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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 015700178
Report Date: 07/09/2024
Date Signed: 07/09/2024 02:43:20 PM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
OAKLAND SOUTH CC RO, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
This is an official report of an unannounced visit/investigation of a complaint received in our office on
07/01/2024 and conducted by Evaluator Jaleesa Jackson
PUBLIC
COMPLAINT CONTROL NUMBER: 52-CC-20240701142256

FACILITY NAME:NECHAYEVA, MARINAFACILITY NUMBER:
015700178
ADMINISTRATOR:NECHAYEVA, MARINAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(415) 490-6605
CITY:FREMONTSTATE: CAZIP CODE:
94538
CAPACITY:14CENSUS: 4DATE:
07/09/2024
UNANNOUNCEDTIME BEGAN:
01:30 PM
MET WITH:Marina NechayevaTIME COMPLETED:
03:00 PM
ALLEGATION(S):
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Licensee did not notify parents of Type A deficiencies
INVESTIGATION FINDINGS:
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On 7/9/2024, Licensing Program Analyst (LPA) Jaleesa Jackson met with Marina Nechayeva to deliver the finding of a complaint filed against the Family Child Care Home regarding the above allegation Present for the inspection were 2 infants and 2 preschool aged children.

LPA Jackson conducted interviews and record review. LPA observed 4 children's files were missing the LIC9224 for the report dated 6/5/2024. The allegation the Licensee did not notify parents of Type A deficiencies has been SUBSTANTIATED. Based on LPA's interviews and record review, the preponderance of evidence standard has been met, therefore the above allegations are found to be SUBSTANTIATED.

See 9099-D for deficiency.
A notice of site visit was given and must remain posted for 30 days.
Appeal Rights were given and discussed. An exit interview was conducted.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Jason Jang
LICENSING EVALUATOR NAME: Jaleesa Jackson
LICENSING EVALUATOR SIGNATURE:

DATE: 07/09/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/09/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 2 of 4
Control Number 52-CC-20240701142256
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION 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
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/09/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
07/16/2024
Section Cited
HSC
1596.8595(c)(1)
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A licensed child day care facility shall provide to the parents or guardians of each child receiving services in the facility copies of any licensing report that documents any Type A citation that represents an immediate risk to the health, safety, or personal rights of children in care...
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Licensee will provide licensing report from 6/5/2024 and have the parents sign the LIC9224. Licensee will submit proof to LPA by email by POC date of 7/16/2024.
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Based on record review and interviews, the licensee did not comply with the section cited above as 4 out of 4 children's files did not have the LIC9224 for the 6/5/2024 licensing report which posed a potential health, safety or personal rights risk to persons in care.
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Failure to correct will result in a $100 per day civil penalty until corrected. Repeat violations are $250 per violation and $100 per day until corrected.
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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.
SUPERVISORS NAME: Jason Jang
LICENSING EVALUATOR NAME: Jaleesa Jackson
LICENSING EVALUATOR SIGNATURE:

DATE: 07/09/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/09/2024
LIC9099 (FAS) - (06/04)
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