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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 073408819
Report Date: 07/02/2020
Date Signed: 07/06/2020 10:50:52 AM

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:BELINSKAYA, IRINAFACILITY NUMBER:
073408819
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY:8CENSUS: 7DATE:
07/02/2020
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
01:55 PM
MET WITH:Irina BelinskayaTIME COMPLETED:
02:30 PM
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On 7/2/20 at 1:55pm, Licensing Program Analyst (LPA) Loretta Dyson conducted a case management inspection for this facility. The licensee submitted an application for an increase of capacity, and the purpose of the inspection today is to complete that process. The inspection was conducted via FaceTime, due to the current COVID-19 pandemic. LPA met with the licensee. The licensee's assistant and 7 children were also present. The licensee's brother was present to assist with interpretation.

With direction from LPA, the licensee pointed the camera so that LPA could inspect the areas of the home that are used by the child care. The on limit areas include the garage, which has been converted into a playroom, the hallway bathroom, and the office which is used for napping. A portion of the backyard on the right side when entering the yard from the home is on limits and is separated, by a fence, from an off limit area. The backyard is fully fenced. LPA observed a locked storage shed. LPA did not observe any toxins, hazardous items, or bodies of water accessible to children, on the camera. LPA observed an ample supply of age appropriate toys and activities. A required inspection was completed on 2/21/20, and the facility did not receive an deficiencies at that time so LPA conducted a limited inspection and did not review any files. An extensive inspection will be conducted at a later date.

A fire clearance, dated 6/25/20, was received from the Contra Costa County Fire Protection Department. The licensee is reminded that the ratio and capacity for a large family child care home must be followed at all times, and that an assistant who is at least 14 years of age, must be present in the home and helping to care for children. The licensee is reminded that any time an assistant is not present, the ratio and capacity requirements for a small family child care home must be followed. All documents required to complete the increase of capacity application have been received.

This facility is recommended for a large family child care home license, effective today 7/2/20.
SUPERVISOR'S NAME: Mayla MendozaTELEPHONE: (510) 873-6408
LICENSING EVALUATOR NAME: Loretta DysonTELEPHONE: (510) 622-2633
LICENSING EVALUATOR SIGNATURE:

DATE: 07/02/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/02/2020
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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