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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 384002696
Report Date: 05/16/2025
Date Signed: 05/16/2025 03:35:13 PM

Document Has Been Signed on 05/16/2025 03:35 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN BRUNO CC RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME:LITTLE ANGELS NURSERY SCHOOLFACILITY NUMBER:
384002696
ADMINISTRATOR/
DIRECTOR:		VILLON, CARMENFACILITY TYPE:
850
ADDRESS:610-A CORTLAND AVENUETELEPHONE:
(415) 722-7476
CITY:SAN FRANCISCOSTATE: CAZIP CODE:
94110
CAPACITY: 20TOTAL ENROLLED CHILDREN: 14CENSUS: 12DATE:
05/16/2025
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:45 AM
MET WITH:Carmen VillonTIME VISIT/
INSPECTION COMPLETED:
03:45 PM
NARRATIVE
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On May 16, 2025 at approximately 8:45am, Licensing Program Analysts (LPAs) Catrina Quimbo and Maria Olguin-Leon, conducted an unannounced, case management visit. LPAs hand delivered letter of approval for director.

LPAs met with director, Carmen Villon, and explained the purpose of the visit. Present during LPAs visit included director, two staff (T1 and T2) and 12 preschool children. All staff present have fingerprint clearance on file. LPAs observed door to kitchen to be closed.

LPAs observed licensing documents posted to include the open space waiver that was previously hand delivered to director during an annual inspection conducted on December 5, 2024. LPAs observed licensing documents posted to also include the license, outdoor rotation waiver, open space waiver, lead testing results, child passenger restraint posted (PUB269) without the local health department information, personal rights (LIC613A), Notification of Parents poster (PUB393), emergency disaster plan (LIC610A), personnel report (LIC500), menu, and daily activity schedule. LPAs did not observe facility sketch (LIC999) nor park permit from San Francisco Parks and Recreation to be posted in facility.

Upon LPAs arrival, children were walking to local park. LPAs walked with children, director, T1 and T2 to park. LPAs observed children at park to be wearing similar T-Shirts that identified the facility children are enrolled in and facility's contact information.

While at park, LPAs observed children to utilize the sand pit and play structures with staff assistance. LPAs did not observed staff to be stationed near play structure to prevent use of structure. LPAs observed children to have access to drinking water with their individual water bottles.

At approximately 9:40am, LPAs returned to facility with director to conduct a file review. A childcare roster was also made available and provided to LPAs. LPAs reviewed director, T1 and T2's staff files.
(Continue, Page 2...)
NAME OF LICENSING PROGRAM MANAGER: Marie Rodriguez
NAME OF LICENSING PROGRAM ANALYST: Catrina Quimbo
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 05/16/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/16/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 7
California Health & Human Services Agency
California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:
  • Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.
  • Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)
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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN BRUNO CC RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME: LITTLE ANGELS NURSERY SCHOOL
FACILITY NUMBER: 384002696
VISIT DATE: 05/16/2025
NARRATIVE
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(Continued, Page 2...)
LPAs observed T1's file to be incomplete. LPAs did not observe a Mandated Reporter certificate, completed Health Screening Report (LIC503), completed Employee Rights (LIC9052) or CPR/First Aid certification in T1's file. Per file review, T1 is currently registered for 12 core ECE units.

At approximately 9:50am, licensee, Rabab Tawfik, arrived to facility. Licensee conducted a prospective parent tour during LPAs' visit.

LPAs reviewed T2's file. T2's Mandated Reporter certification is current and will expire 10/2026. LPAs observed T2 to have been registered for 3 core ECE units in the Fall of 2024. LPAs did not observe completed ECE units or a CPR/First Aid certification in T2's file.

LPAs reviewed director's file. LPAs observed director's Mandated Reporter certification to have expired 03/22/2025. Director's CPR/First Aid certification is current and will expire 05/2026. LPAs also observed licensee's file to include two expired Mandated Reporter certifications only.

Children arrived to facility at approximately 11:00am. Music teacher also arrived to facility for music class with enrolled children. At approximately 11:15am, director left facility. 12 preschool children were present at facility with T1, T2, licensee and music teacher.

