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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 343620088
Report Date: 02/07/2025
Date Signed: 02/07/2025 01:50:43 PM

Document Has Been Signed on 02/07/2025 01:50 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
SACRAMENTO CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME:NESMIYAN, OKSANAFACILITY NUMBER:
343620088
ADMINISTRATOR/
DIRECTOR:		NESMIYAN, OKSANAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(916) 412-9998
CITY:ANTELOPESTATE: CAZIP CODE:
95843
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 11DATE:
02/07/2025
TYPE OF VISIT:POCUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:05 PM
MET WITH:Oksana NesmiyanTIME VISIT/
INSPECTION COMPLETED:
02:05 PM
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On Friday, February 7, 2025, Licensing Program Analyst (LPA) Lea Habtom arrived at the facility for an unannounced case management inspection. The purpose of today's inspection is to follow up on the Type A issued on January 28, 2025, for not adhering to the large license capacity with no assistant. At the time of LPA's arrival, there was 11 preschool children being supervised by licensee and her son.

Based on today's inspection, LPA L. Habtom cleared the citation and provided licensee with a plan of correction letter. No Title regulations were issued during today's inspection. This report was reviewed with licensee, Oksana Nesmiyan. A notice of site visit was provided to be posted for 30 days.
Mai LorTELEPHONE: (916) 263-5728
Lea HabtomTELEPHONE: (916) 208-2538
DATE: 02/07/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/07/2025
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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