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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 073409362
Report Date: 05/09/2023
Date Signed: 05/09/2023 11:27:22 AM

Document Has Been Signed on 05/09/2023 11:27 AM - 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, SUITE 1102
OAKLAND, CA 94612
FACILITY NAME:SAFANIEV, NATALIEFACILITY NUMBER:
073409362
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 2CENSUS: 1DATE:
05/09/2023
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
09:45 AM
MET WITH:Natalie SafanievTIME COMPLETED:
11:35 AM
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On 5/9/23 at 9:45 AM Licensing Program Analyst (LPA) Michelle Sutton conducted an unannounced Case Management inspection for a Capacity Change at Natalie Safaniev Family Childcare Home. LPA met with Natalie Safaniev and explained the purpose of today's inspection.The family childcare home days and hours are Monday to Friday 7:00 AM to 6:00 PM. Present in the home at time of inspection were licensee, licensee's daughter and 1 infant. Licensee is in compliance for the maximum licensed capacity and ratio for a Small Family Child Care Home.

Licensee was reminded that all adults 18 and over living or working in the home, including employees and volunteers, 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 up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

IN-USE AREAS: Family room/playroom, bathroom near family room, living room and right side of back yard


OFF-LIMIT AREAS: entire 2nd level, kitchen, dinning room, bedroom next to family room/playroom, bathroom near front door, garage and left side of backyard.
OUTDOOR SPACE: LPA toured the right side of backyard and it was fully fenced. LPA observed on the left side the backyard there is a pool completely fenced to prevent access to children. The pool gate opens away from the pool and is self closing.

LPA observed: fully charged 2A10BC fire extinguisher, working smoke and carbon monoxide detector. Medicines, cleaning products, sharp objects are stored inaccessible to children. LPA reminded baby walkers, bouncers, jumpers and similar items are not allowed in family childcare homes. Licensee states that there are two dogs. No arms and ammunition stored in the home. LPA discussed conducting disaster drill at least once every six months.
SUPERVISORS NAME: Sherelle Johnson
LICENSING EVALUATOR NAME: Michelle Sutton
LICENSING EVALUATOR SIGNATURE: DATE: 05/09/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/09/2023
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, SUITE 1102
OAKLAND, CA 94612
FACILITY NAME: SAFANIEV, NATALIE
FACILITY NUMBER: 073409362
VISIT DATE: 05/09/2023
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Children files and Facility files were reviewed. Facility contained Children's Roster, Licensee’s mandated reporter training, pediatric CPR and first aid, immunization against influenza, pertussis, measles and opt out statement for current flu season. Fire department granted clearance for fire inspection.

Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual – Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. 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

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-and-resources/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.

A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with the licensee Natalie Safaniev. LPA has approved facility license for a Large family childcare home.
SUPERVISORS NAME: Sherelle Johnson
LICENSING EVALUATOR NAME: Michelle Sutton
LICENSING EVALUATOR SIGNATURE:

DATE: 05/09/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/09/2023
LIC809 (FAS) - (06/04)
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