Per conditions on open space waiver that is posted in facility:
-Facility staff shall ensure that Little Angels Nursery enrolled children utilize the sand pit, swings, tire swing and low tunnel only at playground. Facility staff are to ensure children do not climb on play structure...(#8)
-A staff person should be stationed near the play structure to ensure children do not use any part of the structure other than the play equipment specified on section 8 (#10).
-The approved written permission/agreement shall be renewed with the San Francisco Parks and Recreation Department annually and shall be posted and made available for review at facility (#17)
-The approved written permission/agreement (current and renewed) shall be on file with Community Care Licensing and available for review at the facility. It is the responsibility of the licensee to submit the approved, written permission/agreement to Community Care Licensing (#19).
-All staff accompanying the children to the playground shall wear...T-Shirt with the name and phone number of the facility and also the word "STAFF" clearly visible from a distance (#21).
-Areas of the playground to be used shall be identified by a detailed sketch submitted to Community Care Licensing and posted at the facility next to this waiver (#22).

At approximately 12:00pm, T3 arrived to facility. 12 preschool children were present at facility with music teacher, T1, T2, T3 and licensee.
(Continue Report on Page 3...)
NAME OF LICENSING PROGRAM MANAGER: Marie Rodriguez
NAME OF LICENSING PROGRAM ANALYST: Catrina Quimbo
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 05/16/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/16/2025
LIC809 (FAS) - (06/04)
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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN BRUNO CC RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME: LITTLE ANGELS NURSERY SCHOOL
FACILITY NUMBER: 384002696
VISIT DATE: 05/16/2025
NARRATIVE
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(Continued, Page 3...)
At approximately 12:15pm, director returned to facility and music teacher left facility. LPAs observed a fully charged fire extinguisher in facility.

Facility was issued a Type B citation for director's expired Mandated Reporter certification and T1 not having a completed Mandated Reporter certification. Facility was issued a Type B citation for T1 not having a completed Health Screening Report (LIC503) signed by a physician. Facility was issued a Type B citation for children being left alone with staff who do not have a current current CPR/First Aid certification available for LPAs' review. Facility was issued a Type B citation for Child Passenger Restrain Posted (PUB269) being posted without the local health department contact information. Facility was also issued a Type B citation for not complying with teacher to child ratio as 12 preschool children were left without a fully qualified teacher. Facility was issued a Type B citation for not complying with open space waiver.

During visit, licensee was present and informed LPAs a staff member was in charge of licensee's family childcare home. LPAs reminded licensee of family child care home regulations. At approximately 1:40pm, licensee left facility.

Refer to 9099D for more information. A plan of correction was discussed with director. Appeal rights were provided.

A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with director, Carmen Villon.
NAME OF LICENSING PROGRAM MANAGER: Marie Rodriguez
NAME OF LICENSING PROGRAM ANALYST: Catrina Quimbo
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 05/16/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/16/2025
LIC809 (FAS) - (06/04)
Page: 4 of 7
Document Has Been Signed on 05/16/2025 03:35 PM - It Cannot Be Edited


Created By: Catrina Quimbo On 05/16/2025 at 12:49 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 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: 05/16/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
05/28/2025
Section Cited
HSC
1596.8662(b)(1)

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1596.8662 (b)(1) ... a person who... is a licensed child care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training...and shall complete renewal mandated reporter training every two years following the date on which he or she completed the initial mandated reporter training.
This requirement was not met as evidenced by:
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Director stated they will speak with T1 to complete their certificate. Director stated they will renew their certificate and provide to LPAs by POC due date.
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Based on observation and record review, director had an expired Mandated Reporter certification. T1 also did not have a completed Mandated Reporter certificate available for review. This poses a potential health, safety or personal rights risk to children in care.
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Type B
06/16/2025
Section Cited
HSC1596.866(b)

