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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 384002696
Report Date: 05/02/2023
Date Signed: 05/02/2023 03:09:51 PM

Document Has Been Signed on 05/02/2023 03:09 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 CHILD CARE, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
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: 20TOTAL ENROLLED CHILDREN: 20CENSUS: DATE:
05/02/2023
TYPE OF VISIT:OfficeANNOUNCEDTIME BEGAN:
01:30 PM
MET WITH:Rabab Tawfik, Kathleen MorganTIME COMPLETED:
03:10 PM
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On 5/2/2023, 1:30PM., Regional Manager (RM), Cindy Interiano, Licensing Program Managers (LPM), Ali Zebila, Garfield Leung, and Licensing Program Analysts (LPA), Luis Gomez, Catrina Quimbo met with Licensee, Rabab Tawfik, and Licensee’s Attorney, Kathleen Morgan.

The purpose of meeting was explained and was an informal/ office meeting, to discuss deficiencies cited resulting from complaints received by the Department.

During meeting, Title 22 regulations were discussed regarding: Children’s Personal Rights, Director Qualifications, Health- Related Services, and Incidental Medical Services (IMS).

Per Licensee, Director and Assistant Director are in process of being hired. Licensee will submit documents for review.

Per Licensee, she has enrolled in CPR/first aid course, scheduled for 5/9/2023.

Children's personal rights, and food services policy was discussed with the licensee.

Reporting Requirements was reviewed with licensee.
Licensee was provided information regarding reporting requirements regarding unusual incidents and outbreaks.

Licensee was provided the following resources:
LIC311A- Records to be maintained in facility

Licensee was advised to post complaint investigation report (LIC9099, LIC9099D) and provide copy for parents/ authorized representatives of children in care. Also, to provided complaint report to newly enrolled families for 12 months from date of citation. All families must sign the LIC9224, Notice of A-type deficiency.

Facility will be placed on a Required Annual Visit list. Report was read and reviewed by all parties. Copy was provided to facility.

Report was read and reviewed by all parties. Copy was provided to licensee.
SUPERVISORS NAME: Ali Zebila
LICENSING EVALUATOR NAME: Luis Gomez
LICENSING EVALUATOR SIGNATURE: DATE: 05/02/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/02/2023
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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