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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 384001177
Report Date: 02/23/2022
Date Signed: 02/23/2022 12:36:01 PM


Document Has Been Signed on 02/23/2022 12:36 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
CCLD Regional Office, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066



FACILITY NAME:STAVREVA, NEDYALKAFACILITY NUMBER:
384001177
ADMINISTRATOR:STAVREVA, NEDYALKAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(415) 831-6537
CITY:SAN FRANCISCOSTATE: CAZIP CODE:
94121
CAPACITY:14CENSUS: 8DATE:
02/23/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Nedvalka Stavreva (Nelly)TIME COMPLETED:
01:00 PM
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Licensing Program Analyst (LPA) Mok conducted an unannounced annual inspection today. LPA met with the licensee, Nedvalka Stavreva, and 2 staff (one of the staff was her family member). All adults were fingerprinted. Purpose of the inspection was explained to her. The home was toured and inspected for health and safety hazards. The home is a two unit three story Duplex house. Licensee rents one of the unit included the ground floor and the first floor. Current residents of the home are Licensee, her husband and her son. Day care area is the entire ground floor that including: a play room, study room, two smaller classrooms in the back, two bathrooms and the backyard deck. The entire second floor and the garage on the ground floor are off limit to children. The home was clean and orderly. Temperature and lighting were adequate. The facility had a fully charged 2A10BC fire extinguisher, at least one working smoke and carbon monoxide detector, and fist aid supplies available in the daycare area. Per licensee there is no pet, no firearms or weapons in the unit. . Facility conducts fire drills at lease once every six months and was properly logged. There are plenty of variety of children's toys, books, tables, chairs learning equipment available for children in the day care area and all appeared to be safe and age appropriate for children. The licensee installed carpet to the floor as the soft cushioning to prevent injury. Play pens and cots were used for napping. High chairs were available for feeding only. The children have to be removed from the chair after meal. If there were ill child, staff would separate them in one of the small classroom while waiting for parent to pick them up. The licensee installed a gate between the kitchen and play area to prevent children's access. Facility provided breakfast, AM/PM snacks, and lunch to the children. The children's bathroom was clean and in order. The lower bathroom cabinet and drawers were free of harmful objects. There was a diaper changing table available in one of the bathrooms. The outdoor play area was completely fenced. The area was clean and in order. Licensee installed gates at the stairway to prevent children access to the off-limit area. There were plenty of age-appropriate toys, play house, slide structure with soft cushioning underneath, and ride-on toys available for children. LPA reviewed the children and staff files during the inspection. Facility has purchased liability insurance for her day care. Children's roster and it is updated. LPA obtained a copy of it during the inspection. Parents rights poster and the License are posted. Licensee and her helper both have current pediatric CPR and First Aid training, and Mandated Reporter Training. Per licensee, there were no children on special medication. The facility had hand sanitizer, touchless thermometer, and disinfectant available to COVID19 in the daycare area.

There was no deficiency cited today under Title 22, Div.12 and Chapter 3.

This report was reviewed by the licensee and must be made available to the public upon request. LPA observed Licensee posting report and the report shall remain posted for 30 days. For quarterly update on Licensing information, go to CCL website: www.ccld.ca.gov.
SUPERVISOR'S NAME: Ali ZebilaTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Cindy MokTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:
DATE: 02/23/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/23/2022
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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