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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 384002696
Report Date: 09/18/2024
Date Signed: 09/18/2024 05:25:37 PM

Document Has Been Signed on 09/18/2024 05:25 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:		OUELLETTE, JOYFACILITY TYPE:
850
ADDRESS:610-A CORTLAND AVENUETELEPHONE:
(415) 722-7476
CITY:SAN FRANCISCOSTATE: CAZIP CODE:
94110
CAPACITY: 20TOTAL ENROLLED CHILDREN: 13CENSUS: 11DATE:
09/18/2024
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:00 AM
MET WITH:Carmen Villon TIME VISIT/
INSPECTION COMPLETED:
05:45 PM
NARRATIVE
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On September 18, 2024 at approximately 9:00am, Licensing Program Analysts (LPAs) Catrina Quimbo and Maria Olguin-Leon, conducted an unannounced, case management visit. LPAs arrived to facility and met with teacher, TA1, and explained the purpose of the visit. Upon LPAs' arrival, no children were present in the facility. Per TA1, children and staff are at the local park.

LPAs walked to local park and met with director, Carmen Villon, and explained the purpose of the visit. Present at the park include 11 enrolled children with 2 staff (director and T1). At approximately 9:30am, TA1 arrived to park. LPAs and director walked back to facility to continue with case management visit.



LPAs visit includes a follow up on regulations discussed during office meeting conducted on June 4, 2024. At facility, LPAs met with licensee, Rabab Tawfik, and explained the purpose of the visit. Licensee was reminded facility will receive more frequent, unannounced visits. LPAs also hand delivered amended report dated March 5, 2024 to licensee with appeal decision letter correspondence. At approximately 10:50am, TA2 arrived to facility.

During office meeting, following was advised:
  • Licensee cannot be the director for licensed child care center while licensed family child care home is in operation.
  • A qualified director must be on site during operating hours.
  • Kitchen must be made inaccessible to children.
  • Drinking water cannot be withheld from children at any time.
  • Food cannot be withheld from children at any time.
  • CCLD recommends licensee change program's "restaurant style" food service policy to one of the following: "Family style" food service, obtain food vendor, enroll to food program, or children bring their own food to facility.
  • Children must be supervised at all times.
  • With a signed field trip form, public park can be utilized maximum use of once a week per group. Licensee must obtain a park permit from SF Park and Recreation and an approved waiver from CCL.
(Continue Report on Page 2...)
SUPERVISORS NAME: Marie Rodriguez
LICENSING EVALUATOR NAME: Catrina Quimbo
LICENSING EVALUATOR SIGNATURE: DATE: 09/18/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/18/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.

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: 09/18/2024
NARRATIVE
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(Continued, Page 2...)
LPAs provided and discussed with director and licensee list of documents needed for director packet. LPAs advised director to submit proof of enrollment for infant/toddler course.

During lunch time, LPAs observed a cleaning solution spray bottle located on a children's table, accessible to children. LPAs reminded licensee and director cleaning solutions and hazardous materials must be made inaccessible to children at all times. Cleaning solution spray bottle was moved to a high shelf during visit.

LPAs also observed portable hot plate on kitchen counter that was utilized during lunch time. LPAs observed door to kitchen remained open throughout lunch period. At approximately 12:30pm, T1 and TA1 left facility for the day. LPAs reminded licensee and director hazardous materials, including a portable hot plate, must be made inaccessible to children at all times.

At approximately 3:00pm, LPAs observed director to be in the facility with 5 children, TA2 was in the outdoor area with 6 children. LPAs observed director escorting two children at separate times to the restroom (located in the back of the classroom), while the remaining four children were left in the front of the classroom, unsupervised.

During file review of children's records, LPAs observed one child (C1) present, aged 23 months. LPAs observed C1 to have been enrolled in program when C1 was age 15.5 months old. LPA did not observe an immunization record for C1.

During today's visit, following was also observed:
  • Licensee was present in facility approximately 9:30am to 10:30am. Licensee returned to facility 11:30am to 2:00pm.
  • Director, Carmen Villon, was on site. Incomplete Director packet previously submitted to department.
  • Kitchen door was left open. Child safety locks are installed on kitchen cabinet.
  • Drinking water is made available to children at children's requests.
  • Program's food service includes a "family style" that serves food all at once.
  • Field trip forms for children are signed and made available for review.
  • File reviews for staff present have incomplete files.

