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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 015700178
Report Date: 10/08/2024
Date Signed: 10/08/2024 03:38:33 PM

Document Has Been Signed on 10/08/2024 03:38 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
OAKLAND SOUTH CC RO, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME:NECHAYEVA, MARINAFACILITY NUMBER:
015700178
ADMINISTRATOR/
DIRECTOR:		NECHAYEVA, MARINAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(415) 490-6605
CITY:FREMONTSTATE: CAZIP CODE:
94538
CAPACITY: 14TOTAL ENROLLED CHILDREN: 5CENSUS: 5DATE:
10/08/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:35 PM
MET WITH:Marina NechayevaTIME VISIT/
INSPECTION COMPLETED:
03:50 PM
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On 10/08/2024 at 12:35PM Licensing Program Analyst (LPA) Jaleesa Jackson arrived for an Unannounced Annual/Random Inspection and met with Licensee Marina Nechayeva. LPA informed Licensee of the nature of the visit and entry was granted. Present for this inspection was the Licensee, 3 preschool age children and 2 infants. Also residing in the home is the licensee's minor son. The home was toured to conduct a health and safety inspection. Hours of operation for day care are Monday through Friday, 8:00AM - 6:00PM.

ON LIMITS: Living room, Family room, Dining Area, Bedroom #1 (first room on the left of hallway), Bedroom #2 (first room on right of hallway), Bathroom #1(end of the hall), Back Patio, and Backyard (excluding the 2 side yards.

OFF LIMITS: Garage, Kitchen, Bedroom #3, bedroom #4 (master bedroom), Bathroom #2 (master bathroom), and the sides of the Backyard. Off limit areas are inaccessible by closed and/or locked doors, gates, and visual supervision.

The home is single story with heating and ventilation for safety and comfort. LPA observed there were age appropriate toys and activities that were in safe and good condition. During today's inspection all toxins, medicines, and hazardous items were inaccessible. There was a fully charged 3A40BC fire extinguisher, working dual carbon monoxide and smoke detector, and telephone on the premises. The home has a fireplace but is blocked off by a screen that is properly latched. Licensee provides all food for the children. All food that is brought from the children’s home will be properly labeled and stored. Licensee stated there are no firearms or pets. LPA toured backyard and observed a small water table that was emptied of water.

Continued on 809-C
SUPERVISORS NAME: Jason Jang
LICENSING EVALUATOR NAME: Jaleesa Jackson
LICENSING EVALUATOR SIGNATURE: DATE: 10/08/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/08/2024
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
OAKLAND SOUTH CC RO, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME: NECHAYEVA, MARINA
FACILITY NUMBER: 015700178
VISIT DATE: 10/08/2024
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LPA reviewed 5 children's files. LPA asked for a copy of the 2 infants sleep logs and found only a record of the day before (10/7/2024). Licensee could not provide the paperwork for the other days. LPA let Licensee know that all sleep logs need to be maintain in the child's file. The facility roster was reviewed and a copy obtained. The facility is in ratio today. Licensee does not have the a certificate for Pediatric CPR and First Aid. The certificate that was provide was for Adult CPR and First Aid. Licensee stated she will get this resolved at once. The licensee conducts and documents disaster drills. The last drill was conducted 06/21/24. All required licensing documents are posted and visible for public review.

There were 2 deficiencies cited during today's visit. See 809-D for deficiencies. Appeal rights were given to Licensee.

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.

LPA discussed the safe sleep regulations with licensee and discussed the Child Care Licensing Safe Sleep webpage at https://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.

Continued on 809-C

SUPERVISORS NAME: Jason Jang
LICENSING EVALUATOR NAME: Jaleesa Jackson
LICENSING EVALUATOR SIGNATURE:

DATE: 10/08/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/08/2024
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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
OAKLAND SOUTH CC RO, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME: NECHAYEVA, MARINA
FACILITY NUMBER: 015700178
VISIT DATE: 10/08/2024
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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/.

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

During the exit interview, the LICENSEE Marina Nechayeva, confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.

A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with the licensee Marina Nechayeva.

SUPERVISORS NAME: Jason Jang
LICENSING EVALUATOR NAME: Jaleesa Jackson
LICENSING EVALUATOR SIGNATURE:

DATE: 10/08/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/08/2024
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 10/08/2024 03:38 PM - It Cannot Be Edited


Created By: Jaleesa Jackson On 10/08/2024 at 02:43 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612

FACILITY NAME: NECHAYEVA, MARINA
FACILITY NUMBER: 015700178

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/08/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102425(j)(1)
Infant Safe Sleep
The provider shall supervise infants while they are sleeping and adhere to the following requirements: The provider shall physically check on the infant every 15 minutes.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on interview and record review, the licensee did not comply with the section cited above in 2 out of 2 infants only had 1 days worth of sleep logs which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 10/22/2024
Plan of Correction
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Licensee will send a copy of sleep logs for each infant for 2 weeks to the LPA by email daily until POC date of 10/22/2024 to ensure they are being recorded each day.
Type B
Section Cited
CCR
102416(c)
Personnel Requirements
(c) The licensee and other personnel as specified shall complete training on preventive health practices, including pediatric cardiopulmonary resuscitation and pediatric first aid, pursuant to Health and Safety Code Section 1596.866.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on record review, the licensee did not comply with the section cited above in the CPR and First Aid certificate provided was only for Adults not Pediatric which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 10/22/2024
Plan of Correction
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Licensee will send LPA the correct certifcate that states Pediatric CPR and First aid to the LPA by email.
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:Jason Jang
LICENSING EVALUATOR NAME:Jaleesa Jackson
LICENSING EVALUATOR SIGNATURE:
DATE: 10/08/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/08/2024


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