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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 384002827
Report Date: 03/29/2022
Date Signed: 03/29/2022 10:47:47 AM

Document Has Been Signed on 03/29/2022 10:47 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, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME:NYAMDORJ, GERELMAAFACILITY NUMBER:
384002827
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 6DATE:
03/29/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:35 AM
MET WITH:Gerelmaa NyamdorjTIME COMPLETED:
11:20 AM
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Licensing Program Analyst (LPA) Mok met with the Licensee Gerelmaa Nyamdorj for an annual inspection. The purpose of the inspection was explained. Present, there are 6 children in care with a licensee.. Licensee lives with Husband, two Sons and a Daughter. All adults living or working in the home have criminal background check on file. Licensee provides day care from Monday to Friday between 7AM to 6:00 PM. Licensee provides Breakfast, Lunch and two Snacks.
LPA and Licensee inspected the day care areas. This is a two Bedroom and two Bathroom Single family home on upper level. Day Care areas: Living room, Family room, Dining area, Bathroom #2 and Backyard. Off limit areas: Bedroom #1, Bedroom#2, Bathroom #1, Garage and Kitchen. All off limit areas are properly barricaded and made inaccessible to the children in care. Licensee states that there is no pool, spa or any other body of water in the home. Licensee states, there are no weapons or firearms in the home. The licensee had a dog that was kept in the off-limit area. Cabinets in the bathroom has child protective locks. The house was in good repair and free of hazards with proper temperature and ventilation. There was a carbon monoxide detector, a smoke detector, a fully charged fire extinguisher and a working telephone available in the home. There was a First Aid kit available in the home. There was a variety of age appropriate toys in the home. There was a sufficient amount of sleeping matts available in the home. Licensee has the CPR and First Aid training valid..3/18/2023. Licensee also had a updated mandated reporter training available for review. It will expire in 8/2023. The fireplace was blocked by a shelve. The windows were barricaded in the living room. The gates were installed at the entrance of the living room and dining room, The licensee provided AM/PM snacks, and lunch to the daycare children. LPA obtained a copy of the children roster from the licensee during the inspection. All electrical outlet were covered. The outdoor play area was completely fenced. There were plenty of the age-appropriate toys, and ride-on toys available for the children.

>No deficiencies were issued today under Title 22 Division 12 of the California Code of Regulations.
>This report and rights to comment and appeal were discussed with Licensee. This report must be available in the facility for public review. Notice of site visit shall be posted for 30 days from today's visit.
Licensee was advised for any additional questions to call Office, M-F, 8AM-5Pm, at 650-266-8800 . For Rules and Regulations, visit the Website: www.cdss.ca.gov
SUPERVISORS NAME: Garfield Leung
LICENSING EVALUATOR NAME: Cindy Mok
LICENSING EVALUATOR SIGNATURE: DATE: 03/29/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/29/2022
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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