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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 384002696
Report Date: 03/03/2023
Date Signed: 03/03/2023 01:02:11 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
02/22/2023 and conducted by Evaluator Luis Gomez
PUBLIC
COMPLAINT CONTROL NUMBER: 05-CC-20230222125838
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: 13DATE:
03/03/2023
UNANNOUNCEDTIME BEGAN:
08:40 AM
MET WITH:Rabab Tawfik, Anayeli FrancoTIME COMPLETED:
01:05 PM
ALLEGATION(S):
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Facility yard is unkept.
INVESTIGATION FINDINGS:
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On 3/3/2023 at 8:40AM., 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 13 children. All children have been signed in. Licensee, Rabab Tawfik arrived during inspection. 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 3/3/2023. A review of the facility records was complete, which included staff files and children’s roster (LIC9040). LPA conducted interviews with 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: 03/03/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/03/2023
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 4
Control Number 05-CC-20230222125838
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: 03/03/2023
NARRATIVE
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(Page 2)
Regarding the allegation of facility yard is unkept; Based on site observations; LPA determined allegation made is valid. During inspection, LPA observed broken playthings, flooded sandbox and other hazardous objects accessible to day-care children in outdoor play area.

Based on information obtained, the preponderance of evidence standard has been met, therefore the allegation is found to be SUBSTANTIATED. California code of Regulations (Title 22, Section 12 Chapter 1) are being cited on attached 9099D. Appeal Rights were provided to licensee.

Notice of site visit was provided and must remain posted for 30 days.

This report will be kept in the facility file and will be made available for Public Review upon request. Website for Forms and Regulations: www.ccld.ca.gov.

SUPERVISORS NAME: Ali Zebila
LICENSING EVALUATOR NAME: Luis Gomez
LICENSING EVALUATOR SIGNATURE:

DATE: 03/03/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/03/2023
LIC9099 (FAS) - (06/04)
Page: 2 of 4
Control Number 05-CC-20230222125838
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: 03/03/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
03/17/2023
Section Cited
CCR
101238(a)
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101238(b) Building and Grounds: (a) The child care center shall be clean, safe, sanitary and in good repair at all times to ensure the safety and well-being of children, employees and visitors. This requirement is not met as evidenced by:
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Licensee will repair and remove all hazardous items from outdoor play area by the due date: 3/17/2023.

Proof of correction will be submitted to the department via email.
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 At 9:20AM, Based on observations, LPA confirmed broken playthings, flooded sandbox area and other hazardous objects accessible to day-care children in outdoor play area. This poses a potential health and safety risk to children in care.
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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: 03/03/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/03/2023
LIC9099 (FAS) - (06/04)
Page: 3 of 4