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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 414005161
Report Date: 10/02/2024
Date Signed: 10/02/2024 11:07:44 AM

Document Has Been Signed on 10/02/2024 11:07 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
SAN BRUNO CC RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME:DONTOVA, NATALIAFACILITY NUMBER:
414005161
ADMINISTRATOR/
DIRECTOR:		DONTOVA, NATALIAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(415) 802-9778
CITY:BURLINGAMESTATE: CAZIP CODE:
94010
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 0DATE:
10/02/2024
TYPE OF VISIT:OfficeUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:00 AM
MET WITH:Applicant, Natalia DontovaTIME VISIT/
INSPECTION COMPLETED:
11:10 AM
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On October 2, 2024, at 10:00am, Licensing Program Analysts (LPAs) Melissa Zaragoza and Maria Olguin-Leon and Licensing Program Manager (LPM) Marie Rodriguez, met with applicant, Natalia Dontova, and Gaby Grinberg for an informal office meeting.

The purpose of the meeting was to discuss the current status of applicant's large family childcare home application. Applicant moved into the home on October 1, 2024, according to the lease agreement. Applicant was reminded, licensee needs to live in the home. Applicant was also reminded they needed to be present in the home 80% of the time and shall ensure that children in care are supervised at all times.

A family childcare home application was received on September 13, 2024.

It is to our knowledge that the applicant is the LLC owner of other daycares. During the meeting the applicant was reminded, although they are owners of LLCs, it is required for them to fully be present in the childcare home, in order to provide the most effective and safe family childcare home program. Applicant was reminded that other licensees cannot be present or help in the operation of the home.

During meeting, applicant was reminded:
· Applicant must live in the home to have a childcare home license.
· Applicant must be present in the home 80% of the time.
· Applicant must be aware of department's regulations.
· All adults living or working in the home 18 and over must have fingerprint background check clearance.

Applicant was provided with Capacity Requirements, LIC 9128 Criminal Background Clearance Transfer form to associate helpers, and LIC 311D Form/Records To Keep in Your Family Child Care Home along with regulations 102417 Operation for a Family Child Care Home and 102359 Advertisements and License Number.

Applicant stated they understood and are aware of the importance to follow all licensing regulations.

Applicant will be recommended for licensure for a small childcare home license, effective today's date October 2, 2024.

Exit interview conducted and report was reviewed with applicant, Natalia Dontova.
SUPERVISORS NAME: Marie Rodriguez
LICENSING EVALUATOR NAME: Melissa Zaragoza
LICENSING EVALUATOR SIGNATURE: DATE: 10/02/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/02/2024
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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