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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 384001337
Report Date: 05/19/2026
Date Signed: 05/19/2026 01:39:25 PM

Document Has Been Signed on 05/19/2026 01:39 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:GOLDENSHTEYN, LILIANA & MAMYSHEVA, RUZANAFACILITY NUMBER:
384001337
ADMINISTRATOR/
DIRECTOR:		GOLDENSHTEYN, LILIANA & MAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(415) 681-1571
CITY:SAN FRANCISCOSTATE: CAZIP CODE:
94116
CAPACITY: 14TOTAL ENROLLED CHILDREN: 10CENSUS: 9DATE:
05/19/2026
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:10 AM
MET WITH:Elena Maisevich & Mamysheva RuzanaTIME VISIT/
INSPECTION COMPLETED:
01:50 PM
NARRATIVE
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On May 19, 2026, Licensing Program Analyst (LPA) Van conducted an announced annual inspection and met with the licensee’s assistant, Nino Osepashvili. The purpose of the inspection was explained, and LPA access to the home was granted. Co-licensee, Ruzana Mamysheva, arrived during the inspection. Upon entry, LPA observed children engaged in outdoor activities. Both licensees and two assistants were supervising 9 children (three infants and 6 preschool-age children), and the licensee was operating within her licensed capacity and limitations. All individuals residing or working in the home have criminal record clearances verified through the CDSS Background Check System.

During the visit, co-licensee Ruzana Mamysheva stated that she had to leave for a doctor's appointment.

Licensees confirmed that there have been no changes to the previously approved childcare areas. Childcare areas are located on the ground floor only and include the playroom, kitchenette, nap room, bathroom, and backyard. Off-limits areas include the garage and the entire second-floor level, all of which were observed to be properly barricaded.

The facility operates Monday through Friday from 8:00 a.m. to 5:30 p.m.

LPA began the walkthrough of the childcare areas to assess health and safety hazards. The spaces were clean, organized, and equipped with appropriate books, toys, and learning materials that support children’s development. The home had adequate heating, lighting, and ventilation. A functioning carbon monoxide detector, smoke detector, and a fully charged 2A10BC fire extinguisher were observed. No fireplace was present in the approved childcare areas.


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NAME OF LICENSING PROGRAM MANAGER: Garfield Leung
NAME OF LICENSING PROGRAM ANALYST: Brendon Van
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 05/19/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/19/2026
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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California Health & Human Services Agency
California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:
  • Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.
  • Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)
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Document Has Been Signed on 05/19/2026 01:39 PM - It Cannot Be Edited


Created By: Brendon Van On 05/19/2026 at 12:05 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
, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME: GOLDENSHTEYN, LILIANA & MAMYSHEVA, RUZANA
FACILITY NUMBER: 384001337

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/19/2026

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102425(a)(3)
Infant Safe Sleep
(a) There shall be one crib or play yard for each infant who is unable to climb out of the crib or play yard. (3) Mattresses shall be firm and covered with a fitted sheet that is appropriate to the mattress size, fits tightly on the mattress, and overlaps the underside of the mattress so it cannot be dislodged.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, the licensee did not comply with the above regulation. During the inspection, LPA observed one of the three cribs with an oversized and loose bed sheet, and blankets placed inside multiple cribs and playpens, which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 05/29/2026
Plan of Correction
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The licensee shall remove all blankets from cribs and playpens and shall ensure all crib sheets are tightly fitted and appropriately sized at all times in accordance with infant safe sleep regulations. A return visit is required to verify compliance has been met by May 29, 2026.
Type B
Section Cited
HSC
1597.622(c)
Administration of Child Day Care Licensing
(c) The family day care home shall maintain documentation of the required immunizations or exemptions from immunization, as set forth in this section, in the person's personnel record that is maintained by the family day care home.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on the record review, the licensee did not comply with the above requirement. LPA observed that one licensee’s immunization record was incomplete, with no documentation of pertussis (Tdap) immunization on file. This concern was previously discussed with the licensee during the prior year’s annual inspection. Failure to maintain complete immunization records poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 05/29/2026
Plan of Correction
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The licensee shall obtain and submit written proof of Tdap immunization. Proof shall be submitted to LPA no later than May 29, 2026. A return visit is required to verify compliance.
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
Garfield Leung
NAME OF LICENSING PROGRAM MANAGER:
Brendon Van
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 05/19/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/19/2026


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: GOLDENSHTEYN, LILIANA & MAMYSHEVA, RUZANA
FACILITY NUMBER: 384001337
VISIT DATE: 05/19/2026
NARRATIVE
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Cleaning products and disinfectants were stored out of children’s reach. The licensee stated there are no firearms or weapons in the home. No baby walkers, bouncers, or similar prohibited equipment were observed. LPA reminded the licensee that smoking is prohibited in the family childcare home.

In the nap area, LPA observed that one of the three cribs contained an oversized and loose bed sheet. This issue had been previously identified during the annual inspection conducted on May 2, 2025, at which time a technical violation was issued. In addition, LPA observed several blankets placed inside the playpens and cribs.

LPA reviewed the infant sleep logs and observed that the logs were prepopulated with times, requiring staff only to place check marks. LPA advised the licensee that sleep logs must be completed in real time, as it is not always clear when infants fall asleep. LPA reminded the licensee that accurate, real-time documentation is required to ensure compliance with infant safe sleep regulations. LPA reminded the licensee that sleep logs must be maintained for at least 30 days and retained for three years, and noted that sleep sacks are not permitted in the facility.

LPA then reviewed children’s and personnel records. Children’s files contained required emergency information, immunization records, and parental rights forms. Both Licensees and all assistants have current Pediatric CPR/First Aid and mandated reporter training certificates. LPA reminded the licensee that staff who decline the influenza vaccine must have a flu declination form on file.

All required licensing postings were observed. The licensee reported that fire and earthquake drills are conducted at least every six months, with the most recent drill completed on January 14, 2026.

Both 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.


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NAME OF LICENSING PROGRAM MANAGER: Garfield Leung
NAME OF LICENSING PROGRAM ANALYST: Brendon Van
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 05/19/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/19/2026
LIC809 (FAS) - (06/04)
Page: 4 of 5
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: GOLDENSHTEYN, LILIANA & MAMYSHEVA, RUZANA
FACILITY NUMBER: 384001337
VISIT DATE: 05/19/2026
NARRATIVE
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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: www.ada.gov/childqanda.htm.

LPA discussed the safe sleep regulations with the Licensees and discussed the Child Care Licensing Safe Sleep webpage https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed the 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 that as of September 1, 2016, a person may not be employed or volunteer at a childcare 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.

LPA 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.

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

During the exit interview, the LICENSEES, LILIANA GOLDENSHTEYN AND RUZANA MAMYSHEVA confirmed that there are no Registered Sex Offenders living in the facility, and LPA completed the RSO profile in FAS.

See LIC 809D for deficiencies cited today.

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

An exit interview was conducted, and the report and appeals rights were reviewed with the licensee, Liliana Goldenshteyn.

NAME OF LICENSING PROGRAM MANAGER: Garfield Leung
NAME OF LICENSING PROGRAM ANALYST: Brendon Van
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 05/19/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/19/2026
LIC809 (FAS) - (06/04)
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