073406294-8-5-2019-02-CC-GRED-BERN83-20190805101340

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 073406294
Report Date: 08/05/2019
Date Signed: 08/05/2019 10:14:09 AM

COMPREHENSIVE INSPECTION

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:	GUREVICH, MARIANNA		FACILITY NUMBER:	073406294
ADMINISTRATOR:	GUREVICH, MARIANNA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(925) 691-6705
CITY:	CONCORD	STATE: CA	ZIP CODE:	94521
CAPACITY:	14	CENSUS: 2	DATE:	08/05/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	09:15 AM
MET WITH:	GUREVICH, MARIANNA		TIME COMPLETED:	10:20 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) Redmond, conducted an unannounced, Annual/Random inspection visit. The purpose of the inspection is to ensure Licensee is in compliance with Title 22, CCR and Health and Safety Code statutes for a Family Day Care home. During the inspection, LPA met with Marianna Gurevich, Licensee. Licensee accompanied LPA during the inspection. LPA inspected all areas of the facility which are accessible to children. During the inspection, LPA made the following observations: Capacity/Staffing: The facility operates as a Family Day Care (large), with a capacity of fourteen (14) children. Today, there are two (2) children in care. Licensee and husband are present. The facility is in compliance with ratio and capacity requirements. "On Limit" Areas (accessible to children in care): · Classroom: has age appropriate and safe toys, books and equipment · Kitchen: there are no cleaning solutions, poisons, sharps or other hazardous items · Bedroom: for sleeping. Pack and play type devices for infant sleep · Restroom (one): available for children’s use. The toilet and sinks are in good repair. There are no cleaning solutions or other toxins accessible to children · Back yard: there are safe toys and equipment. There are no pools, hot tubs or other bodies of water present "Off Limit" Areas (not accessible to children in care): · Garage · Upstairs

SUPERVISOR'S NAME: Antranette Robinson	TELEPHONE: (510) 622-2591
LICENSING EVALUATOR NAME: Geneen Redmond	TELEPHONE: (510) 873-6410
LICENSING EVALUATOR SIGNATURE:	DATE: 08/05/2019

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/05/2019

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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612

FACILITY NAME: GUREVICH, MARIANNA	FACILITY NUMBER: 073406294
	VISIT DATE: 08/05/2019

NARRATIVE

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Physical Plant: Overall, the facility is clean and orderly and in good repair. There is adequate heating and ventilation. There are safe, healthful and comfortable accommodations, furnishings and equipment. There are no other visible chemicals and toxins or other hazards accessible to children on this date.

Emergency Preparedness/Safety: There are smoke and carbon monoxide detectors. LPA tested and found each to be operable. There is a fully charged fire extinguisher, with an appropriate classification of (3-A:40-B:C). First aid supplies available. Emergency Disaster Plan is current, per Licensee. Fire and disaster drills were conducted on 04/10/19 and meet six month requirement. Facility utilizes a landline for phone service. Per the Licensee, there are no firearms present. The Licensee is not currently providing *Incidental Medical Services (IMS) for children in care and LPA discussed IMS requirements with Licensee.
Training/Record Review: Licensee and adults residing in the home have criminal background clearances and are associated to the facility. Licensee’s CPR/First Aid, expired on 01/2019. Advisory given. LPA provides care for infants. LPA discussed new Safe Sleep requirements with Licensee and additional information is included on the last page of this report. Licensee and staff have completed Mandated Reporter training, dated 05/14/18. Licensee has immunization records including tuberculosis and a statement regarding influenza.

Posted as required: Facility License, Emergency Disaster Plan, Notification of Parent's Rights, Earthquake Preparedness Checklist.

Not posted as required: If You See Something, Say Something, Pub 475 not posted. Notice given to Licensee of posting requirement. Poster can be obtained online.

NO DEFICIENCIES CITED ON THIS DATE.

Licensee is reminded that ALL assistants, volunteers, frequent visitors, or adults living in the home, that are 18 years of age or older must be fingerprint cleared and associated to this facility prior to being in the presence of children in care or an immediate civil penalty will be assessed from $100 to $3000 per person, per incident. Licensee was reminded of the responsibility as a mandated reporter.

CONTINUED ON LIC 809

SUPERVISOR'S NAME: Antranette Robinson	TELEPHONE: (510) 622-2591
LICENSING EVALUATOR NAME: Geneen Redmond	TELEPHONE: (510) 873-6410
LICENSING EVALUATOR SIGNATURE:	DATE: 08/05/2019

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/05/2019

LIC809 (FAS) - (06/04)

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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612

FACILITY NAME: GUREVICH, MARIANNA	FACILITY NUMBER: 073406294
	VISIT DATE: 08/05/2019

NARRATIVE

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Exit interview conducted. This Facility Evaluation Report discussed with the Licensee and signature obtained below. Notice of site visit was issued and shall be posted remain posted for 30 days. Failure to keep this notice posted for the 30 consecutive days will result in an immediate $100 civil penalty. A copy of this report shall be maintained for 3 years and available for public review upon request. Additional reminders and resources provided on next page.
Licensee was encouraged to frequently visit our website at www.ccld.ca.gov for licensing regulations and updates.

SUPERVISOR'S NAME: Antranette Robinson	TELEPHONE: (510) 622-2591
LICENSING EVALUATOR NAME: Geneen Redmond	TELEPHONE: (510) 873-6410
LICENSING EVALUATOR SIGNATURE:	DATE: 08/05/2019

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/05/2019

LIC809 (FAS) - (06/04)

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