380505725-5-5-2020-05-CC-AMAG-BPHTMJ-20200511145111

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 380505725
Report Date: 05/05/2020
Date Signed: 05/05/2020 11:46:52 AM

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
02/10/2020 and conducted by Evaluator Luis Gomez

PUBLIC

COMPLAINT CONTROL NUMBER: 05-CC-20200210114240

FACILITY NAME:	ST. NICHOLAS DAY CARE AND PRESCHOOL-INFANT		FACILITY NUMBER:	380505725
ADMINISTRATOR:	TUWAI, KATHY		FACILITY TYPE:	830
ADDRESS:	5200 DIAMOND HEIGHTS BLVD.		TELEPHONE:	(415) 550-1536
CITY:	SAN FRANCISCO	STATE: CA	ZIP CODE:	94131
CAPACITY:	39	CENSUS: 0	DATE:	05/05/2020
		UNANNOUNCED	TIME BEGAN:	10:30 AM
MET WITH:	Director, Kathy Tuwai		TIME COMPLETED:	11:15 AM

ALLEGATION(S):

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9

Unqualified staff providing care and supervision to day-care children
Staff operating out of ratio

INVESTIGATION FINDINGS:

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13

THIS INSPECTION WAS CONDUCTED VIA TELE-INSPECTION DUE TO THE COVID-19 SHELTER-IN PLACE.

On 5/5/2020 at 10:30 A.M., Licensing Program Analyst (LPA), Luis J. Gomez met with director, Kathy Tuwai, for a complaint investigation of the above allegation. Purpose of the inspection was explained.

During today's inspection, LPA interviewed the facility director.

As part of this investigation, LPA conducted inspection of the facility on 2/13/2020, and did an evaluation the supervision. A review of the facility records was also completed which include the staff rosters, staff weekly schedule, personnel files and parent handbook. Also, as part of his complaint investigation interviews were conducted the director and a sample of staff members assigned to the center’s infant/ toddler program.
(Continuation on page 9099-C)

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Alma Malig	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Luis Gomez	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 05/05/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/05/2020

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-20200210114240

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: 05/05/2020

NARRATIVE

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(Page 2)

Regarding the allegation of unqualified staff providing care and supervision to day-care children. Based on a record review, observations conducted and interviews with facility personnel, LPA is unable to determine if unqualified staff provided care and supervision to day-care children. During the on-site inspection, LPA observed facility’s infant classroom is properly staffed with qualified personnel.

Regarding the allegations of facility operating out of ratio. Based on interviews, observations and a record review, LPA is unable to determine if facility is operating out of ratio. During the investigation, interviewed parties stated that a qualified teacher is always present in the infant classroom.

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.

Exit interview was conducted with director.

Director signed copy of complaint investigation report located in the facility file.

SUPERVISOR'S NAME: Alma Malig	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Luis Gomez	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 05/05/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/05/2020

LIC9099 (FAS) - (06/04)

Page: 2 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
02/10/2020 and conducted by Evaluator Luis Gomez

PUBLIC

COMPLAINT CONTROL NUMBER: 05-CC-20200210114240

FACILITY NAME:	ST. NICHOLAS DAY CARE AND PRESCHOOL-INFANT		FACILITY NUMBER:	380505725
ADMINISTRATOR:	TUWAI, KATHY		FACILITY TYPE:	830
ADDRESS:	5200 DIAMOND HEIGHTS BLVD.		TELEPHONE:	(415) 550-1536
CITY:	SAN FRANCISCO	STATE: CA	ZIP CODE:	94131
CAPACITY:	39	CENSUS: 0	DATE:	05/05/2020
		UNANNOUNCED	TIME BEGAN:	10:30 AM
MET WITH:	Director, Kathy Tuwai		TIME COMPLETED:	11:15 AM

ALLEGATION(S):

1
2
3
4
5
6
7
8
9

Staff engaged in a verbal altercation in the presence of day-care children.

INVESTIGATION FINDINGS:

1
2
3
4
5
6
7
8
9
10
11
12
13

THIS INSPECTION WAS CONDUCTED VIA TELE-INSPECTION DUE TO THE COVID-19 SHELTER-IN PLACE.

On 5/5/2020 at 10:30 A.M., Licensing Program Analyst (LPA), Luis J. Gomez met with director, Kathy Tuwai, for a complaint investigation of the above allegation. Purpose of the inspection was explained.

During today's inspection, LPA interviewed facility director.

As part of this investigation, LPA conducted inspection of the facility on 2/13/2020, and did an evaluation the supervision. A review of the facility records was also completed which include the staff rosters, weekly schedule, personnel files and parent handbook. Also, as part of his complaint investigation interviews were conducted the director and staff members assigned to the center’s infant/ toddler program.
(Continuation on 9099-C)

Substantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Alma Malig	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Luis Gomez	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 05/05/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/05/2020

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

Page: 3 of 5

Control Number 05-CC-20200210114240

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: 05/05/2020

NARRATIVE

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(Page 2)

Regarding the allegation of staff engaged in a verbal altercation in the presence of day-care children. Based on interviews conducted, on-site observations and record review, LPA confirmed that staff had engaged in a verbal altercation in the presence of day-care children. In LPA’s interviews with involved parties, it was reported that infant classroom personnel had engaged in verbal arguments, in-which staff used an inappropriate tone of voice.

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 director and plan of correction was developed. Appeal rights were given and explained to director.

Director signed copy of complaint investigation report located in the facility file.

SUPERVISOR'S NAME: Alma Malig	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Luis Gomez	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 05/05/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/05/2020

LIC9099 (FAS) - (06/04)

Page: 4 of 5

Control Number 05-CC-20200210114240

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: 05/05/2020

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 05/15/2020 Section Cited CCR 101223(a)(1)	1 2 3 4 5 6 7	101223(a)(1) Personal Rights. (a) The licensee shall ensure that each child is accorded the following personal rights: (1) To be accorded dignity in his/her personal relationships with staff and other persons. This requirement has not been met as evidenced by.	1 2 3 4 5 6 7	Director shall submit a written plan, describing how the center will ensure all staff receives proper training on the personal rights of children by the due date: 5/15/2020
	8 9 10 11 12 13 14	Based on interviews conducted, LPA confirmed that staff had engaged in a verbal altercation in the presence of day-care children. This poses a potential health and safety risk to children in care.	8 9 10 11 12 13 14	Director will submit facility plan of correction to LPA Gomez via email.
	1 2 3 4 5 6 7		1 2 3 4 5 6 7
	1 2 3 4 5 6 7		1 2 3 4 5 6 7

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 Malig	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Luis Gomez	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 05/05/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/05/2020

LIC9099 (FAS) - (06/04)

Page: 5 of 5