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

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434416875
Report Date: 02/21/2024
Date Signed: 02/21/2024 11:24:07 AM

Document Has Been Signed on 02/21/2024 11:24 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, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME:ZHANNA,ATABEKOVA, ARAILYM, KARIBAYFACILITY NUMBER:
434416875
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 0CENSUS: 0DATE:
02/21/2024
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME BEGAN:
10:30 AM
MET WITH:Zhanna AtabekovaTIME COMPLETED:
11:45 AM
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
Licensing Program Analyst (LPA) Mel Matos met with Zhanna Atabekova, Applicant, for an unannounced prelicensing inspection. The San Jose Child Care District Office received an Application for a small Family Child Care License on February 2, 2024. Notification of Incomplete Application - Family Child Care Home (LIC 184B) was mailed to the Applicants on February 6, 2024. The application lists Zhanna Atabekova & Arailym Karibay as the Applicants.

Zhanna states that Arailym will work as her assistant in the day care and does not reside in the home. LPA advised Zhanna that Arailym will have to "withdraw" as an Applicant since she does not reside in the home. LPA also reminded Zhanna of the required items that need to be submitted as noted on the Notification of Incomplete Application - Family Child Care Home (LIC 184B).

LPA advised Zhanna that a follow up prelicensing inspection will be scheduled on all items noted on the LIC 184B and the "withdrawal" letter for Arailym Karibay have been submitted to the Department.
SUPERVISORS NAME: Diana Stephenson
LICENSING EVALUATOR NAME: Melvin S Matos
LICENSING EVALUATOR SIGNATURE: DATE: 02/21/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/21/2024
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