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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 015700158
Report Date: 06/30/2022
Date Signed: 06/30/2022 10:37:59 AM

Document Has Been Signed on 06/30/2022 10:37 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
CCLD Regional Office, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME:ZAYMAK, DINAFACILITY NUMBER:
015700158
ADMINISTRATOR:ZAYMAK, DINAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(408) 921-5033
CITY:FREMONTSTATE: CAZIP CODE:
94536
CAPACITY: 14TOTAL ENROLLED CHILDREN: 11CENSUS: 8DATE:
06/30/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
08:01 AM
MET WITH:Dina ZamakTIME COMPLETED:
10:45 AM
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On June 30, 2022 at approximately 8:01am Licensing Program Analyst (LPA) Russ Haderer arrived for an unannounced visit and met with licensee Dina Zaymak for the purpose of conducting an annual inspection for Health and Safety. Present for today’s inspection was the licensee, her TB and fingerprint cleared assistant. Children arrived during the inspection totaling 8 (3 two-years old; 2 three-years old; 2 four-years old; 1 five-years old). The hours of operation remain Monday-Friday, 8:30 AM to 5:30PM.

The facility is a 2 bedroom, one and 1/2 bath two-story townhouse with no garage. It is owned by the licensee and contains a living room, dining room, kitchen, 2 bedrooms and one and 1/2 bathrooms and two enclosed (fenced) outside patio areas. There is no fireplace in the home. The home is neat and clean with heating and ventilation for safety and comfort. The Per the licensee, the ISOLATION AREA will be in the kitchen area and away from the other children in care.



On-limit areas include: First floor area consisting of the living room (day care area); kitchen; dining room; downstairs half-bath and both patio areas off the kitchen and living room. Licensee was reminded that other than wipes or things used for the children in the on limits children’s bathroom, they need to be empty of most all items (or locked up) such as cleaning products. There are no accessible hazardous cleaning chemicals or other liquids in the on-limits area.
Off-limit areas include: The closet in the living room (there is a slide-bolt latch mounted high and out of reach of children), the entire upstairs consisting of 2 bedrooms, full bathroom and laundry area. The stairs have a gate preventing children from accessing the off-limit area upstairs and other off limit areas will be inaccessible by closed and/or locked doors, and/or by child supervision.

Disaster drills are conducted at least every six months, the last one was done February 24, 2022. Per licensee, there are no firearms in the home. No hazardous materials, or toxins accessible to children were observed during the inspection.
SUPERVISORS NAME: Chandra Charles
LICENSING EVALUATOR NAME: Russell Haderer
LICENSING EVALUATOR SIGNATURE: DATE: 06/30/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/30/2022
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
CCLD Regional Office, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME: ZAYMAK, DINA
FACILITY NUMBER: 015700158
VISIT DATE: 06/30/2022
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There is a children’s play area in the common area of the condominium complex with soft ground cover materials and safe and solid structures. Licensee has a first aid kit and plastic outlet covers on all electrical outlets in the on-limit areas.

Licensee has ample age-appropriate toys and learning materials. The home has a fully charged 2A10BC fire extinguisher mounted in the kitchen, a working smoke and carbon monoxide detector (tested and functioning), and a working telephone.

The Licensee’s Health and Safety training is completed, and CPR and First Aid certificate is current and expires 08/22/2022. Assistant’s CPR/1st Aid expires 8/18/2023. The licensee completed and received a certificate in mandated reporter training (verified AB1207), expires on 12/14/2023; assistant’s MR expires 3/05/2024. The licensee and assistant are in compliance with the immunization laws which pertains to day care providers.

LPA reminded the licensee of the following; Mandated Reporter training is to be renewed every two years, CPR/First Aid is also renewed every two years. Baby bouncers & drop-down cribs are not allowed at the day-care facility.



Children’s and facility files were reviewed. All files complete and well organized. Licensee does not carry liability insurance, appropriate signed LIC252 forms are in all the children's files.

Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual – Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. 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: http://www.ada.gov/childqanda.htm

Licensee was reminded that all adults 18 and over living or working in the home, including employees and volunteers, 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 up to $500.00 maximum per day/per person will be assessed if this regulation is violated.
SUPERVISORS NAME: Chandra Charles
LICENSING EVALUATOR NAME: Russell Haderer
LICENSING EVALUATOR SIGNATURE:

DATE: 06/30/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/30/2022
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
CCLD Regional Office, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME: ZAYMAK, DINA
FACILITY NUMBER: 015700158
VISIT DATE: 06/30/2022
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To improve the quality and value of the new inspection process, a survey will 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 tools, please send them by email 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.

There were no deficiencies issued during today’s inspection: This report will remain on file for 3 years.

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

Exit interview conducted and report was reviewed with the licensee Dina Zaymak.

SUPERVISORS NAME: Chandra Charles
LICENSING EVALUATOR NAME: Russell Haderer
LICENSING EVALUATOR SIGNATURE:

DATE: 06/30/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/30/2022
LIC809 (FAS) - (06/04)
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