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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 073409296
Report Date: 05/08/2023
Date Signed: 05/08/2023 12:05:19 PM

Document Has Been Signed on 05/08/2023 12:05 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
CCLD Regional Office, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612
FACILITY NAME:GELFMAN, LARISAFACILITY NUMBER:
073409296
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 6DATE:
05/08/2023
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
11:15 AM
MET WITH:Larisa GelfmanTIME COMPLETED:
12:45 PM
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On 5/8/23 Licensing Program Analyst Monica Mathur conducted a unannounced Case Management inspection at Larisa Gelfman's day care home for CAPACITY INCREASE to Large Family Childcare Home. Fire clearance was granted in April 2023.

Present in the home were Licensee, her spouse, and 6 day care children (3 infants, 3 preschool age). Facility is in ratio compliance today. Licensee wants to make add additional areas for day care from those noted during Prelicensing inspection. LPA inspected new areas and granted approval for use. Licensee was reminded to maintain Sleep Log for infants.

ON LIMITS: Living/Dining, Storage room converted into Large Play Room, Son's bedroom converted into Play/Nap Room, Master Bedroom (for naps), Hall Bathroom, Half Bathroom attached to large play room
OFF LIMITS: Kitchen, Entire Level 2 which comprises of 1 Bedroom, 1 Bathroom, Office

Outdoor space for day care has been extended to cover more area. It is enclosed and off limit areas are inaccessible. Children will access the outdoor play area through the deck, walk down few steps to yard on the lower level.

Children and Licensee files were reviewed. Licensee's CPR/First Aid certification and Mandated Reporter training is current and updated. LPA reviewed large family home ratios and assistant requirements. Facility is approved for Capacity Increase. Exit interview was conducted with Larisa Gelfman. NOTICE OF SITE VISIT WAS ISSUED, MUST BE POSTED FOR 30 DAYS.
SUPERVISORS NAME: Sherelle Johnson
LICENSING EVALUATOR NAME: Monica Mathur
LICENSING EVALUATOR SIGNATURE: DATE: 05/08/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/08/2023
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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