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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 380505725
Report Date: 11/19/2019
Date Signed: 11/19/2019 02:22:06 PM



STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
This is an official report of an unannounced visit/investigation of a complaint received in our office on
10/04/2019 and conducted by Evaluator Luis Gomez
COMPLAINT CONTROL NUMBER: 05-CC-20191004085908
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: 32DATE:
11/19/2019
UNANNOUNCEDTIME BEGAN:
09:45 AM
MET WITH:Director, Kathy TuwaiTIME COMPLETED:
02:35 PM
ALLEGATION(S):
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Facility is operating out of ratio
INVESTIGATION FINDINGS:
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Licensing Program Analysts (LPA) Luis J. Gomez met with the Director, Kathy Tuwai, for complaint investigation of above allegation. Purpose of the inspection was explained. Present is Director and 9 staff supervising 32 infant children. LPA’s inspected facility for health and safety hazards.

During today's inspection LPA's interviewed site director, staff and performed classroom observations.

As part of this investigation, LPA's conducted inspections of the facility on 10/11/2019 and 11/19/19, and did an evaluation of the supervision. A review of facility records was also completed which included a review of the childrens records, personnel records, personnel roster, and facility personnel schedule. Also, as part of this complaint investigation, interviews were conducted with the Director, random sample of parents and staff.

Continue on 9099-D...
Substantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Alma MaligTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Luis GomezTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:

DATE: 11/19/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/19/2019
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 1 of 5
Control Number 05-CC-20191004085908
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		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-INFANT
FACILITY NUMBER: 380505725
VISIT DATE: 11/19/2019
NARRATIVE
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(Page 2)
Regarding the allegation of facility operating out of ratio. Based on interviews conducted, review of personnel files and classroom observations made on 11/19/2019, LPA confirmed facility is not operating within the required Staff- Infant ratio. Director stated, infant classroom does not have a fully qualified teacher present, due to teachers being out sick.

Therefore, The preponderance of evidence standard has been met, there for the above allegation is found to be SUBSTANTIATED. California Code of Regulations (Title 22, section 12 & chapter are being cited on the attached 9099-D

Exit interview was conducted with site coordinator, Kathy Tuwai and plan of correction was developed with the director.

LPA observed notice of site visit was posted in the facility.
SUPERVISOR'S NAME: Alma MaligTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Luis GomezTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:

DATE: 11/19/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/19/2019
LIC9099 (FAS) - (06/04)
Page: 4 of 5
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
This is an official report of an unannounced visit/investigation of a complaint received in our office on
10/04/2019 and conducted by Evaluator Luis Gomez
PUBLIC
COMPLAINT CONTROL NUMBER: 05-CC-20191004085908

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: 32DATE:
11/19/2019
UNANNOUNCEDTIME BEGAN:
09:45 AM
MET WITH:Kathy TuwaiTIME COMPLETED:
02:35 PM
ALLEGATION(S):
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Unqualified staff providing care to daycare children
INVESTIGATION FINDINGS:
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Licensing Program Analysts (LPA) Luis J. Gomez met with the Director, Kathy Tuwai, for complaint investigation of above allegation. Purpose of the inspection was explained. Present is the Director and 9 staff supervising 32 Infant children. LPA’s inspected facility for health and safety hazards.

During today's inspection LPA interviewed site director, staff and performed classroom observations.

As part of this investigation, LPA conducted inspections of the facility on 10/11/2019 and 11/19/19, and did an evaluation of the supervision of the children. A review of facility records was also completed which included a review of the childrens's records, personnel records, personnel roster, and facility personnel break schedule. Also, as part of this complaint investigation, interviews were conducted with the Director, random sample of parents and staff.

Continue to 9099-D...
Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Alma MaligTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Luis GomezTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:

DATE: 11/19/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/19/2019
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 2 of 5
Control Number 05-CC-20191004085908
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		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-INFANT
FACILITY NUMBER: 380505725
VISIT DATE: 11/19/2019
NARRATIVE
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(Page 2)

Regarding the allegation of unqualified staff providing care to daycare children. Based on the interviews conducted, observations made, and a review of the facility files, LPA is unable to determine there is unqualified staff providing care to daycare children. Director stated that all hired teacher are fully qualified with the required semester units.

Although the allegations may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation(s) did or did not occur, therefore the allegation is unsubstantiated. Copy of this report is reviewed and provided to the director. No deficiencies are cited.

Exit interview was conducted with director Kathy Tuwai. LPA observed notice of site visit was posted in the facility.

SUPERVISOR'S NAME: Alma MaligTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Luis GomezTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:

DATE: 11/19/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/19/2019
LIC9099 (FAS) - (06/04)
Page: 3 of 5
Control Number 05-CC-20191004085908
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		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-INFANT
FACILITY NUMBER: 380505725
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/19/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
11/20/2019
Section Cited
CCR
101416.5(b)
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101416.5(b) Staff-Infant Ratio. There shall be a ratio of one teacher for every four infants in attendance. This requirement is not met as evidenced by.
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Director stated she will submit a revised staff schedule showing each of the qualified teacher's and aide's: scheduled breaks, lunch hour and daily, weekly shift times, to ensure infant classroom remains within the required Staff- Infant ratios by the due date: 11/20/2019
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Based on observations, a file review and interviews conducted, LPA confirmed facility is not operation at the required Staff- Infant ratio. This is an immediate health and safety risk to children in care.
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Director stated she will submit proof of correction to LPA Gomez via email.
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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: Alma MaligTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Luis GomezTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:

DATE: 11/19/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/19/2019
LIC9099 (FAS) - (06/04)
Page: 5 of 5