414004470-11-8-2019-05-CC-MROZ-BHR3UL-20191108173345

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 414004470
Report Date: 11/08/2019
Date Signed: 11/08/2019 05:33:51 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:	GALANT, GALINA		FACILITY NUMBER:	414004470
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY:	8	CENSUS: 5	DATE:	11/08/2019
TYPE OF VISIT:	Case Management - Licensee Initiated	UNANNOUNCED	TIME BEGAN:	02:05 PM
MET WITH:	Galina Galant		TIME COMPLETED:	05:50 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	Licensing Program Analyst (LPA) Marie Rodriguez made an unannounced Case Management inspection in conjunction with an Annual Random inspection to review application received on September 30, 2019 for a capacity increase of home from 8 to 14 children. LPA met with Licensee Galina Galant and explained purpose of inspection. Present in home were the Licensee, her adult son, her minor son, a helper, and 5 children (preschool age). Hours of operation are Monday to Friday 7:30am - 6:00pm. Day Care Areas: Living room, dining room, bathroom #2, and backyard. Off Limit Areas: First floor: Kitchen, laundry room, bedroom #1, bedroom #2, bedroom #3, bathroom #1, garage, side yards, hot tub, and separate living space. Second floor: Whole entire second floor. LPA inspected day care areas of home with Licensee. LPA observed home to be clean and in good repair with proper temperature and ventilation. Per Licensee, there are no weapons or firearms in the home. There is a variety of age appropriate toys and equipment in the home and outside in the outdoor play area which are in good condition. Outdoor play area is fenced for supervision and cushioning on ground. There is a hot tub in the off limit area of the backyard that is covered and locked. There is a gate at the foot of the stairs to the second floor and in the kitchen area. Child proof knobs were installed to the doors on all of the off limit rooms on the first floor to prevent children access. Napping equipment is in good condition and properly stored. All cleaning supplies, poisons, and other chemicals are stored inaccessible to children. There is a working smoke detector and carbon monoxide detector, a fully charged fire extinguisher, a working telephone, and a first aid kit available. Licensee is reminded all adults, 18 years and older living in the home, helper, or assistant must have criminal record clearance and must be associated to the facility by submitting an LIC 9182 with a copy of CA Driver's License or CA ID prior to having any contact with children in care. Failure to do so may result in an immediate civil penalty of $100 per day. (Continued on second page)

SUPERVISOR'S NAME: Alma Malig	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Marie Rodriguez	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 11/08/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/08/2019

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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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: GALANT, GALINA	FACILITY NUMBER: 414004470
	VISIT DATE: 11/08/2019

NARRATIVE

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(Continued from first page)

Capacity limits of a Small and Large License has been reviewed with Licensee. Licensee was reminded that when operating at a Large capacity, there must be a Helper present.

Licensee is in the process of installing a fire alarm in the home with a licensed per request of fire department. Licensee will inform LPA when the installation has been completed.

Large Family Child Care License will be approved once the Fire Clearance inspection has been granted.

This report was reviewed and discussed with Licensee Galina Galant. A copy of report was provided.

SUPERVISOR'S NAME: Alma Malig	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Marie Rodriguez	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 11/08/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/08/2019

LIC809 (FAS) - (06/04)

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