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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 103906689
Report Date: 10/17/2019
Date Signed: 10/17/2019 03:02:31 PM

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, 1310 E. SHAW AVE,
FRESNO, CA 93710
FACILITY NAME:MITYA, ALLA FAMILY CHILD CAREFACILITY NUMBER:
103906689
ADMINISTRATOR:MITYA, ALLAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(559) 324-1623
CITY:FRESNOSTATE: CAZIP CODE:
93720
CAPACITY:14CENSUS: 11DATE:
10/17/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
01:00 PM
MET WITH:Alla MityaTIME COMPLETED:
03:15 PM
NARRATIVE
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Licensing Program Analyst (LPA) Juvenal Moctezuma conducted an unannounced Annual/Random inspection and met with Licensee, Alla Mitya and assistants. LPA explained the reason of the inspection and a tour of the home was conducted both inside and outside. LPA observed licensee caring for 11 children of whom 2 were her own children.

Licensee stated that children have access to the playroom, 1 bathroom, and her backyard. LPA observed plenty of age appropriate toys in the play room like small cubbies, cots, and small tables and chairs. LPA Observed that the play room was clean and free of toxins. Licensee stated that children don't have access to the rest of her house. Licensee has a children's safety gate that prevents children to have access to her laundry room which then leads to her kitchen area and rest of the house. The children's bathroom has a door that leads to the living room and licensee stated that she keeps that door closed and locked at all times. The bathroom was found clean and free of toxins during the inspection. The backyard has a fence that goes all around. LPA observed a playground, plenty of age appropriate toys and shade area. Licensee has 1 dog in the backyard and states that they don't have contact with children in care. Licensee understands responsibility of any action taken by pets involving day care children.

LPA spoke about the safe sleep regulations that will take affect this year (2019) with the licensee and reminded her to not store anything inside the cribs and playpens. LPA also provided licensee with a safe sleep brochure and the new lead brochure.

Licensee has a 3A40 BC fire extinguisher. LPA explained to licensee that she needs to get it serviced or replaced yearly. Licensees CPR/First Aid certificate is good until 05/26/2020. The last time the licensee conducted fire drills was on 05/02/2018. LPA reminded licensee that fire drills need to be conducted at least once every 6 months. The smoke detector was tested and found in working condition. Licensee does not have a working Carbon Monoxide.
Report continued onto LIC 809-C
SUPERVISOR'S NAME: Duane MatsubaraTELEPHONE: (559) 650-7855
LICENSING EVALUATOR NAME: Juvenal MoctezumaTELEPHONE: (559) 580-0275
LICENSING EVALUATOR SIGNATURE:

DATE: 10/17/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/17/2019
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 5
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1310 E. SHAW AVE,
FRESNO, CA 93710

FACILITY NAME: MITYA, ALLA FAMILY CHILD CARE
FACILITY NUMBER: 103906689
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/17/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
10/31/2019
Section Cited

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On or before 3/30/2018, a person who, on 1/1/2018, is a licensed child care provider, admin, or employee of a licensed child day care facility shall complete the mandated reporter training provided pursuant to paragraphs (2) and (3) of subdivision (a), and shall complete renewal mandated reporter training every 2 years following the date on which he or she completed the initial mandated reporter training.
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This requirement was not met as evidenced by LPA doing file review and licensee stating that she and her 3 assistants have not taken the mandated reporter training AB 1207 because they were unaware. This poses a potential health/safety risk to children in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME: Duane MatsubaraTELEPHONE: (559) 650-7855
LICENSING EVALUATOR NAME: Juvenal MoctezumaTELEPHONE: (559) 580-0275
LICENSING EVALUATOR SIGNATURE:
DATE: 10/17/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/17/2019
LIC809 (FAS) - (06/04)
Page: 5 of 5
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1310 E. SHAW AVE,
FRESNO, CA 93710
FACILITY NAME: MITYA, ALLA FAMILY CHILD CARE
FACILITY NUMBER: 103906689
VISIT DATE: 10/17/2019
NARRATIVE
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5 children's files were reviewed and everything was completed and up to date. Through File review it was verified that Licensee did not have an updated children's roster. Licensee stated that there are no guns or ammunition in the home and LPAs did not observe any bodies of water during todays inspection. Licensee is current with the immunization requirements per SB 792. Assistant #1 and Assistant #2 did not have proof of immunization. Licensee and 3 assistants were not aware of the Mandated Reporter Training AB 1207. LPA explained that this is a training is available to them online at www.mandatedreporterca.com

