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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197493251
Report Date: 01/15/2020
Date Signed: 01/15/2020 03:38:45 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME:PERESECHANSKAYA FAMILY CHILD CAREFACILITY NUMBER:
197493251
ADMINISTRATOR:YERESECHANSKAYA, ZHANNETAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(818) 800-0911
CITY:RESEDASTATE: CAZIP CODE:
91335
CAPACITY:14CENSUS: 8DATE:
01/15/2020
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
01:30 PM
MET WITH:Zhanna PeresechanskayaTIME COMPLETED:
03:00 PM
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Margarit Sislyan, Licensing Program Analyst (LPA) arrived at the facility to deliver the amended report.

LPA met with Licensee, Zhanna Peresechanskaya.
LPA observed 7 children were present at home.
It was nap time. the facility complied.

The report was delivered.

Exit interview
SUPERVISOR'S NAME: Mary RuizTELEPHONE: (424) 301-3061
LICENSING EVALUATOR NAME: Margarit SislyanTELEPHONE: (424) 430-3049
LICENSING EVALUATOR SIGNATURE:

DATE: 01/15/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/15/2020
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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