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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 013422917
Report Date: 11/09/2021
Date Signed: 11/09/2021 02:45:59 PM

Document Has Been Signed on 11/09/2021 02:45 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
CCLD Regional Office, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME:GRUZMAN, CHANAFACILITY NUMBER:
013422917
ADMINISTRATOR:GRUZMAN, CHANAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(510) 342-9326
CITY:CASTRO VALLEYSTATE: CAZIP CODE:
94546
CAPACITY: 14TOTAL ENROLLED CHILDREN: 7CENSUS: 5DATE:
11/09/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
01:00 PM
MET WITH:Chana GruzmanTIME COMPLETED:
03:00 PM
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On 11/9/21 at 1:00pm, Licensing Program Analyst Briana Plumboy met with licensee Chana Gruzman for an UNANNOUNCED RANDOM INSPECTION. Present for this visit was 3 infants (2 which are licensees), 2 preschool age children, and licensee's fingerprint clear and associated husband Shneur Gruzman. The home was toured to conduct a Health and Safety Inspection. Per licensee, the facility currently operates Monday through Friday from 8:00am until 6:00pm.

The home has two levels. The home consists of a living room, family room, dining room, kitchen/dining room combo, 2 bedrooms, 2 bathrooms, a master bedroom/bathroom/closet, a laundry room, and an extension of the home which can be accessed through the home by a door located in between the laundry room and bathroom. ON LIMITS: the dining room, living room, kitchen/dining room combo, and family room. Also on limit is the bedroom located inside the left hallway first on the right, the bedroom located at the end of the hallway, both downstairs bathrooms, and the first level of extension of the home off the right of the kitchen. OFF LIMITS: the master bed/bath/closet, laundry room, and the entire upstairs portion of the home. The isolation area will be will be the first bedroom on the right located inside the hallway on the left of the dining room. There are 2 fire extinguishers, carbon monoxide detector, working smoke detector, and 2 pull down fire alarms.
Outdoor play area is completely fenced. There are toys, learning materials, and play equipment. Hazardous materials and toxins are kept out of the reach of children and it was observed that there are no toxins or hazardous items accessible to children during today's inspection.

The licensee's CPR and First Aid certificate is current and expires 11/11/2021. The licensee's mandated reporter training is complete and she received a certification of completion on 09/29/20. The licensee is in compliance with the immunization law which pertains to day care providers. The fireplaces are boarded and cannot be used. Per licensee, there are no firearms in the home. The licensee conducts and documents fire and disaster drills twice a year with the last fire drill conducted on 09/02/21. The licensee is in ratio today. All REQUIRED forms are posted and visible for public review. See 809-C for continuance
SUPERVISORS NAME: Wynn Norona
LICENSING EVALUATOR NAME: Briana Plumboy
LICENSING EVALUATOR SIGNATURE: DATE: 11/09/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/09/2021
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, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME: GRUZMAN, CHANA
FACILITY NUMBER: 013422917
VISIT DATE: 11/09/2021
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Incidental Medical Services (IMS) policy was discussed. 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: http://www.ada.gov/childqanda.htm

Licensee was encouraged to frequently visit our website at ccld.ca.gov for licensing regulations and updates.

Licensee is reminded that ALL assistants, volunteers, and staff, that are 18 years of age or older must be fingerprint cleared and associated to this facility prior to being in the presence of children in care or an immediate civil penalty will be assessed from $100 to $3000 per person, per incident. Licensee was reminded of the responsibility as a mandated reporter. All forms can be downloaded at www.ccld.ca.gov



LPA discussed the safe sleep regulations with licensee Chana Gruzman 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 licensee Chana Gruzman 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.

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

No deficiencies cited during today's inspection. Appeal rights provided and discussed. Exit interview conducted and report was reviewed with licensee Chana Gruzman.

SUPERVISORS NAME: Wynn Norona
LICENSING EVALUATOR NAME: Briana Plumboy
LICENSING EVALUATOR SIGNATURE:

DATE: 11/09/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/09/2021
LIC809 (FAS) - (06/04)
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