414003045-10-10-2024-05-CC-CQUO-D9WSTN-20241010140950

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 414003045
Report Date: 10/10/2024
Date Signed: 10/10/2024 02:09:58 PM

Document Has Been Signed on 10/10/2024 02:09 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 CC RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME:	TSENDJAV, OYUNDELGER		FACILITY NUMBER:	414003045
ADMINISTRATOR:	TSENDJAV, OYUNDELGER		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(415) 316-9365
CITY:	DALY CITY	STATE: CA	ZIP CODE:	94015
CAPACITY:	14	CENSUS: 8	DATE:	10/10/2024
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	11:10 AM
MET WITH:	Oyundelger Tsendjav		TIME COMPLETED:	02:30 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 October 10, 2024 at approximately 11:10am, Licensing Program Analyst (LPA) Catrina Quimbo conducted an unannounced, annual inspection. LPA met with licensee, Oyundelger Tsendjav, and explained the purpose of the visit. Present during LPA's visit included 8 children (5 infants and 3 preschool age) and licensee's spouse/assistant. LPA discussed capacity limits and ratio with licensee. LPA reminded licensee there cannot be more than 4 infants (under 24 months) at any time in a licensed family child care home. Licensee lives in the multilevel home with their spouse and adult child. All adults living in the home have fingerprint clearance on file. There is an additional unit with the same address as licensee's address. Unit is separate from licensee's unit. Currently, there is a tenant living in the separate unit, that also has fingerprint clearance on file. Hours of operation are Monday through Friday 7:00am to 5:30pm. Day care operates on the ground level of the home only. With licensee, LPA inspected day care areas for health and safety hazards. The DAY CARE AREAS are the living room (main day care area), dining room (napping area), bathroom (not currently in use) and portion of backyard. The OFF LIMIT AREAS are all bedrooms, kitchen, garage and portion of backyard (with unit). All off limit areas are made inaccessible with child safety gates. There are stairs in the home that are made inaccessible to children. LPA observed living room to have a variety of toys and equipment that are in good condition. Home is in good repair with appropriate temperature and ventilation. There is a fireplace in the living room that is made inaccessible to children with a child safety gate. There are also windows in the living room that have a child safety gate installed for additional safety. Flooring in day care areas include carpets and rugs that are clean and free of stains. In living room, LPA observed baby bouncer. LPA reminded licensee baby bouncers, walkers and similar items are not allowed in a licensed family child care home. Licensee's spouse removed baby bouncer during LPA's visit. LPA observed cleaning solutions and poisons to be stored in home's high shelves. LPA observed electrical outlets in day care areas to be made inaccessible with child safety covers. Home is equipped with a first aid kit, fully charged fire extinguisher, and multiple smoke and carbon monoxide detectors. During LPA's visit, carbon monoxide detector was tested and was observed to be working. (Continue Report on Page 2...)

SUPERVISOR'S NAME: Marie Rodriguez	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Catrina Quimbo	TELEPHONE: 650-266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 10/10/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/10/2024

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
SAN BRUNO CC RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME: TSENDJAV, OYUNDELGER	FACILITY NUMBER: 414003045
	VISIT DATE: 10/10/2024

NARRATIVE

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Napping area for children includes 8 cribs. Cribs do not hinder the entrance or exit to dining area. LPA observed blankets hanging on the outside of each crib. LPA also observed one crib to have a mobile hanging above it. LPA reminded licensee nothing can hang above a crib or can be attached on the outside of the crib. Licensee removed mobile hanging above crib and blankets hanging on the outside of the cribs. During visit, LPA also observed children sleeping with blankets inside the crib. LPA reminded licensee blankets and loose materials and articles cannot be used while an infant is sleeping in a crib.

LPA requested for sleeping logs for napping infants in care. Per licensee, children are always supervised, however, sleeping logs are not maintained. LPA reminded licensee 15 minute sleeping logs for each napping infant must be conducted, documented and maintained.

LPA discussed the safe sleep regulations with licensee and discussed the Child Care Licensing Safe Sleep webpage athttps://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-andresources/safe-sleep as an additional resource. LPA also informed 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.

Bathroom for children's use was observed to be in working condition. Per licensee, children enrolled are all currently in diapers and do not utilize bathroom at this time. LPA observed children's diapers to be appropriately stored and maintained. Dirty diapers are disposed of daily.

Backyard is fully fenced and enclosed. Off limit areas in backyard have a separate child safety gate/fence. Backyard includes a variety of outdoor toys and equipment that are in good condition. There is a play structure and swings in backyard that has resilient padding underneath. LPA did not observe any pools, spas or bodies of water on site.

Licensee currently provides a food service that includes breakfast, lunch and snack. Children are also able to bring their own food to facility, that is labeled and stored appropriately.

Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02-CCP. 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: https://www.ada.gov/resources/child-care-centers/.
(Continue Report on Page 3...)

SUPERVISOR'S NAME: Marie Rodriguez	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Catrina Quimbo	TELEPHONE: 650-266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 10/10/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/10/2024

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
SAN BRUNO CC RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME: TSENDJAV, OYUNDELGER	FACILITY NUMBER: 414003045
	VISIT DATE: 10/10/2024

NARRATIVE

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Licensing documents are posted and available for review. LPA reviewed facility records that included 8 children's records. Children's files have their immunization records available for review. Licensee's CPR/First Aid certification is current and will expire 04/2025. Licensee's spouse's CPR/First Aid certification and Mandated Reporter certification are current. Licensee's Mandated Reporter certification has expired. LPA reminded licensee Mandated Reporter certification must be renewed every two years by all staff working with children. Both licensee and licensee's spouse have their immunizations, available for LPA's review.

