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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197494651
Report Date: 10/23/2020
Date Signed: 10/26/2020 07:04:04 AM

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:PINCHEVSKIY FAMILY CHILD CAREFACILITY NUMBER:
197494651
ADMINISTRATOR:PINCHEVSKIY, NATALIAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(818) 730-7320
CITY:SHERMAN OAKSSTATE: CAZIP CODE:
91403
CAPACITY:14CENSUS: 9DATE:
10/23/2020
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
08:56 AM
MET WITH:Applicant Natalia PinchevskiyTIME COMPLETED:
01:00 PM
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On 10.23.20, Licensing Program Analyst (LPA) Miguel Garcia conducted this announced second pre- Licensing tele-inspection at 15433 Huston Street, Sherman Oaks, CA 91403. The purpose of this pre- Licensing inspection is to ensure that the applicant Natalia Pinchevskiy made the necessary corrections agreed on 10.02.20 during the first pre-licensing inspection.
  • LPA Garcia observed that on the side of the house by the driveway, the double door fence was closed. LPA Garcia reminded Ms. Pinchevskiy that the double door fence must be closed during the hours of operations.
  • LPA Garcia obtained a copy of an utility bill with Ms. Pinchevskiy’s name on it, this provides evidence that she resides in the home. Ms. Pinchevskiy stated that she lives in the home.

LPA Garcia informed Ms. Pinchevskiy about the recently approved safe sleep regulations. LPA Garcia provided the link below where the regulations can be founded:

https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep

Technical Assistant (TA) tele-visit: LPA Garcia also conducted a TA tele-visit. Prior to the tele-visit, LPA Garcia sent to the applicant via email the following materials: COVID-19 Self-assessment guide, COVID-19 guidance, COVID-19 Infection Prevention, and Posters for children and staff. LPA Garcia observed that the applicant put the posters up on the wall. LPA Garcia observed that the licensee has an adequate amount of hygiene equipment and PPE. LPA Garcia observed that the facility has security cameras in the interior and exterior of the house. There aren’t security cameras in the bathrooms.

An exit interview was conducted with the applicant Natalia Pinchevskiy via telephone. LPA Garcia sent to Ms. Pinchevskiy via email a copy of this report. Ms. Pinchevskiy agrees to sign the report and email it back to LPA Garcia. Licensure of this application will be considered by Community Care Licensing Division (CCLD) after it conducts a review of the application.

SUPERVISOR'S NAME: Victor BautistaTELEPHONE: (414) 301-3008
LICENSING EVALUATOR NAME: Miguel GarciaTELEPHONE: (424) 301-3206
LICENSING EVALUATOR SIGNATURE:

DATE: 10/23/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/23/2020
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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