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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 384002827
Report Date: 09/23/2024
Date Signed: 09/23/2024 10:53:06 AM

Document Has Been Signed on 09/23/2024 10:53 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
SAN BRUNO CC RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME:NYAMDORJ, GERELMAAFACILITY NUMBER:
384002827
ADMINISTRATOR/
DIRECTOR:		FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 7CENSUS: 7DATE:
09/23/2024
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:45 AM
MET WITH:Gerelmaa NyamdorjTIME VISIT/
INSPECTION COMPLETED:
11:05 AM
NARRATIVE
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On September 23, 2024 at approximately 8:40 PM, Licensing Program Analyst (LPA) Tso conducted an unannounced Case Management Inspection for capacity change. LPA met with licensee, Gerelmaa Nyamdorj. The purpose of the inspection was explained, and LPA is allowed entry by licensee. This inspection is due to the receipt of a Capacity Change Application received in the Regional Office. The facility is going from a small license to a large license allowing a maximum of 14 children. Present in the home is licensee and a helper caring for 6 children in care (2 infants and 4 preschoolers). At approximately 9.20am, the 7th preschool child came in for care. The licensee operates out of ratio (Refer to LIC809D). The DAY CARE AREAS are Living room, Family room, Dining area, Bathroom #2 and Backyard. The OFF LIMIT AREAS are Bedroom #1, Bedroom#2, Bathroom #1, Garage, outside balcony and Kitchen. The days and hours of operation are Monday – Friday, 7:00 AM to 6:00 PM.

With licensee, LPA inspected the home for Health and Safety Hazards. LPA observed the followings: Day-care area is clean and equipped with age-appropriate toys and equipment for the children. The home has sufficient lighting and ventilation. The home has a working telephone, a working combination of smoke and carbon monoxide detector, and a fully charged fire extinguisher. The home is equipped with a first aid kit that is completely loaded with everything that is required for the treatment of injuries. There are no bodies of water observed at the property. Products for cleaning and washing, detergents, and any other materials that could put children in danger are stored out of the children’s reach. Per the licensee, there is reportedly no firearms or other weapons in the home. The licensee’s Pediatric First Aid and CPR is current and will expire in 03/2025. The licensee has current Mandated Reporter training and will expire in 02/2025.

LPA discussed the capacity requirements with licensee. Licensee understands that care cannot be provided for more than the capacity as stated on the license.

Licensee was reminded that all adults 18 and over living or working in the home, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, 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 for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.

(Continued on page 2, …)

SUPERVISORS NAME: Garfield Leung
LICENSING EVALUATOR NAME: Man Tso
LICENSING EVALUATOR SIGNATURE: DATE: 09/23/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/23/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 3
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: NYAMDORJ, GERELMAA
FACILITY NUMBER: 384002827
VISIT DATE: 09/23/2024
NARRATIVE
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The licensee has obtained a signed Property Owner/Landlord Consent form (LIC9149). Without this consent, the applicant understands that, once licensed, they can operate with a maximum capacity of 6 [or 12] children. If property owner/landlord consent is obtained in the future, the applicant is advised that a new Application for a Family Child Care Home License (LIC 279) must be submitted with a change of capacity fee of $25, to increase the capacity and provide care to 8 [or 14] children.

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-andresources/safe-sleep as an additional resource. LPA also informed licensee [or facility representative] 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.

Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02- CCP. 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: https://www.ada.gov/resources/child-care-centers/.

Licensee was 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.

Prior to licensure to the Large Family Child Care Home, the following issues must be addressed.


· Provide the proof of County Fire Department issued a fire clearance of the home as necessary for a Large Family Child Care Home.

See 809D for Type "A" deficiency issued today. A copy of today’s report and the facility’s appeal rights were discussed and given to the Licensee. The Facility is advised to provide a copy of the Evaluation Report and the Type "A" Deficiency cited to the parents and guardians of children currently enrolled in care and parents of newly enrolled children during the next 12 months. A signed and dated LIC 9224 shall be maintained in all Children's files. This report will be maintained in the facility file and made available for public review three years after the thirty-day posting requirement has been met. A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with the licensee, Gerelmaa Nyamdorj.
SUPERVISORS NAME: Garfield Leung
LICENSING EVALUATOR NAME: Man Tso
LICENSING EVALUATOR SIGNATURE:

DATE: 09/23/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/23/2024
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 09/23/2024 10:53 AM - It Cannot Be Edited


Created By: Man Tso On 09/23/2024 at 10:32 AM
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: NYAMDORJ, GERELMAA
FACILITY NUMBER: 384002827

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/23/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
09/24/2024
Section Cited
HSC
1597.44(a)

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1597.44 Small family day care homes; number of children. A small family day care home may provide care for more than six and up to eight children, without an additional adult attendant, if all of the following conditions are met: (a) At least one child is enrolled in and attending kindergarten or elementary school and a second child is at least six years of age.

This requirement is not met, as evidenced by:
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The licensee contacted the parent of a preschool aged child to pick the child at 10.02am. The license would not provide the care to more than 6 until receiving the fire clearance to license for the capacity 14 by the due date: 9/23/2024.
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At 9.20am on 9/23/2024, based on record review, interview and observations, LPA confirmed licensee is operating over ratio with 2 infants and 5 preschool aged children in care, which pose an immediate health, safety, or personal rights risk to persons in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Garfield Leung
LICENSING EVALUATOR NAME:Man Tso
LICENSING EVALUATOR SIGNATURE:
DATE: 09/23/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/23/2024


LIC809 (FAS) - (06/04)
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