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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 414003045
Report Date: 10/18/2024
Date Signed: 10/18/2024 12:15:09 PM


Document Has Been Signed on 10/18/2024 12:15 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, OYUNDELGERFACILITY NUMBER:
414003045
ADMINISTRATOR:TSENDJAV, OYUNDELGERFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(415) 316-9365
CITY:DALY CITYSTATE: CAZIP CODE:
94015
CAPACITY:14CENSUS: 6DATE:
10/18/2024
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
11:15 AM
MET WITH:Oyundeleger TsendjavTIME COMPLETED:
12:30 PM
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On October 18, 2024 at approximately 11:15am, Licensing Program Analyst (LPA) Catrina Quimbo conducted an unannounced, plan of correction (POC) visit. LPA met with licensee, Oyundelger Tsendjav, and explained the purpose of the visit.

Present during LPA's visit included licensee, licensee's spouse and 6 children (4 infants and 2 preschool age). Licensee is a large license and is operating within capacity limits during LPA's visit.

On October 10, 2024 at approximately 11:10am, LPA conducted an unannounced, annual inspection to home. During annual inspection, LPA observed licensee to be operating over capacity with 8 children (5 infants and 3 preschool age). Licensee was reminded a licensed family child care home can not operate with more than 4 infants (under 24 months) at any time. LPA issued a Type A citation for operating over capacity.

During annual inspection, LPA also observed an accessible baby bouncer in day care area, observed loose articles in children's cribs, observed objects hanging above/over a child's crib and observed objects hanging on the outside of children's cribs. Licensee also did not maintain sleeping logs for napping infants. LPA issued four Type B citations. A POC was discussed with licensee.

As of this date, LPA observed licensee to be operating within capacity limits of a large family child care home. Licensee stated additional infant is part time and will be turning 2 years old 10/24/2024. During today's inspection, LPA observed signed and completed Acknowledgement of Receipt of Licensing Reports (LIC9224) for every enrolled child. LPA observed licensing documents and previous Notice of Site Visit to be properly posted, available for review.

Licensee maintained sleeping logs for all napping infants starting from the date of LPA's annual inspection to today's date. LPA observed sleeping logs include a 15 minute time stamp of when the infant was checked on while sleeping. The sleeping logs also include the infants' sleeping positions and the initials of the individual checking on the napping infant. LPA also observed completed Individual Infant Sleeping Plans (LIC9227) for all enrolled infants.
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SUPERVISOR'S NAME: Marie RodriguezTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Catrina QuimboTELEPHONE: 650-266-8800
LICENSING EVALUATOR SIGNATURE:
DATE: 10/18/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/18/2024
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 2


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: 10/18/2024
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LPA also observed all cribs to be free of loose articles and objects. LPA did not observe objects to be hanging above a crib or hanging on the outside of a crib. LPA did not observe any accessible baby bouncers, walkers or exersaucers in day care areas. LPA also observed licensee's Mandated Reporter certification has also been renewed and will expire 10/2026.

Deficiencies issued on October 10, 2024 have been cleared with today's visit. LPA provided licensee copy of POC letters. No deficiencies were cited today.

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

Exit interview conducted and report was reviewed with licensee, Oyundelger Tsendjav.
SUPERVISOR'S NAME: Marie RodriguezTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Catrina QuimboTELEPHONE: 650-266-8800
LICENSING EVALUATOR SIGNATURE:

DATE: 10/18/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/18/2024
LIC809 (FAS) - (06/04)
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