S NAME: Alma MaligTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Luis GomezTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:

DATE: 01/06/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/06/2020
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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