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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 414004766
Report Date: 02/22/2024
Date Signed: 02/23/2024 07:44:58 AM

Document Has Been Signed on 02/23/2024 07:44 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:BAKIROVA, HANNA & BAKIROV, MYKHAILOFACILITY NUMBER:
414004766
ADMINISTRATOR:BAKIROVA, H & BAKIROV, M.FACILITY TYPE:
810
ADDRESS:TELEPHONE:
(224) 410-8115
CITY:SAN MATEOSTATE: CAZIP CODE:
94404
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 7DATE:
02/22/2024
TYPE OF VISIT:Required - 3 YearUNANNOUNCEDTIME BEGAN:
02:40 PM
MET WITH:Hanna Bakirova & Mykhailo BakirovaTIME COMPLETED:
04:40 PM
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On February 22, 2024 at approximately 2:40PM, Licensing Program Analysts (LPAs) Maria Olguin-Leon and Janet Gil conducted an unannounced annual inspection and met with licensee, Mykhailo Bakirov, and purpose of inspection was explained. Licensee Hanna arrived at facility at approx. 3:20PM. Present in-home today was Licensees, helper and 7 preschool age children. Licensee is operating within capacity and ratio requirements on this day. Facility hours of operation are Monday - Friday, from 8:00AM to 6:00PM.

LPAs and Licensee toured the home for health and safety hazards. Home is a two-story home. Day Care Areas: both living rooms, dining room, bathroom, and backyard. Off Limits Areas: Kitchen, garage, and entire 2nd floor. Kitchen and staircase are properly barricaded with a child proof gate. Off limits area have child proof knobs. Fireplace is properly barricaded and cushioned. Home is well light and has proper ventilation. Cleaning supplies and other potentially harmful items are stored inaccessible to children and behind child proof cabinets. All electrical outlets are secured with child proof covers. There are plenty of age-appropriate toys, books, child size furnishings, learning material, and sleeping cots. Backyard has plenty of age-appropriate play toys, ride one toys, and playhouse. Backyard has cement patio and artificial grass to cushion falls. The entire backyard is surrounded with a 5 ft. fence. LPAs did not observe any spas, pools, or other bodies of water.

Home is equipped with a dual working carbon monoxide/smoke detector and a fully charged fire extinguisher. Isolation area for ill children will be in dining room and away from other children. LPAs reviewed first aid kit and kit is fully stocked and stored in bathroom. Licensee uses cell phone on the premises and understands phone must remain on premises during childcare hours. Per licensee, there are no weapons or firearms in the home. Licensee provides sheets for sleeping cots and washes them on a weekly basis or as needed.

Cont. page 2…
SUPERVISORS NAME: Marie Rodriguez
LICENSING EVALUATOR NAME: Maria Olguin-Leon
LICENSING EVALUATOR SIGNATURE: DATE: 02/22/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/22/2024
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 4
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: BAKIROVA, HANNA & BAKIROV, MYKHAILO
FACILITY NUMBER: 414004766
VISIT DATE: 02/22/2024
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LPAs reviewed 5 children’s record which were complete with all required documents, included LIC282. Licensee maintains an updated Children’s roster. Licensees CPR/FA expires 01/2025. Licensees Mandated Reporter training expires 02/2025. Licensee provides breakfast, lunch, and two snacks to children in care. LPA reminded Licensee to label children's food/bottles brought from home. LPA observed Childcare License, Emergency Disaster Plan (LIC610A) and Parent's rights posted. Last emergency drill was conducted on November 1, 2023 and is properly documented.

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.

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/.

The Licensee was reminded about the Provider Information Notices (PINs) on the CCLD website. Licensee was 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's reviewed AB 1207 with the Licensee.

As of January 1, 2018, all staff must complete Mandated Reporter Training every two years. LPA reminded licensee about Mandated Reporter training available www.mandatedreporterca.com

Cont.page 3...
SUPERVISORS NAME: Marie Rodriguez
LICENSING EVALUATOR NAME: Maria Olguin-Leon
LICENSING EVALUATOR SIGNATURE:

DATE: 02/22/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/22/2024
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: BAKIROVA, HANNA & BAKIROV, MYKHAILO
FACILITY NUMBER: 414004766
VISIT DATE: 02/22/2024
NARRATIVE
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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-and-resources/safe-sleep as an additional resource. LPAs also informed 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. LPA discussed sleeping logs with Licensee.

To improve the quality and value of the new inspection process, a survey may be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or CARE tools, please send email inquiries to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/inspection-process

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


During the exit interview, the LICENSEES, Mykhailo & Hanna Bakirova, confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.

No deficiencies were issued today under Title 22 Division 12 of the California Code of Regulations.

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

Exit interview conducted and report was reviewed with the licensees, Mykhailo & Hanna Bakirova.
SUPERVISORS NAME: Marie Rodriguez
LICENSING EVALUATOR NAME: Maria Olguin-Leon
LICENSING EVALUATOR SIGNATURE:

DATE: 02/22/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/22/2024
LIC809 (FAS) - (06/04)
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