To improve the quality and value of the new inspection process, a survey may 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 CARE tools, please send email inquiries 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/inspection-process.

Licensee was reminded that all adults 18 and over living or working in the home, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, 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 for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.

Licensee was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

During the exit interview, the licensee, Oyundelger Tsendjav, confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.

Licensee was issued one Type A citation for operating over capacity. Licensee was issued four type B citations for not maintaining sleeping logs for infants, loose articles in cribs, objects hanging above and on the outside of the crib, and an accessible baby bouncer. Appeal rights were provided during visit.

LPA Quimbo informed licensee, Oyundelger Tsendjav, that this report dated October 10, 2024 documents one Type A citation which shall be posted for 30 consecutive days as there is/are immediate risk(s) to the health, safety, or personal rights of children in care. Also, LPA Quimbo informed the licensee to provide a copy of this licensing report dated October 10, 2024 that documents any Type A citation to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification.

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

Exit interview conducted and report was reviewed with the licensee, Oyundelger Tsendjav.

SUPERVISOR'S NAME: Marie Rodriguez	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Catrina Quimbo	TELEPHONE: 650-266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 10/10/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/10/2024

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 10/10/2024 02:09 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

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

FACILITY NAME: TSENDJAV, OYUNDELGER	FACILITY NUMBER: 414003045
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 10/10/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type A

Section Cited

CCR

102416.5(d)(1)

Staffing Ratio and Capacity

(d) For a Large Family Child Care Home, the maximum number of children for whom care may be provided at any one time when there is an assistant provider in the home, including children under age 10 who reside at the licensee's home and the assistant provider's children under age 10, shall be either: (1) Twelve children, no more than four of whom may be infants; or This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on observation, interview and record review, the licensee did not comply with the section cited above. There were 5 infants (under 24 months) present during today's visit, which poses an immediate health, safety or personal rights risk to persons in care.
	POC Due Date: 10/11/2024
	Plan of Correction
1 2 3 4	LPA discussed capacity limits and ratio with licensee. LPA reminded licensee a liensed family child care home cannot have more than 4 infants at any time. Capacity limits and ratio sheet was provided to licensee during visit. Licensee must either stagger infants' schedules or disenroll an infant to ensure licensee complies with capacity limits and ratio.

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

SUPERVISOR'S NAME: Marie Rodriguez	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Catrina Quimbo	TELEPHONE: 650-266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 10/10/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/10/2024

LIC809 (FAS) - (06/04)

Page: 4 of 6

Document Has Been Signed on 10/10/2024 02:09 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

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

FACILITY NAME: TSENDJAV, OYUNDELGER	FACILITY NUMBER: 414003045
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 10/10/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

102417(g)(10)

Operation of A Family Child Care Home

(g) The home shall be free from defects or conditions which might endanger a child. Safety precautions shall include but not limited to: (10) A baby walker shall not be allowed on the premises of a family child care home in accordance with Health and Safety Code Sections 1596.846(b) and (c). This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on observation, interview and record review, the licensee did not comply with the section cited above. LPA observed an accessible baby bouncer in the day care area, which poses a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 10/10/2024
	Plan of Correction
1 2 3 4	LPA reminded licensee baby walkers, bouncers and similar items are not allowed in a licensed family child care home. During LPA's visit, licensee removed baby bouncer from day care area to an off limit area.

Type B

Section Cited

CCR

102425(b)

Infant Safe Sleep

(b) Cribs or play yards shall be free from all loose articles and objects. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on observation, interview and record review, the licensee did not comply with the section cited above. LPA observed children sleeping in cribs with loose blankets, which poses a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 10/10/2024
	Plan of Correction
1 2 3 4	LPA reminded licensee cribs must be free of loose articles, objects and materials when in use. Licensee removed blankets from cribs during LPA's visit.

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

SUPERVISOR'S NAME: Marie Rodriguez	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Catrina Quimbo	TELEPHONE: 650-266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 10/10/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/10/2024

LIC809 (FAS) - (06/04)

Page: 5 of 6

Document Has Been Signed on 10/10/2024 02:09 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

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

FACILITY NAME: TSENDJAV, OYUNDELGER	FACILITY NUMBER: 414003045
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 10/10/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

102425(b)(3)

Infant Safe Sleep

(b) Cribs or play yards shall be free from all loose articles and objects. (3) There shall be no objects hanging above or attached to the side of the crib. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on observation, interview and record review, the licensee did not comply with the section cited above. LPA observed a mobile toy hanging over one crib . LPA also observed blankets hanging on the outside of each crib, which poses a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 10/10/2024
	Plan of Correction
1 2 3 4	LPA reminded licensee nothing can hang above or on the outside of a crib. LPA reminded licensee they must be able to visually observe children through the crib. Licensee removed mobile hanging over crib during LPA's visit. Licensee also removed all blankets on the outside of each crib during LPA's visit.

Type B

Section Cited

CCR

102425(j)(2)

Infant Safe Sleep

The provider shall supervise infants while they are sleeping and adhere to the following requirements: The provider shall check and document the following: This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on observation, interview and record review, the licensee did not comply with the section cited above. 5 infants present did not have a sleeping log maintained, which poses a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 10/18/2024
	Plan of Correction
1 2 3 4	LPA provided licensee with PIN 20-24-CCP. LPA reminded licensee sleeping logs must be maintained for all napping infants. Licensee will maintain sleeping logs for napping infants that includes a 15 minute time check.

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

SUPERVISOR'S NAME: Marie Rodriguez	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Catrina Quimbo	TELEPHONE: 650-266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 10/10/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/10/2024

LIC809 (FAS) - (06/04)

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