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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 414004960
Report Date: 01/12/2024
Date Signed: 02/13/2024 04:48:09 PM


COMPREHENSIVE INSPECTION

Document Has Been Signed on 02/13/2024 04:48 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:BASNINA, ANASTASIIAFACILITY NUMBER:
414004960
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: DATE:
01/12/2024
TYPE OF VISIT:Required - 3 YearUNANNOUNCEDTIME BEGAN:
10:30 AM
MET WITH:Anastasiia BasninaTIME COMPLETED:
01:30 PM
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On January 12, 2024 at approximately 10:30AM, Licensing Program Analyst (LPA) Maria Olguin-Leon conducted an unannounced annual inspection in conjunction with a case management inspection for an increase of capacity. LPA met with Anastasiia Basnina, and purpose of inspection was explained. Licensee applied to increase capacity from a small to a large capacity license on December 20, 2023. Regional Office received Fire inspection clearance from San Mateo Consolidated Fire Dept. on January 4, 20023. Licensee’s one year anniversary as a small licensee was on January 10, 2024. Present in home today was Licensee, helper and 6 children (3 infants and 3 preschool age). Licensee is operating within capacity and ratio requirements on this day. Adults present today and Licensee’s spouse have fingerprint clearance and associated with facility. Facility hours of operation are from 8:30AM to 5:30PM.


LPA and Licensee toured the home for health and safety hazards. Home is a one-story home. Day Care Areas: Living room, bedrooms #2, #3(both napping rooms) and #4(classroom), bathroom, hallway (next to dining room), and backyard. Off Limits Areas: Bedroom #1, kitchen, and garage. Off limits areas are properly barricaded with child proof gate and closed doors. Home is well light and has proper ventilation. Fireplace is properly barricaded with cubbies and inaccessible to children. 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, cribs and sleeping mats. Backyard has plenty of age-appropriate play toys, large play structure, ride on toys and playhouse. Outdoor is equipped with a cement patio and grass to cushion falls. The entire backyard is surrounded with a 5 ft. fence. LPA 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. Fire alarm is located in living room. Isolation area for ill children will be in bedroom #2 (classroom) and away from other children. LPA reviewed first aid kit and kit is fully stocked. Licensee uses cell phone on the premises and understands phone must remain on premises during childcare hours. er licensee, there are no weapons or firearms in the home. Parents provide sheets for crib and mats and are sent home weekly for laundering.

Cont. page 2…
SUPERVISORS NAME: Marie Rodriguez
LICENSING EVALUATOR NAME: Maria Olguin-Leon
LICENSING EVALUATOR SIGNATURE: DATE: 02/13/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/13/2024
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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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: BASNINA, ANASTASIIA
FACILITY NUMBER: 414004960
VISIT DATE: 01/12/2024
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LPA reviewed 6 children’s records and 1 staff record. All children’s and staff records are complete. Licensee maintains an updated Children’s roster. Licensees CPR/FA expires 10/2024. Licensee Mandated Reporter training expires 09/2024. 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 11/02/2023 and is properly documented. Licensee carries liability insurance via Accord and will ex. 10/2024. LPA reviewed and provided Licensee capacity regulations.

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.


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

DATE: 02/13/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/13/2024
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: BASNINA, ANASTASIIA
FACILITY NUMBER: 414004960
VISIT DATE: 01/12/2024
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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

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 sleep sacks.

The licensee provided proof of control of property. The licensee has not 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.

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 child care by connecting them to childcare providers and Resource and Referral Agencies (R&Rs) throughout California.

Cont. page 4...
SUPERVISORS NAME: Marie Rodriguez
LICENSING EVALUATOR NAME: Maria Olguin-Leon
LICENSING EVALUATOR SIGNATURE:

DATE: 02/13/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/13/2024
LIC809 (FAS) - (06/04)
Page: 3 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: BASNINA, ANASTASIIA
FACILITY NUMBER: 414004960
VISIT DATE: 01/12/2024
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During the exit interview, the LICENSEE, Anastasiia Basnina 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.

LPA will approve Large Family Child Care License as of today, January 12, 2024.

Exit interview conducted and report was reviewed with the licensee, Anastasiia Basnina.

SUPERVISORS NAME: Marie Rodriguez
LICENSING EVALUATOR NAME: Maria Olguin-Leon
LICENSING EVALUATOR SIGNATURE:

DATE: 02/13/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/13/2024
LIC809 (FAS) - (06/04)
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