384001337-1-20-2022-05-CC-BVAN-CAV2UT-20220120164250

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 384001337
Report Date: 01/20/2022
Date Signed: 01/20/2022 04:43:32 PM

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:	GOLDENSHTEYN, LILIANA R.		FACILITY NUMBER:	384001337
ADMINISTRATOR:	GOLDENSHTEYN, LILIANA R.		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(415) 681-1571
CITY:	SAN FRANCISCO	STATE: CA	ZIP CODE:	94116
CAPACITY:	14	CENSUS: 0	DATE:	01/20/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	12:30 PM
MET WITH:	Liliana Goldenshteyn and Nino Osepashvili		TIME COMPLETED:	04:15 PM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	On January 20, 2022, Licensing Program Analyst (LPA), Van, conducted an unannounced annual inspection and met with Licensee Liliana Goldenshteyn and her helper Nino Osepashvili. The purpose of the inspection was explained and granted entry to the home by the Licensee. Today, Licensee has no children in care. Per Licensee, one of her helpers tested positive for COVID. As a precaution and recommendation from the Local Department of Public Health, the Licensee decided to close the daycare and resume operation on January 24, 2022. All adults living in the home or working at the daycare have cleared criminal records. The Licensee owns this two-story single-family house. Daycare areas are on the ground floor only, including the playroom, kitchenette, nap room, bathroom, and backyard. The off-limit areas are the garage and the entire second-floor level. Days and operation hours are 7:30 am - 6:00 pm, Monday - Friday. Per Licensee, sick children will be separated from the group and waited in the nap room for the parent to pick them up. LPA and Licensee inspected the daycare areas for health and safety hazards during the inspection. LPA observed the following; The daycare area is clean, orderly, and equipped with age-appropriate toys and equipment. The home has adequate lighting and ventilation. The Licensee had posted all the required forms, such as facility License, Notification of Parent's Rights, Earthquake preparedness checklist, and Notification of Personal Rights. The house has a working smoke alarm, carbon monoxide detector, and a fully charged fire extinguisher. First aid supplies are available for children. Per Licensee, there are no firearms, weapons, or pets in the home. All cleaning, disinfectants, or chemicals are stored in the kitchen cabinets with child-proof locks installed. The Licensee states breakfast, lunch, morning and afternoon snacks are provided to the children. Drinking water is available through the water dispensary, and each child has their own cup with their name labeled. LPA observed no pools, spas, or other bodies of water on the premises. All unused electrical outlets were observed to have child-proof covers. Per Licensee, fire drills are conducted and documented accordingly, and the last fire drill was conducted on January 3, 2022.

SUPERVISOR'S NAME: Garfield Leung	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Brendon Van	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 01/20/2022

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/20/2022

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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME: GOLDENSHTEYN, LILIANA R.	FACILITY NUMBER: 384001337
	VISIT DATE: 01/20/2022

NARRATIVE

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The Licensee and helper have up-to-date Pediatric FirstAid and CPR with an expiration of January 2024. Records of staff immunization, mandated reporter training certification, and Criminal Record Statements are on their respective file.

Licensee 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.

LPA discussed the safe sleep regulations with Licensee 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 the Licensee 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.

The Licensee was reminded about the Provider Information Notices (PINs) on the CCLD website. Licensee was informed that as of September 1, 2016, a person may not be employed or volunteer at a child care facility unless he or she has been immunized against influenza, pertussis, and measles or qualifies for an exemption pursuant to Health and Safety code 1596.7995 and 1597.662. LPA reviewed AB 1207 with the Licensee. As of January 1, 2018, all staff must complete Mandated Reporter Training every two years. The training can be obtained online at www.mandatedreporterca.com.

LPA encouraged the Licensee to frequently visit our website at www.ccld.ca.gov for licensing regulations and new updates. The Licensee can also email at childcareadvocatesprogram@dss.ca.gov and ask to be added to the email list for the updates.

SUPERVISOR'S NAME: Garfield Leung	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Brendon Van	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 01/20/2022

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/20/2022

LIC809 (FAS) - (06/04)

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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME: GOLDENSHTEYN, LILIANA R.	FACILITY NUMBER: 384001337
	VISIT DATE: 01/20/2022

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To improve the quality and value of the new inspection process, a survey will be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or tools, please send them by email to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/process.

The report was reviewed and signed by the Licensee, Liliana Goldenshteyn. No deficiencies were observed in today's inspection. Today's report, 1/20/2022, and notice of site visit will be sent to the Licensee email by the close of business on 1/20/2022. Confirmation of receipt is required, and a notice of site visit must remain posted for 30 days.

SUPERVISOR'S NAME: Garfield Leung	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Brendon Van	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 01/20/2022

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/20/2022

LIC809 (FAS) - (06/04)

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