384001243-1-29-2024-05-CC-YNAR-CZXW3T-20240129155629

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 384001243
Report Date: 01/29/2024
Date Signed: 01/29/2024 03:56:36 PM

Document Has Been Signed on 01/29/2024 03:56 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
SAN BRUNO CC RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME:	GOLDFELD, GALINA & GOLDFELD, VLADIMIR		FACILITY NUMBER:	384001243
ADMINISTRATOR:	GOLDFELD, GALINA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(415) 531-0018
CITY:	SAN FRANCISCO	STATE: CA	ZIP CODE:	94116
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 14	CENSUS: 8	DATE:	01/29/2024
TYPE OF VISIT:	Required - 3 Year	UNANNOUNCED	TIME BEGAN:	01:50 PM
MET WITH:	Galina & Vladimir Goldfeld		TIME COMPLETED:	04:15 PM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	On 1/29/2024, at approximately 1:50pm, Licensing Program Analysts (LPAs) Nasiripour and Van arrived at the facility to conduct an annual inspection. LPAs were granted entrance and met by Licensees, Galina and Vladimir Goldfeld, and an Aide, Madlena. LPAs explained the purpose of the inspection. Present in the facility were both Licensees and 1 Aide supervising 8 children (1 infant and 7 preschool age children). The facility is operating within capacity limits on this day. All adults living and working in the home are fingerprint cleared and associated, confirmed through a check on CDSS Guardian Background Check System. The hours of the operation are from Monday - Friday, 8:00am - 5:30pm. DAY CARE AREAS: Ground floor, including the playroom, bedroom, study room, bathroom, and backyard. OFF-LIMIT AREAS: Garage and the entire second-level floor. The backyard's ground is padded to prevent injuries after a fall. LPAs toured day care areas of home with Licensees to inspect for health and safety hazards. LPAs observed home to be clean and in good repair with proper temperature and ventilation. There were a variety of age-appropriate toys and equipment in the home which were in good condition. No fireplaces were observed in daycare areas. The Licensees have no pets in the home. There are no pools or bodies of water in the premises. All cleaning supplies, poisons and other chemicals were stored inaccessible to children. Discipline Policy was discussed. Infant children sleep in a pack and play and preschool-aged children sleep on age appropriate cots. All children sleep in the "nap room," located in the daycare area, under the supervision of the Aide and/or Licensee Galina. The Licensees were reminded to place wire covers over land line telephone and lamp. There was a fully charged fire extinguisher, smoke alarm and carbon monoxide alarm, and a working telephone on site. Phone number listed for Licensees are current. Per Licensees, there are no weapons or firearms in the home. LPAs reviewed six children's' records. LPA also reviewed facility and aide's records. Both Licensees and Aide's CPR & First Aid Certificates will expire 12/10/2024. Licensee's and Aide's Mandated Reporter Training are up to date and expire 11/10/2024. The last Emergency drill was conducted 09/1/2023. Emergency drills must be conducted at least once every six months and should be properly logged. Continued on Page 2...

SUPERVISORS NAME: Ali Zebila
LICENSING EVALUATOR NAME: Yasha Nasiripour
LICENSING EVALUATOR SIGNATURE:	DATE: 01/29/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/29/2024

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
SAN BRUNO CC RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME: GOLDFELD, GALINA & GOLDFELD, VLADIMIR	FACILITY NUMBER: 384001243
	VISIT DATE: 01/29/2024

NARRATIVE

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Licensees were 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.

Per Licensees, there are no children enrolled with allergies. Incidental Medical Services (IMS) policy was discussed. For IMS information 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: on 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 www.ada.gov/childqanda.htm.

The Licensees were reminded about the Provider Information Notices (PINs) on the CCLD website. Licensee was informed that as of September 1, 2016, a person may not be employed or volunteer at a child care facility unless he or she has been immunized against influenza, pertussis, and measles or qualifies for an exemption pursuant to Health and Safety code 1596.7995 and 1597.662.

LPAs reviewed AB 1207 with the Licensees. As of January 1, 2018, all staff must complete Mandated Reporter Training every two years. The training can be obtained online at www.mandatedreporterca.com. Effective July 1, 2020, Licensees must have proof of completion of EMSA certified lead poison training if applying for a change of location or capacity change to an existing license.

LPAs encouraged the Licensees to visit the Licensing website at www.ccld.ca.gov for licensing regulations and new updates. The Licensees can also email at childcareadvocatesprogram@dss.ca.gov and ask to be added to the email list for the updates.

To improve the quality and value of the new inspection process, a survey will 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 tools, please send them by email 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/process.

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SUPERVISORS NAME: Ali Zebila
LICENSING EVALUATOR NAME: Yasha Nasiripour
LICENSING EVALUATOR SIGNATURE:	DATE: 01/29/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/29/2024

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
SAN BRUNO CC RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME: GOLDFELD, GALINA & GOLDFELD, VLADIMIR	FACILITY NUMBER: 384001243
	VISIT DATE: 01/29/2024

NARRATIVE

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LPAs discussed the safe sleep regulations with Licensees 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.

LPAs also informed Licensees 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.

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

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

A copy of this report was given to the Licensee and a site visit notification must be posted for 30 days.

>No Deficiencies were cited today under Title 22 Division 12 of the California Code of Regulations.

Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

Exit interview conducted and report was reviewed with the Licensees, Galina and Vladimir Goldfeld.

SUPERVISORS NAME: Ali Zebila
LICENSING EVALUATOR NAME: Yasha Nasiripour
LICENSING EVALUATOR SIGNATURE:	DATE: 01/29/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/29/2024

LIC809 (FAS) - (06/04)

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