<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 414005071
Report Date: 01/16/2024
Date Signed: 01/16/2024 02:44:34 PM

Document Has Been Signed on 01/16/2024 02:44 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:ATLANOVA, ALEXANDRAFACILITY NUMBER:
414005071
ADMINISTRATOR:ATLANOVA, ALEXANDRAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(646) 258-1158
CITY:FOSTER CITYSTATE: CAZIP CODE:
94404
CAPACITY: 14TOTAL ENROLLED CHILDREN: 0CENSUS: 0DATE:
01/16/2024
TYPE OF VISIT:OfficeANNOUNCEDTIME BEGAN:
02:00 PM
MET WITH:Alexandra AtlanovaTIME COMPLETED:
03:00 PM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
On January 16, 2023 at 2:00pm, Licensing Program Analyst (LPA) Maria Olguin-Leon and Licensing Program Manager (LPM) Marie Rodriguez, met with applicant, Alexandra Atlanova for an informal office meeting.

The purpose of the informal office meeting was to discuss the status of applicant's family childcare home application.

The applicant submitted a large capacity family childcare home application on December 8, 2023. The applicant was previously a co-licensee for license #414004709 – 650 Pilgrim Dr., Foster City. Regional office received a letter signed by both licensees requesting closure of dual license. Applicant has applied as a sole applicant for the home.

During meeting, Applicant was reminded:
· Applicant must live in the home.
· Applicant must be present 80% of operating hours.
· Applicant is the primary caregiver for the family childcare home.
· Applicant must be aware of department's regulations.
· Applicant must have a current, working phone number the department can reach during operating
hours.
· Applicant cannot engage in outside employment that may directly or indirectly infringe applicant's ability to be the primary caregiver in their family childcare home.
· A complaint filed with the department, that alleges applicant does not live in the home, while licensed, can be substantiated.
· Applicant is the only individual responsible and liable for everything that occurs in the home.

The applicant stated they understood and are aware of the importance to be in compliance with all licensing regulations.

Prior to licensure, applicant must move into home. LPA will conduct a visit on January 30, 2024 to confirm applicant is living in home.

Exit interview was conducted and report was reviewed with applicant, Alexandra Atlanova.
SUPERVISORS NAME: Marie Rodriguez
LICENSING EVALUATOR NAME: Maria Olguin-Leon
LICENSING EVALUATOR SIGNATURE: DATE: 01/16/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/16/2024
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 1