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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 015700322
Report Date: 02/05/2025
Date Signed: 02/05/2025 02:46:29 PM

Document Has Been Signed on 02/05/2025 02:46 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 EAST, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME:ARMEEVA, ANNAFACILITY NUMBER:
015700322
ADMINISTRATOR/
DIRECTOR:		ARMEEVA, ANNAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(925) 322-9126
CITY:DUBLINSTATE: CAZIP CODE:
94568
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 13DATE:
02/05/2025
TYPE OF VISIT:POCUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:30 PM
MET WITH:Licensee, Anna ArmeevaTIME VISIT/
INSPECTION COMPLETED:
03:00 PM
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 Licensing Program Analyst (LPA) Jyoti Saini conducted an Unannounced Plan of Correction (POC) visit to the facility and met with facility representative Anna Armeeva. Present during the inspection were a licensee and helper supervising 13 children ( 12 preschoolers and one school-age). The facility was operating within the large family child care ratio.

On 01/30/2025, the facility was issued a Type A and Type B citation for the following violations: an uncleared, fingerprint individual supervising the children and a staff member present did not have CPR and First Aid certification on file. LPA Saini verified through Guardian that the individual with uncleared fingerprints has now obtained clearance; however, were not present during the inspection. The licensee was present with a valid CPR and First Aid certification, which expires on 02/03/2026. Additionally, the licensee's helper is scheduled to attend CPR and First Aid training on 02/09/2025. LPA obtained a copy of the CPR and First Aid training confirmation.

During the visit, both the Type A and Type B deficiencies were cleared and POC letters were issued.

No deficiency is cited today.

Exit interview was conducted and report was reviewed with licensee, Anna Armeeva.

SUPERVISORS NAME: Wynn Norona
LICENSING EVALUATOR NAME: Jyoti Saini
LICENSING EVALUATOR SIGNATURE: DATE: 02/05/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/05/2025
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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