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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434416875
Report Date: 10/21/2024
Date Signed: 10/21/2024 02:11:06 PM

Document Has Been Signed on 10/21/2024 02:11 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 JOSE CC RO, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME:ATABEKOVA, ZHANNAFACILITY NUMBER:
434416875
ADMINISTRATOR/
DIRECTOR:		FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 6CENSUS: 2DATE:
10/21/2024
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:00 PM
MET WITH:Zhanna AtabekovaTIME VISIT/
INSPECTION COMPLETED:
02:30 PM
NARRATIVE
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Licensing Program Analyst (LPA) Mel Matos met with Zhanna Atabekova, Licensee, and Aray Sabyrzhan, Licensee's daughter in law, for an unannounced case management inspection. LPA also observed two napping preschool children in the home during today's inspection.

LPA reviewed six children's files during today's inspection. LPA reminded the Licensee and Licensee's daughter in law to keep the Child Care Facility Roster (LIC 9040) and California Pre-Kindergarten and School Immunization (PH 286) current at all times.

Entrance Checklist - Family Child Care Homes (LIC 126) was reviewed with the Licensee and Licensee's daughter in law during today's inspection.

Exit interview conducted and report was reviewed with the Licensee, Zhanna Atabekova. No deficiencies issued during today's inspection. A Notice of Site Visit was given and must remain posted for 30 days.

Note: Today's inspection and report were translated from English to Russian by Aray Sabyrzhan, Licensee's daughter in law.

SUPERVISORS NAME: Belinda Devall
LICENSING EVALUATOR NAME: Melvin S Matos
LICENSING EVALUATOR SIGNATURE: DATE: 10/21/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/21/2024
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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