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1596.866(b) Day care center directors … shall ensure...at least one staff member who has a current course completion card in pediatric first aid and pediatric CPR … that has been approved by the Emergency Medical Services Authority … shall be onsite at all times.
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Director stated all staff members have a current CPR/First Aid certification. Director stated they will print staffs’ completed CPR/First Aid certification that will be placed in their facility file.
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Based on observation and record review, director was the only staff member who had a current CPR/First aid certificate on site. During LPAs’ visit, director left facility for approximately one hour, leaving 12 preschool children with T1, T2, T3, and licensee, who did not have a CPR/First aid certificate available for review. This poses a potential health, safety or personal rights risk to children in care.
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Director will email completed CPR/First Aid certifications to LPAs by POC due date. Per director, one staff member not present will obtain their CPR/First Aid certificate.
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
Marie Rodriguez
NAME OF LICENSING PROGRAM MANAGER:
Catrina Quimbo
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 05/16/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/16/2025


LIC809 (FAS) - (06/04)
Page: 5 of 7
Document Has Been Signed on 05/16/2025 03:35 PM - It Cannot Be Edited


Created By: Catrina Quimbo On 05/16/2025 at 01:04 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 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: 05/16/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
05/23/2025
Section Cited
CCR
101216(g)(2)

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101216 Personnel Requirements (g)(2) Each person specified in (g) above shall have a health-screening report signed by the person performing the screening.
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Director stated they will have T1 complete the LIC503 with physician signature. Proof of completed LIC503 will be submitted to LPAs by POC due date.
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Based on observation and record review, T1 does not have a completed health screening report (LIC503) that is signed by a physician. This poses a potential health, safety or personal rights risk to children in care.
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Type B
05/19/2025
Section Cited
CCR101225(f)

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101225 Transportation (f) The licensee shall post signs at the entrance to the child care center that provide the telephone number of the local health department and information on child passenger restraint systems…
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Director stated they complete the information of local health department and include information on PUB269. Director will complete form appropriately and submit proof completed form is posted in facility to LPAs by POC due date.
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Based on observation and record review, the child passenger restraint poster (PUB269) is posted in facility, however, is not complete with local health department information. This poses a potential health, safety or personal rights 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.
Marie Rodriguez
NAME OF LICENSING PROGRAM MANAGER:
Catrina Quimbo
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 05/16/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/16/2025


LIC809 (FAS) - (06/04)
Page: 6 of 7
Document Has Been Signed on 05/16/2025 03:35 PM - It Cannot Be Edited


Created By: Catrina Quimbo On 05/16/2025 at 01:18 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 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: 05/16/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
05/23/2025
Section Cited
CCR
101216.3(a)

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101216.3 Teacher-Child Ratio (a) There shall be a ratio of one teacher visually observing and supervising no more than 12 children in attendance…
This requirement was not met as evidenced by:
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Director stated T1 and T2 have completed units. Director stated they will obtain completed T1 and T2's transcripts and submit to LPAs by POC due date.
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Based on observation and record review, director left facility for approximately 1 hour leaving T1, T2 and licensee present with 12 preschool children. T1, T2 and licensee did not have completed ECE units in their staff files for LPAs to determine T1, T2 and licensee are qualified teachers.
This poses a potential health, safety or personal rights risk to children in care.
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Type B
06/16/2025
Section Cited
CCR101151(b)

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101151 General (b) The licensee shall ensure compliance with all applicable laws and regulations.
This requirement was not met as evidenced by:
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Director stated they will have a meeting with staff to verify conditions will be met. Director stated they will post park permit in facility and will provide LPAs with renewed permit by POC due date. Proof of meeting will also be submitted to LPAs by POC due date.
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Based on observation, interview and record review, terms and conditions of open space waiver that was hand delivered to and discussed with director on December 5, 2024 were not followed. Conditions 8, 10, 17, 21 and 22 were not followed during LPAs’ visit on this date. This poses a potential health, safety or personal rights 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.
Marie Rodriguez
NAME OF LICENSING PROGRAM MANAGER:
Catrina Quimbo
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 05/16/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/16/2025


LIC809 (FAS) - (06/04)
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