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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 015700178
Report Date: 01/22/2024
Date Signed: 01/22/2024 01:21:02 PM

Document Has Been Signed on 01/22/2024 01:21 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:NECHAYEVA, MARINAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(415) 490-6605
CITY:FREMONTSTATE: CAZIP CODE:
94538
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 8DATE:
01/22/2024
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
12:45 PM
MET WITH:Marina NechayevaTIME COMPLETED:
01:30 PM
NARRATIVE
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On Monday 01/22/2024 at 12:45PM, Licensing Program Analyst (LPA) Jaleesa Jackson conducted a Unannounced Case Management Deficiencies visit. LPA met with Licensee Marina Nechayeva and explained the nature of the visit. Present on this visit were 3 infants and 5 preschool aged children and uncleared adult.

At 10:40AM LPA observed 1 adult (A1) without a criminal record clearance assisting with the daycare. Licensee was informed that A1 must submit fingerprints to obtain a criminal record clearance by tomorrow 01/23/2024.

There was 1 deficiency cited on today's visit. See 809-D for deficiency.

LPAs informed Licensee that this report dated 01/22/2024 documents 1 Type A citation which shall be posted for 30 consecutive days as there is immediate risk to the health, safety, or personal rights of children in care.

Also, LPA informed the facility representative to provide a copy of this licensing report dated 01/22/2024 that documents any Type A citation to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification.

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



Appeal rights were printed and given to Licensee.

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: 01/22/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/22/2024
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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Document Has Been Signed on 01/22/2024 01:21 PM - It Cannot Be Edited


Created By: Jaleesa Jackson On 01/22/2024 at 01:02 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: 01/22/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
01/23/2024
Section Cited
CCR
102370(d)

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(d) All individuals subject to a criminal record review pursuant to Health and Safety Code Section 1596.871 shall prior to working, residing or volunteering in a licensed facility:

This requirement is not met as evidenced by:
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Director will immediately have A1 submit fingerprints to obtain a criminal record clearance by tomorrow 01/23/2024 and send proof to LPA by email.
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This requirement is not met as evidenced by: Based on observation, interview, and record review licensee has an unclear adult working in the facility which poses an immediate risk to the health, safety, and personal rights to children in care.
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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: 01/22/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/22/2024


LIC809 (FAS) - (06/04)
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