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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 435700366
Report Date: 01/27/2025
Date Signed: 01/27/2025 12:32:04 PM

Document Has Been Signed on 01/27/2025 12:32 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
OAKLAND SOUTH CC RO, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME:DZHYLIALOVA, NIIARAFACILITY NUMBER:
435700366
ADMINISTRATOR/
DIRECTOR:		DZHYLIALOVA, NIIARAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(650) 480-0218
CITY:PALO ALTOSTATE: CAZIP CODE:
94306
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 12DATE:
01/27/2025
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:00 AM
MET WITH:Niiara DzhylialovaTIME VISIT/
INSPECTION COMPLETED:
01:00 PM
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On 01/27/2025 at 10:00am, Licensing Program Analyst (LPA) Jialing “Julianne” Zhu met with licensee Niiara Dzhylialova for an unannounced annual inspection. Upon arrival, LPA provided licensee a copy of the Entrance Checklist (LIC 126). The facility is a two-story home. Also residing in the home is licensee’s nephew and niece-in-law. The home was toured to conduct a Health and Safety Inspection in the on-limits areas only. The facility’s current hours of operation are Monday - Friday from 8:00am - 6:00pm. Licensee’s primary language is Russian. The inspection was completed with translation assistance from an assistant and licensee’s adult daughter over the telephone.

Ratio/Capacity: The facility operates as a large Family Child Care Home licensed with a capacity of 14 children. At the time of the inspection, there were 12 children in care. Two (2) fingerprint-cleared assistant were present. The licensee is within ratio and in compliance with capacity regulations today.

On-limit Areas (accessible by children in care): The on-limit areas are the living room, dining area, 1st floor bedroom, 1st floor bathroom, and backyard. The isolation area is the dining room. When a child shows signs of illness, he/she will be separated from other children here. The inside of the home is observed to be clean and orderly, with central heating and ventilation for safety and comfort. LPA observed there are ample safe and age-appropriate toys, play equipment and materials. All toxins, cleaning products, and hazardous materials have been made inaccessible to the children. The fireplace in the living room has been made inaccessible to children with a wooden board.

The outdoor play area is the backyard, which is completely fenced with visual supervision. The outdoor play area is free from defects or dangerous conditions. There is an ample supply of age-appropriate toys and activities available for children, and they are in good condition. There is ample shade available, and gates are locked at all times while children are in the backyard. There are no pools, hot tubs, or similar bodies of water on premises. Page 1 of 3. See LIC 809C.

SUPERVISORS NAME: Chandra Charles
LICENSING EVALUATOR NAME: Jialing Zhu
LICENSING EVALUATOR SIGNATURE: DATE: 01/27/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/27/2025
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 7
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
OAKLAND SOUTH CC RO, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME: DZHYLIALOVA, NIIARA
FACILITY NUMBER: 435700366
VISIT DATE: 01/27/2025
NARRATIVE
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Off-limit Areas (not accessible by children in care): The off-limit areas are the kitchen and entire second floor, which are inaccessible by closed and/or locked doors and visual supervision. Stairs in the home are properly fenced and barricaded with a child safety gate, which makes the second floor inaccessible to children in care. LPA advised licensee he/she must contact Licensing for an inspection prior to changing an OFF-Limit area to ON-Limit.

Child Care Operations: Licensee provides AM/PM snacks and lunch for the children. LPA observed cribs, beds, and additional mattresses available for nap time. Cribs are in the facility with the correct size mattresses and fitted sheets. Licensee provides bedding to the children during nap time.

Emergency Preparedness/Safety: A fully charged 3A40BC fire extinguisher is located in the closet near the entrance. LPA observed at least one functional smoke detector and one carbon monoxide detector in the home. Fire/disaster drills are conducted at least once every six months, and the last drill was on 09/16/2024. The home is equipped with telephone service and first aid supplies. Per licensee, there are no firearms in the home. LPA observed two cats in the home.

Recordkeeping Review: All adults living in the home have obtained a criminal record clearance. Licensee’s Pediatric CPR/First Aid certification expired on 01/22/2024. Licensee’s Mandated Reporter training for Child Care Providers expired on 02/09/2024. The licensee is in compliance with the immunization laws.

A current facility roster is available for review. LPA reviewed five (5) children’s files and two (2) staff files. 15-minute sleep check were conducted and documented for all infants ages 0-24 months. The licensee rents the property. Landlord notification and consent of child care operations are on file. The facility has liability insurance. All required Licensing documents are posted by the entrance.

Licensee was reminded that California Law requires licensees to report unusual incidents or injuries to children in care, to child's parents, and to the Department of Social Services using the Unusual Incident/Injury form (LIC 624B). Any structural changes to the home or additions to the childcare facility must be reported to Community Care Licensing. Incidents must be reported within 24 hours by phone, fax, or email. LPA informed the Licensee that all forms can be downloaded at www.ccld.ca.gov. Licensee was also reminded that Mandated Reporter Training ("Child Care Providers") is required for all staff and is to be renewed every 2 years by visiting https://mandatedreporterca.com/. Licensee was reminded that EMSA approved Pediatric CPR & First Aid training must be completed every two (2) years.

Page 2 of 3. See LIC 809C.

SUPERVISORS NAME: Chandra Charles
LICENSING EVALUATOR NAME: Jialing Zhu
LICENSING EVALUATOR SIGNATURE:

DATE: 01/27/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/27/2025
LIC809 (FAS) - (06/04)
Page: 6 of 7
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
OAKLAND SOUTH CC RO, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME: DZHYLIALOVA, NIIARA
FACILITY NUMBER: 435700366
VISIT DATE: 01/27/2025
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Licensee was reminded that all adults 18 and over living in the home, persons who provide care and supervision to children, and staff who have contact with children, 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.

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. LPA also informed licensee 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) or (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm.

Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other important information communication platforms. To receive important licensed related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-care-licensing/subscribe and select the Child Care option to receive email communication.

No deficiencies cited during today's inspection. Four (4) Advisory Notes were issued:


· Licensee's Mandated Reporter (Child Care Providers) expired on 02/09/2024. 1 assistant only has current General Training, and not the Child Care Providers Training as required by Licensing.
· 1 of 2 assistant files reviewed by LPA did not have proof of immunization for MMR.
· 3 of 5 children's files reviewed by LPA did not have up-to-date immunization records.
· 2 of 5 children's files reviewed by LPA did not have LIC 995A on file.
A Notice of Site Visit was given and must remain posted for 30 days. Exit interview was conducted, report was reviewed, and Appeal Rights were provided to licensee Niiara Dzhylialova. Page 3 of 3. End of Report.
SUPERVISORS NAME: Chandra Charles
LICENSING EVALUATOR NAME: Jialing Zhu
LICENSING EVALUATOR SIGNATURE:

DATE: 01/27/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/27/2025
LIC809 (FAS) - (06/04)
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