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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 384002696
Report Date: 02/21/2023
Date Signed: 02/22/2023 05:34:19 PM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN BRUNO CHILD CARE, 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
02/13/2023 and conducted by Evaluator Luis Gomez
PUBLIC
COMPLAINT CONTROL NUMBER: 05-CC-20230213153737
FACILITY NAME:LITTLE ANGELS NURSERY SCHOOLFACILITY NUMBER:
384002696
ADMINISTRATOR:OUELLETTE, JOYFACILITY TYPE:
850
ADDRESS:610-A CORTLAND AVENUETELEPHONE:
(415) 722-7476
CITY:SAN FRANCISCOSTATE: CAZIP CODE:
94110
CAPACITY:20CENSUS: 15DATE:
02/21/2023
UNANNOUNCEDTIME BEGAN:
08:30 AM
MET WITH:Rabab Tawfik, Anayeli FrancoTIME COMPLETED:
01:20 PM
ALLEGATION(S):
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Staff is forcing day care children to drink water and eat food.
Facility is operating outside the scope of the license.
INVESTIGATION FINDINGS:
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(THIS IS AN AMENDED REPORT FOR COMPLAINT INSPECTION CONDUCTED ON 2/21/2023)
On 2/21/2023 at 8:30AM., Licensing Program Analyst (LPA) Luis J. Gomez met with Teacher, Anayeli Franco. Purpose of the inspection was explained and was for an unannounced, complaint investigation. Present were three staff caring for 15 children. Licensee, Rabab Tawfik arrived during inspection. All children had been signed in. LPA inspected facility for health and safety hazards.

During inspection, LPA performed site observations, interviews and reviewed facility records.

During the course of the investigation, observations were conducted on 2/21/2023. A review of the facility records was complete, which included staff files, children’s roster (LIC9040) and parent handbook. LPA conducted interviews with the licensee, children, staff and involved parties.
(REFER TO LIC9099C, FOR CONT.)
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Ali Zebila
LICENSING EVALUATOR NAME: Luis Gomez
LICENSING EVALUATOR SIGNATURE:

DATE: 02/21/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/21/2023
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-20230213153737
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN BRUNO CHILD CARE, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME: LITTLE ANGELS NURSERY SCHOOL
FACILITY NUMBER: 384002696
VISIT DATE: 02/21/2023
NARRATIVE
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(THIS IS AN AMENDED REPORT FOR COMPLAINT INSPECTION CONDUCTED ON 02/21/2022)
(Page 2)
Regarding the allegations of day care children are forced to drink water, eat food and facility is operating outside scope of licensee; Based on interviews, observations, and record review; LPA determined allegations made are valid. Therefore, the preponderance of evidence standard has been met, with allegations found to be SUBSTANTIATED. California code of Regulations (Title 22, Section 12 Chapter 1) are being cited on attached 9099D.

Notice of site visit was provided to the facility. LPA was unable to print report during inspection. Signed copy of report will be mailed to licensee and stored and facility file.

Website for Forms and Regulations: www.ccld.ca.gov. Appeal rights were provided to licensee.

SUPERVISORS NAME: Carol Marcroft
LICENSING EVALUATOR NAME: Cindy Interiano
LICENSING EVALUATOR SIGNATURE:

DATE: 02/21/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/21/2023
LIC9099 (FAS) - (06/04)
Page: 2 of 5
Control Number 05-CC-20230213153737
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN BRUNO CHILD CARE, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME: LITTLE ANGELS NURSERY SCHOOL
FACILITY NUMBER: 384002696
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/21/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Request Denied
Type B
02/28/2023
Section Cited
CCR
101223(a)(3)
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***Amended Deficiency***
101223(a)(3) Personal Rights: To be free from corporal or unusual punishment, infliction of pain, humiliation, intimidation, ridicule, coercion, threat, mental abuse or other actions of a punitive nature including but not limited to: interference with functions of daily living including eating, sleeping or toileting; or withholding of shelter, clothing, medication or aids to physical functioning. This requirement is not met as evidenced by:
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Licensee will conducted staff training to review children's Personal Right's. Training must include resource videos provided on CDSS web page. Proof of participation, staff sign-in sheet, and training agenda will be submitted to the department prior to the due date: 2/28/2023.

Licensee will submit policy regarding food services for department review.
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Based on interviews, observations, and record review; LPA determined day care children were forced to drink water and eat food. This poses an immediate health and safety risk to children in care.
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Informal Conference will be scheduled at the San Bruno Childcare Regional Office at a later date.
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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.
SUPERVISORS NAME: Carol Marcroft
LICENSING EVALUATOR NAME: Cindy Interiano
LICENSING EVALUATOR SIGNATURE:

DATE: 02/21/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/21/2023
LIC9099 (FAS) - (06/04)
Page: 3 of 5
Control Number 05-CC-20230213153737
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN BRUNO CHILD CARE, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME: LITTLE ANGELS NURSERY SCHOOL
FACILITY NUMBER: 384002696
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/21/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
02/28/2023
Section Cited
CCR
101175
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101175 Waiver and Exemption: Unless the licensee receives prior written departmental approval for a waiver or an exception as specified in (b) below, the licensee shall maintain continuous compliance with all licensing regulations. This requirement is not met as evidenced by:
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Licensee will ensure maximum limit of only 8 children may be in the outside play area at one time. Updated outside activity plan will be submitted by due date: 2/28/2023.
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Based Interview, Observations and Record Review; LPA determined facility is operating outside the scope of the license. This poses a potential health and safety risk to children in care.
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Informal Conference will be scheduled at the San Bruno Childcare Regional Office at a later date.
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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.
SUPERVISORS NAME: Ali Zebila
LICENSING EVALUATOR NAME: Luis Gomez
LICENSING EVALUATOR SIGNATURE:

DATE: 02/21/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/21/2023
LIC9099 (FAS) - (06/04)
Page: 5 of 5