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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 414004252
Report Date: 07/25/2019
Date Signed: 07/25/2019 01:10:26 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:NADELMAN, AMINTAFACILITY NUMBER:
414004252
ADMINISTRATOR:NADELMAN, AMINTAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(650) 452-4228
CITY:PACIFICASTATE: CAZIP CODE:
94044
CAPACITY:14CENSUS: 8DATE:
07/25/2019
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
12:20 PM
MET WITH:Aminta Nadelman, Fanny NadelmanTIME COMPLETED:
01:20 PM
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Licensing Program Analysts (LPAs) Andrea Medlin and Winnie Ly met with Licensee and helper for this plan of correction visit established on 6/20/19. There are 8 children present during the visit. The following previously cited deficiencies are checked today:
  • Section 102418(g) Immunization. Licensee shall document and maintain each child’s immunizations as long as the child is enrolled. All children noted on previous visit now have current immunizations on file.
  • H&S Code 1596.8662(3) On and after January 1, 2018, a person who becomes an administrator or employee of a licensed child day care facility shall complete the mandated reporter training provided pursuant to paragraphs (2) and (3) of subdivision (a) within the first 90 days of employment. S2 now has verification of the mandated child abuse reporter training as compliant with AB1207 (completed 7/14/19).
  • H&S Code 1597.622(a)(1) Commencing September 1, 2016, a person shall not be employed at a family day care home if he/she has not been immunized against influenza, pertussis, and measles. S2 now has verification of the measels (MMR) immunization.

This report is reviewed with Licensee and a copy of this report must be made available for public review upon request.

Notice of site visit posted and shall remain posted for 30 days.
SUPERVISOR'S NAME: Garfield LeungTELEPHONE: (650) 266-8867
LICENSING EVALUATOR NAME: Andrea MedlinTELEPHONE: 650-266-8800
LICENSING EVALUATOR SIGNATURE:

DATE: 07/25/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/25/2019
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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