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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 384002696
Report Date: 04/02/2024
Date Signed: 04/02/2024 03:22:56 PM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN BRUNO CC RO, 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
02/28/2024 and conducted by Evaluator Luis Gomez
PUBLIC
COMPLAINT CONTROL NUMBER: 05-CC-20240228133143
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: 17DATE:
04/02/2024
UNANNOUNCEDTIME BEGAN:
08:30 AM
MET WITH:Rabab TawfikTIME COMPLETED:
03:35 PM
ALLEGATION(S):
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9
Staff isolated child from other children.
Staff spoke inappropriately to daycare child.
INVESTIGATION FINDINGS:
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On 4/2/2024 at 8:30AM., Licensing Program Analyst, (LPA) Luis Gomez met with Lead Teacher, Merve Perk. The purpose of inspection was explained and was for an unannounced, complaint inspection. Present is facility were 2 staff supervising 13 children. During inspection, 5 additional children and licensee arrived to the facility. Children present had been signed in. LPA inspected facility for health and safety hazards.

During inspection, LPA performed interviews, record review and observations.
At 9:45AM., Based on record review, Interview and observations, LPA confirmed individual present (S1) without criminal record clearance or association on file. Per licensee, individual is present with children for interview and observation. Deficiency was cited on attached case management report (LIC809).

During the course of this investigation, observations were conducted on 3/5/2024 and 4/2/2024. A review of facility records was complete, which included the Children’s File and Staff Files. Interviews were conducted with Licensee, Staff, Children and Involved Parties. (REFER TO LIC9099c, FOR CONT.)
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Marie Rodriguez
LICENSING EVALUATOR NAME: Luis Gomez
LICENSING EVALUATOR SIGNATURE:

DATE: 04/02/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/02/2024
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 6
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN BRUNO CC RO, 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
02/28/2024 and conducted by Evaluator Luis Gomez
PUBLIC
COMPLAINT CONTROL NUMBER: 05-CC-20240228133143

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: 17DATE:
04/02/2024
UNANNOUNCEDTIME BEGAN:
08:30 AM
MET WITH:Rabab TawfikTIME COMPLETED:
03:35 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Staff used inappropriate form of punishment.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On 4/2/2024 at 8:30AM., Licensing Program Analyst, (LPA) Luis Gomez met with Lead Teacher, Merve Perk. The purpose of inspection was explained and was for an unannounced, complaint inspection. Present is facility were 2 staff supervising 13 children. During inspection, 5 additional children and licensee arrived to the facility. Children present had been signed in. LPA inspected facility for health and safety hazards.

During inspection, LPA performed interviews, record review and observations.
At 9:45AM., Based on record review, Interview and observations, LPA confirmed individual present (S1) without criminal record clearance or association on file. Per licensee, individual is present with children for interview and observation. Deficiency was cited on attached case management report (LIC809).

During the course of this investigation, observations were conducted on 3/5/2024 and 4/2/2024. A review of facility records was complete, which included the Children’s File and Staff Files. Interviews were conducted with Licensee, Staff, Children and Involved Parties. (REFER TO LIC9099c, FOR CONT.)
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Marie Rodriguez
LICENSING EVALUATOR NAME: Luis Gomez
LICENSING EVALUATOR SIGNATURE:

DATE: 04/02/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/02/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 2 of 6
Control Number 05-CC-20240228133143
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION 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: 04/02/2024
NARRATIVE
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(PAGE 2)
Regarding the allegation of facility staff using inappropriate form of punishment; Based on information collected, LPA determine allegation made is valid.

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.

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. This report and and appeal rights were discussed with licensee.

SUPERVISORS NAME: Marie Rodriguez
LICENSING EVALUATOR NAME: Luis Gomez
LICENSING EVALUATOR SIGNATURE:

DATE: 04/02/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/02/2024
LIC9099 (FAS) - (06/04)
Page: 3 of 6
Control Number 05-CC-20240228133143
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION 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
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/02/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Request Denied
Type B
04/08/2024
Section Cited
CCR
101223
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101223 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 was not met as evidenced by:
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Licensee will removed required water breaks from center's schedule programming by the due date: 4/8/2024.

Updated facility schedule will be submitted to LPA.
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Based on information collected, LPA determine allegations made is valid. This poses a potential health and safety risk to children in care.
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Proof of correction will be submitted to The Department via email.
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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: Marie Rodriguez
LICENSING EVALUATOR NAME: Luis Gomez
LICENSING EVALUATOR SIGNATURE:

DATE: 04/02/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/02/2024
LIC9099 (FAS) - (06/04)
Page: 4 of 6
Control Number 05-CC-20240228133143
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION 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: 04/02/2024
NARRATIVE
1
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5
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12
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(PAGE 2)
Regarding the allegations of facility staff isolated child and spoke inappropriately to day-care children; Based on interviews, observations and record review, LPA was unable to determine if allegations made are valid.

Although the allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegation is Unsubstantiated.



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. This report and rights to comment and appeal were discussed with licensee.
SUPERVISORS NAME: Marie Rodriguez
LICENSING EVALUATOR NAME: Luis Gomez
LICENSING EVALUATOR SIGNATURE:

DATE: 04/02/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/02/2024
LIC9099 (FAS) - (06/04)
Page: 6 of 6