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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 384004709
Report Date: 04/07/2023
Date Signed: 04/07/2023 03:42:50 PM

Document Has Been Signed on 04/07/2023 03:42 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 CHILD CARE, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME:MASALITINA, OLENAFACILITY NUMBER:
384004709
ADMINISTRATOR:MASALITINA, OLENAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(415) 742-0593
CITY:SAN FRANCISCOSTATE: CAZIP CODE:
94122
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 4DATE:
04/07/2023
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME BEGAN:
11:25 AM
MET WITH:Olena MasalitinaTIME COMPLETED:
12:15 PM
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On April 07, 2023 at approximately 11:25am, Licensing Program Analyst (LPA) Ly, conducted Unannounced Pre-Licensing inspection and met with Licensee Olena Masalitina. Purpose of today's visit is to change Co-Licensee Olena Masalitina who was previously licensed with PETROSYAN, KRISTINE 384002700 into having just Olena Masalitina on this license as Licensee. Present during today's visit were Licensee Olena Masalitina and an Assistant caring for 4 children. An Annual Inspection was conducted for License number 384002700 for this address on March 09, 2023.

During today's visit, Licensee also have been informed this family child care will not be approved for a Large Family Child Care License. The denial is based on the denied fire clearance by the San Francisco Fire Department completed on March 27, 2023.

Title 22 Regulation 102371 (a) – Fire Safety Clearance states the following:
(a) A fire safety clearance approved by the city or county fire department, the district providing fire protection services, or the State Fire Marshal shall be required for a large family child care home.

Based on the denied fire clearance, you are not eligible to increase capacity and will therefore, remain a small family child care home with an allowable capacity of up to 8 children.

A copy of this report and appeal rights were discussed and left with Licensee whose signature on this form confirm receipt of reports. For updates on Licensing information, go to CCL website: www.ccld.ca.gov. For Provider Information Notice: ccld.ca.gov/PG5098.htm
SUPERVISORS NAME: Garfield Leung
LICENSING EVALUATOR NAME: Winnie Ly
LICENSING EVALUATOR SIGNATURE: DATE: 04/07/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/07/2023
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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