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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 015700158
Report Date: 08/31/2021
Date Signed: 08/31/2021 10:04:55 AM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME:ZAYMAK, DINAFACILITY NUMBER:
015700158
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY:8CENSUS: 5DATE:
08/31/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
08:05 AM
MET WITH:Dina ZaymakTIME COMPLETED:
10:10 AM
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On August 31, 2021 at approximately 8:05am Licensing Program Analyst (LPA) Russ Haderer met with licensee Dina Zaymak for the purpose of conducting an unannounced 1-year annual inspection for Health and Safety compliance. Present for today’s inspection was the licensee, her TB and fingerprint cleared assistant and her 11-year-old daughter. Children arrived during the beginning of the inspection totaling 4 (two 3-years old; two 4-years old). The hours of operation are Monday-Friday, 8:30 AM to 5:15PM.

The facility is a 2 bedroom, one and 1/2 bath two-story townhouse with no garage. It is owned by the licensee and contains a living room, dining room, kitchen, 2 bedrooms and one and 1/2 bathrooms and two enclosed (fenced) outside patio areas. There is no fireplace in the home. The home is neat and clean with heating and ventilation for safety and comfort. The Per the licensee, the ISOLATION AREA will be in the kitchen area and away from the other children in care.



Licensee requested to add second patio area to the on-limits area. LPA inspected the area which contains two locked sheds and a gate to provide access to the common area. The patio is enclosed by a five foot wooden fence and the gate has a latch too high for children to reach. There were no hazardous items observed in the patio area. The additional area is approved and added to the on-limits area.

Disaster drills are conducted every six months, the last one was done June 3, 2021. Per licensee, there are no firearms in the home. LPA did not observe any bodies of water or hazardous materials, or toxins accessible to children on the premises during the inspection.

There is a children’s play area in the common area of the condominium complex with soft ground cover materials and safe and solid structures. Licensee has a first aid kit and plastic outlet covers on all electrical outlets in the on-limit areas.
SUPERVISOR'S NAME: Chandra CharlesTELEPHONE: (510) 286-0966
LICENSING EVALUATOR NAME: Russell HadererTELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:

DATE: 08/31/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/31/2021
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 3
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME: ZAYMAK, DINA
FACILITY NUMBER: 015700158
VISIT DATE: 08/31/2021
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On-limit areas include: First floor area consisting of the living room (day care area), kitchen, dining room, downstairs half-bath and both patio areas off the kitchen and living room. Licensee was reminded that other than wipes or things used for the children in the on limits children’s bathroom, they need to be empty of most all items (or locked up) such as cleaning products. There are no accessible hazardous cleaning chemicals or other liquids in the on-limits area.

Off-limit areas include: The closet in the living room (has a slide-bolt latch mounted high and out of reach of children), the entire upstairs consisting of 2 bedrooms, full bathroom and laundry area. The stairs have a gate preventing children from accessing the off-limit area upstairs and other off limit areas will be inaccessible by closed and/or locked doors, and/or by child supervision.

Licensee has ample age-appropriate toys and learning materials. The home has a fully charged 2A10BC fire extinguisher mounted in the children’s bathroom, a working smoke and carbon monoxide detector (tested and functioning), and a working telephone. The Licensee’s CPR and First Aid certificate is current and expires 08/22/2022. The licensee completed and received a certificate in mandated reporter training (verified AB1207), expires on 11/23/2021. The licensee and assistant are in compliance with the immunization laws which pertains to day care providers. LPA reminded the licensee of the following; Mandated Reporter training is to be renewed every two years, CPR/First Aid is also renewed every two years. Baby bouncers & drop-down cribs are not allowed at the day-care facility.

Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual – Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. When any IMS is provided, a Plan for Providing IMS must be submitted to the Department. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice)/ (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm



Licensee [or facility representative] was reminded that all adults 18 and over living or working in the home, including employees and volunteers, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a licensed Family Child Care Home. A civil penalty of $100.00 minimum/day up to $500.00 maximum per day/per person will be assessed if this regulation is violated.
SUPERVISOR'S NAME: Chandra CharlesTELEPHONE: (510) 286-0966
LICENSING EVALUATOR NAME: Russell HadererTELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:

DATE: 08/31/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/31/2021
LIC809 (FAS) - (06/04)
Page: 2 of 3
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME: ZAYMAK, DINA
FACILITY NUMBER: 015700158
VISIT DATE: 08/31/2021
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LPA discussed the safe sleep regulations with licensee [or facility representative] and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed licensee [facility representative] of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

At 9:05am, LPA reviewed facility files including records for licensee and assistants and the Children’s files. All files complete and well organized.

Licensee does not carry liability insurance, appropriate signed forms are in all children's files.

For licensing updates email childcareadvocatesprogram@dss.ca.gov and advised to be added to the email list.

A review of operating safely during the Covid-19 pandemic was conducted.

There were no deficiencies issued during today’s inspection: This report will remain on file for 3 years.

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



Exit interview conducted and report was reviewed with the licensee Dina Zaymack.

LPA left the home at 10:05 am.
SUPERVISOR'S NAME: Chandra CharlesTELEPHONE: (510) 286-0966
LICENSING EVALUATOR NAME: Russell HadererTELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:

DATE: 08/31/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/31/2021
LIC809 (FAS) - (06/04)
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