Incidental Medical Services (IMS) policy was discussed. Incidental Medical Services (IMS) are not currently being provided. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. Licensee is aware that an IMS plan is required to be submitted to the licensing office if they provide any of these services. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice)/ (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm

During todays inspection, The following Type B Deficiencies were observed. Appeal rights were explained and provided to licensee.



Licensee was reminded that it is her responsibility to know the regulations for Family Child Care Home which can be accessed on-line at www.ccld.ca.gov.

LPA observed licensee post the Notice of Site visit.
FAILURE TO POST THE NOTICE OF SITE VISIT FOR 30 DAYS MAY RESULT IN A $100.00 CIVIL PENALTY.
SUPERVISOR'S NAME: Duane MatsubaraTELEPHONE: (559) 650-7855
LICENSING EVALUATOR NAME: Juvenal MoctezumaTELEPHONE: (559) 580-0275
LICENSING EVALUATOR SIGNATURE:

DATE: 10/17/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/17/2019
LIC809 (FAS) - (06/04)
Page: 2 of 5
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1310 E. SHAW AVE,
FRESNO, CA 93710

FACILITY NAME: MITYA, ALLA FAMILY CHILD CARE
FACILITY NUMBER: 103906689
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/17/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
10/31/2019
Section Cited

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Commencing September 1, 2016, a person shall not be employed or volunteer at a family day care home if he or she has not been immunized against influenza, pertussis, and measles... This requirement was not met as evidenced by licensee stating that she did not have proof of immunization for Assistant #1 and Assistant #2.
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This poses a potential health and safety risk to the chidlren in care.
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Type B
10/31/2019
Section Cited

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Carbon monoxide detectors required; inspection
Every family day care home for children shall have one or more carbon monoxide detectors in the facility... This requirement was not met as evidenced by
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Licensee not having a working Carbon Monoxide detector in the home. The carbon monoxide did not have a battery. This poses an potential health/safety risk to children in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME: Duane MatsubaraTELEPHONE: (559) 650-7855
LICENSING EVALUATOR NAME: Juvenal MoctezumaTELEPHONE: (559) 580-0275
LICENSING EVALUATOR SIGNATURE:
DATE: 10/17/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/17/2019
LIC809 (FAS) - (06/04)
Page: 3 of 5
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1310 E. SHAW AVE,
FRESNO, CA 93710

FACILITY NAME: MITYA, ALLA FAMILY CHILD CARE
FACILITY NUMBER: 103906689
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/17/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
10/25/2019
Section Cited

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Each child day care facility shall maintain a current roster of children who are provided care in the facility. The roster shall include the name, address, and daytime telephone number of the child's parent or guardian, and the name and telephone number of the child's physician. This roster shall be available to the licensing agency upon request.
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This requirement was not met as evidenced by licensee not having a completed Children's Roster. Licensee was missing all of the children's information that she was caring for during the inspection. This poses a potential health safety risk to the children in care.
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Type B
10/25/2019
Section Cited

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Operation of a Family Child Care Home. Each family child care home shall conduct fire drills and disaster drills at least once every six months. The licensee shall document the drills, including the date and time of each drill. This documentation shall be kept at the family child care home. This requirement was not met as
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evidenced by: Based on interview and records review, licensee failed to produce a fire drill log reflecting current fire drills. This poses a potential risk to the health, safety, or personal rights of children.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME: Duane MatsubaraTELEPHONE: (559) 650-7855
LICENSING EVALUATOR NAME: Juvenal MoctezumaTELEPHONE: (559) 580-0275
LICENSING EVALUATOR SIGNATURE:
DATE: 10/17/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/17/2019
LIC809 (FAS) - (06/04)
Page: 4 of 5