197413741-9-6-2022-58-CC-JLAO-CHZMPB-20220906094653

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 197413741
Report Date: 08/31/2022
Date Signed: 09/06/2022 09:47:07 AM

Document Has Been Signed on 09/06/2022 09:47 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
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME:	KOVSHILOVSKAYA FAMILY CHILD CARE		FACILITY NUMBER:	197413741
ADMINISTRATOR:	KOVSHILOVSKAYA, SVETLANA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(323) 876-7037
CITY:	LOS ANGELES	STATE: CA	ZIP CODE:	90046
CAPACITY:	14	CENSUS: 12	DATE:	08/31/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	01:00 PM
MET WITH:	Svetlana Kovshilovskaya		TIME COMPLETED:	03:30 PM

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	On 8/31//2022 Program Analyst (LPA), Judy Laureano conducted an unannounced Annual Required Inspection and was met by Svetlana Kovshilovskaya. Days and hours of operation are 8 am to 6:00 p.m.., Monday through Friday. Currently applicant cares for children ages 2 years old to 5 years old. Licensee confirmed that she does not provide overnight care, weekend care or infant care- children under the age of 12 months old. LPA toured the home inside and outside and a census was taken; 12 children were present with 2 assistants and license. Licensee confirmed the following areas are used for day care: room 1, living room, dining room, kitchen and bedroom 1 and bathroom located in the hallway next bedroom 1. LPA observed a ½ bath near the laundry room, outside the kitchen that children use. Children nap in bedroom 1. LPA observed a sun room/ that is used to store children’s belongings and sometimes families use the side room to enter the home. LPA observed a working smoke detector and napping cots in bedroom 1. Kitchen area was observed to have a eating area where children eat. Licensee confirmed the following areas are off limits: bedroom 2, LPA observed the door to be locked and OFF Limits to the children in care. Two closets located in the hallway have been designated as OFF LIMITS, LPA observed the doors to be locked. There is no swimming pool or other bodies of water on the premises. There are no firearms or ammunition on the premises. No poisons were observed during the inspection. Detergents, cleaning compounds, medication and other hazardous items are made inaccessible; under the sink cabinet in the bathroom that was observed to have a safety latch.

SUPERVISOR'S NAME: Claudia Escobedo	TELEPHONE: (424) 301-3044
LICENSING EVALUATOR NAME: Judy Laureano	TELEPHONE: 424-301-3060
LICENSING EVALUATOR SIGNATURE:	DATE: 08/31/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/31/2022

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
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME: KOVSHILOVSKAYA FAMILY CHILD CARE	FACILITY NUMBER: 197413741
	VISIT DATE: 08/31/2022

NARRATIVE

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There is a non working fireplace located in the living room that has been barricaded and not in use. There are three working fire extinguisher in the kitchen and laundry room.
Adequate heating and ventilation for safety and comfort were observed in the space. LPA did no to observe any stairs in the home. Safe toys and play equipment are observed. The home has working telephone service and LPA confirmed the phone number is (323) 876-7037 and mobile number 323-804-6861

Licensee does not take in children under the age of 12 months. Program only takes in children ages: 2 years old to 5 years old.

Licensee ensures that children in care are supervised at all times and is aware children shall not be left in parked vehicles. Car seats are used for transportation purposes only and are not used for sleeping children. The outdoor play area in the backyard is fenced and there are no hazards to children present. Capacity as specified on the license is being maintained.

LPA reviewed a sample of children’s files and observed files were complete. Licensee’s Mandated Reporter Training was not available for review and Technical Violation was issues. Licensee agrees to complete online training and submit proof of completion by 9/14/2022. Licensee’s pediatric CPR/First Aid was recently completed and licensee agrees to submit proof of certification to LPA by 9/14/2022.

All adults who reside or work in the home have a criminal record clearance or exemption. There are no excluded individuals present at this home.

LPA discussed the LIC 311D provided licensee with a sample of all necessary LIC forms and LEAD Prevention flyer.

To improve the quality and value of the new inspection process, a survey will be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or tools, please send them by email to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/inspection-process.

SUPERVISOR'S NAME: Claudia Escobedo	TELEPHONE: (424) 301-3044
LICENSING EVALUATOR NAME: Judy Laureano	TELEPHONE: 424-301-3060
LICENSING EVALUATOR SIGNATURE:	DATE: 08/31/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/31/2022

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
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME: KOVSHILOVSKAYA FAMILY CHILD CARE	FACILITY NUMBER: 197413741
	VISIT DATE: 08/31/2022

NARRATIVE

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Licensee was reminded that all adults 18 and over living or working in the home, including employees and volunteers, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a licensed Family Child Care Home. A civil penalty of $100.00 minimum/day up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

LPA discussed the safe sleep regulations with licensee and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed licensee of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

A notice of site visit was given and must remain posted for 30 days.
Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

Exit interview conducted and report was reviewed with the licensee Svetlana Kovshilovskaya.

SUPERVISOR'S NAME: Claudia Escobedo	TELEPHONE: (424) 301-3044
LICENSING EVALUATOR NAME: Judy Laureano	TELEPHONE: 424-301-3060
LICENSING EVALUATOR SIGNATURE:	DATE: 08/31/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/31/2022

LIC809 (FAS) - (06/04)

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