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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 384002827
Report Date: 09/27/2024
Date Signed: 09/27/2024 12:48:21 PM

Document Has Been Signed on 09/27/2024 12:48 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:NYAMDORJ, GERELMAAFACILITY NUMBER:
384002827
ADMINISTRATOR/
DIRECTOR:		NYAMDORJ, GERELMAAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(415) 988-1154
CITY:SAN FRANCISCOSTATE: CAZIP CODE:
94118
CAPACITY: 14TOTAL ENROLLED CHILDREN: 6CENSUS: 4DATE:
09/27/2024
TYPE OF VISIT:POCUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:15 PM
MET WITH:Gerelmaa NyamdorjTIME VISIT/
INSPECTION COMPLETED:
01:05 PM
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On September 27, 2024., at approximately 12.05pm, Licensing Program Analysts (LPA) Tso met with the Licensee, Gerelmaa Nyamdorj for an unannounced inspection of the Plan of Correction (POC). The purpose of the inspection was explained, and the Licensee granted LPAs entry to the home. There were four children (1 infant and 3 preschool age) in care with the Licensee.

During the required annual inspection on September 23, 2024, the Licensee received a citation for a type A deficiency. The Type A was cited deficiency for the licensee did not comply with the section cited above in having 7 children present, 2 infants and 5 preschool ages. It is out of ratio (the 7th child in care should be school aged or attending kindergarten).

During today's inspection, LPAs observed there were 1 infant and 3 preschoolers that no out of ratio was found. LPA observed that the Notice of Site Visit posted. LPA reminded the licensee to arrange the LIC9224 Acknowledge Receipt of Licensing Reports were signed by all parents of the children in care.

Deficiency cited on September 23, 2024, weas cleared today. Plan of Correction letter was provided to the Licensee.

There were no deficiencies cited at this time under CCR, Title 22, Div. 12, Chapter 3. A copy of today’s report was given to the licensee.

Exit interview was conducted with the Licensee, Gerelmaa Nyamdorj.
SUPERVISORS NAME: Garfield Leung
LICENSING EVALUATOR NAME: Man Tso
LICENSING EVALUATOR SIGNATURE: DATE: 09/27/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/27/2024
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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