Facility was issued three Type B citations for incomplete staff files, an accessible cleaning solution and accessible hot plate and operating beyond limitations of license. Civil penalty was also assessed due to repeat violation within 12 months.
SUPERVISORS NAME: Marie Rodriguez
LICENSING EVALUATOR NAME: Catrina Quimbo
LICENSING EVALUATOR SIGNATURE:

DATE: 09/18/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/18/2024
LIC809 (FAS) - (06/04)
Page: 2 of 6
Document Has Been Signed on 09/18/2024 05:25 PM - It Cannot Be Edited


Created By: Catrina Quimbo On 09/18/2024 at 02:52 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: 09/18/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
09/18/2024
Section Cited
CCR
101238(g)

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101238 Buildings and Grounds (g) Disinfectants, cleaning solutions, poisons and other items that could pose a danger if readily available to children shall be stored where inaccessible to children. This requirement was not met as evidenced by:
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Cleaning solution was moved from a children's table to a high shelf during visit. Door to kitchen, with portable hot plate, was closed during visit. LPAs reminded director and licensee items that could pose a danger to children must be inaccessible.
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Based on observation and interview, LPAs observed an accessible cleaning solution and an accessible, portable hot plate in kitchen, while kitchen door remained open. This poses a potential health and safety risk to children in care.
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Deficiency cleared during visit. Civil penalty assessed for a repeat violation within 12 months.
Request Denied
Type B
10/09/2024
Section Cited
CCR101217(d)

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101217 Personnel Records (d) All personnel records shall be maintained at the child care center and shall be available to the licensing agency for review. This requirement was not met as evidenced by:
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Director to obtain completed files for all staff present. LPAs to conduct a follow up visit to verify staff files are complete.
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Based on observation, interview and record review, LPAs did not observe a complete personnel record for any staff present. 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.
SUPERVISOR'S NAME:Marie Rodriguez
LICENSING EVALUATOR NAME:Catrina Quimbo
LICENSING EVALUATOR SIGNATURE:
DATE: 09/18/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/18/2024


LIC809 (FAS) - (06/04)
Page: 3 of 6
Document Has Been Signed on 09/18/2024 05:25 PM - It Cannot Be Edited


Created By: Catrina Quimbo On 09/18/2024 at 03:51 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: 09/18/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Deficiency Dismissed
Type B
10/09/2024
Section Cited
CCR
101161(a)

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101161 Limitations on Capacity (a) A licensee shall not operate a child care center beyond the conditions and limitations specified on the license, including the capacity limitation. This requirement was not met as evidenced by:
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Director was reminded children under license limitations cannot be enrolled in program.
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Based on observation and record review, C1 was enrolled at 15.5 months old. Limitations on license specifies the youngest age for program is 18 months. This poses a potential health and safety risk to children in care.
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Director to submit an exception request for C1 to participate in preschool program (over 24 months) while C1 is under age (under 24 months). Director to develop a written plan on how to prevent enrolling children underage in future.

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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:Marie Rodriguez
LICENSING EVALUATOR NAME:Catrina Quimbo
LICENSING EVALUATOR SIGNATURE:
DATE: 09/18/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/18/2024


LIC809 (FAS) - (06/04)
Page: 4 of 6
Document Has Been Signed on 09/18/2024 05:25 PM - It Cannot Be Edited


Created By: Catrina Quimbo On 09/18/2024 at 03:57 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: 09/18/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Deficiency Dismissed
Type A
09/19/2024
Section Cited
HSC
1596.99(c)(3)

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1596.66 Levy of civil penalty in addition to suspension, temporary suspension, or revocation; amounts; regulations setting forth appeal procedures for deficiencies (c)(3) Absence of supervision, including, but not limited to, a child left unattended, and supervision of a child. This requirement was not met as evidenced by:
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Director to have a staff meeting with all staff, reinforcing importance of supervision.

Signed agenda by all staff present to be submitted to LPAs, from director, no later than POC due date.
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Based on observation, LPAs observed director escorting two children at separate times to the restroom, (located in the back of the classroom), while the remaining four children were left in the front of the classroom, unsupervised. This poses an immediate health and safety risk to children in care.
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Director stated they will consider additional staff.

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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:Marie Rodriguez
LICENSING EVALUATOR NAME:Catrina Quimbo
LICENSING EVALUATOR SIGNATURE:
DATE: 09/18/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/18/2024


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: 09/18/2024
NARRATIVE
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(Continued, Page 3...)
Facility was also issued a Type A citation for absence of supervision. Additional civil penalty was assessed during visit. Appeal rights were provided along with printed copy of report.

LPA Quimbo informed facility representative, Carmen Villon, that this report dated September 18, 2024 documents one Type A citation which shall be posted for 30 consecutive days as there is/are immediate risk(s) to the health, safety, or personal rights of children in care.

Also, LPA Quimbo informed the facility representative to provide a copy of this licensing report dated September 18, 2024 that documents any Type A citation to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification.

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

Exit interview conducted and report was reviewed with facility representative, Carmen Villon.
SUPERVISORS NAME: Marie Rodriguez
LICENSING EVALUATOR NAME: Catrina Quimbo
LICENSING EVALUATOR SIGNATURE:

DATE: 09/18/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/18/2024
LIC809 (FAS) - (06/04)
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