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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197700339
Report Date: 03/20/2020
Date Signed: 03/20/2020 01:14:09 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME:YEGANOVA FAMILY CHILD CAREFACILITY NUMBER:
197700339
ADMINISTRATOR:YEGANOVA, LIANAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(310) 920-7387
CITY:SUN VALLEYSTATE: CAZIP CODE:
91352
CAPACITY:14CENSUS: 0DATE:
03/20/2020
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME BEGAN:
11:45 AM
MET WITH:Liana Yeganova, ApplicantTIME COMPLETED:
01:25 PM
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Licensing Program Analyst (LPA) Monique Ayala met with Applicant, Liana Yeganova who guided LPA on a tour of the facility for an Pre-Licensing Inspection. This is a two story house with 5 bedrooms (2 bedrooms downstairs and 3 bedrooms upstairs), 3 bathrooms (1 bathroom downstairs and 2 bathrooms upstairs) home with Kitchen, Dining Room, Living Room, Outdoor Patio and complete fenced in back yard area.There is no pool/spa or body of water on the premises. Family members residing in the home include 3 adults (Applicant, Spouse, adult child), who were present during the inspection were applicant and daughter Lina Grymchan. Days/hours of operation will be Monday through Friday from 8:00 AM to 6:00 PM.

Main care is provided in both bedrooms downstairs to the left of the entrance hallway. 1 bedroom will be used for play time/activities and second bedroom will be used for napping. Applicant was reminded that children need to be supervised at all times. Children use the Bathroom 1 located downstairs in between day care room to the left of hallway. Children have access to both bedrooms downstairs, downstairs bathroom, living room, dinning room, kitchen and rear yard. Off limit areas include all of the upstairs, stairs have a child proof gate that does not give children in care access to upstairs area. The home was inspected inside and out for safety, comfort, cleanliness, telephone service, heating (central) and ventilation, inaccessibility to poisons, detergents/cleaning compounds, medicines and hazardous items (sharp knives stored in high cabinet) that can pose a danger to children.
SUPERVISOR'S NAME: Mariela RamonTELEPHONE: (661) 369-2168
LICENSING EVALUATOR NAME: Monique Jessica AyalaTELEPHONE: (661) 202-3365
LICENSING EVALUATOR SIGNATURE:

DATE: 03/20/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/20/2020
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 4
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: YEGANOVA FAMILY CHILD CARE
FACILITY NUMBER: 197700339
VISIT DATE: 03/20/2020
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The fenced outside play area is free from defects or dangerous conditions.

Per Applicant, there are no weapons or firearms on the premise. LPA did not observe any in the home. There are age appropriate toys (tricycles, sea saw, sand table and water table). Age appropriate napping equipment (cots, mats). The required fire extinguisher (2A10BC) and smoke detector are in operable condition. The home has a Carbon Monoxide detector. Home has central AC and heat. CPR/First Aid expires 05/01/2021. The First Aid kit was observed and is complete.

The following was discussed with the Applicant:


Capacity requirements, Notification of Parent's Rights, Roster requirements (keep updated names and blue sheet), Documentation requirements for disaster drills (fire and earthquake). Mandatory Forms for the children’s files and provider’s files, Safe Sleep and information on shaking baby syndrome. The role and responsibilities of being a mandated reporter were reviewed. Applicant reminded that 100% supervision is required at all times to children in care. Applicant was advised on how to access forms and Regulations for Family Child Care online at www.ccld.ca.gov. Applicant was made aware that it is her responsibility to know the regulations as well as anyone who assists in providing care. Applicant advised that inaccessibility of hazards must be constantly reassessed depending on the children in care. Licensing must always have the facility’s phone number; if the phone number is changed, licensing must be notified. Regulation prohibits the smoking of tobacco in a private residence that is licensed as a family child care home and in those areas of the family day care home where children are present (24/7 ban). State law prohibits baby walkers, bouncy seats, exersaucers and any other items that fall into that category.
SUPERVISOR'S NAME: Mariela RamonTELEPHONE: (661) 369-2168
LICENSING EVALUATOR NAME: Monique Jessica AyalaTELEPHONE: (661) 202-3365
LICENSING EVALUATOR SIGNATURE:

DATE: 03/20/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/20/2020
LIC809 (FAS) - (06/04)
Page: 2 of 4
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: YEGANOVA FAMILY CHILD CARE
FACILITY NUMBER: 197700339
VISIT DATE: 03/20/2020
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Requirements for fingerprint clearances and associations were discussed with the Applicant

Applicant was advised of the requirement to report unusual incidents and/or injuries to the parent/guardian and Licensing within the time frame specified by the regulation and on the form LIC624B (Same day/ASAP or within next business day within normal business hours 8-5 and written report within 7 days). Pamphlet providing Information regarding, Seat Belt Safety and Notification of Parent's Rights poster (Palmdale Regional Child Care Office) was provided. The "Notification of Parent's Rights" poster must be posted in an area of the home accessible to parents. The information regarding new legislation with regards to exemptions and Parent’s Rights was also discussed.

Applicant was advised that the Notice of Site Visit must be posted at the entrance of the facility for a period of 30 days. If a serious violation is cited, a copy of the licensing report (LIC809 or LIC9099) must also be posted for 30 days. If these requirements are not met, civil penalties in the amount of $100 per violation will be assessed. Copies of the reports must also be provided to each parent when a serious deficiency, Type A, is cited (LIC9224).

Applicant informed to review Quarterly updates/regulations for 2015-2019 on the department website: Summer 2015 - Incidental Medical Services information.



--Applicant was advised visit www.shotsforschool.org for Immunization information.
--Applicant was informed of responsibility to report suspected Child Abuse, 1-800-827-8724
--Family Child Care Providers (Disaster Planning information): https://ccld.family-child-care-providers/disaster-planning-and-fire-safety/
SUPERVISOR'S NAME: Mariela RamonTELEPHONE: (661) 369-2168
LICENSING EVALUATOR NAME: Monique Jessica AyalaTELEPHONE: (661) 202-3365
LICENSING EVALUATOR SIGNATURE:

DATE: 03/20/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/20/2020
LIC809 (FAS) - (06/04)
Page: 3 of 4
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: YEGANOVA FAMILY CHILD CARE
FACILITY NUMBER: 197700339
VISIT DATE: 03/20/2020
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--Child Care Videos: https://ccld.childcarevideos.org
--Child Care Advocates information: www.childcareadvocatesprogram@cdss.ca.gov
--Applicant was advised to visit the CCL website (www.ccld.ca.gov) to obtain updates of courses and updates/changes to the regulations.

Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. When any IMS is provided, a Plan for Providing IMS must be submitted to the Department. 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.html (Plan is on file or currently no plan on file).

During this inspection facility was observed to be in compliance with Title 22. The application for Large Family Child Care Home with a maximum capacity of 014 with parent notification will be submitted for approval.

An exit interview was conducted, and a copy of this report was provided to the applicant on this date.

SUPERVISOR'S NAME: Mariela RamonTELEPHONE: (661) 369-2168
LICENSING EVALUATOR NAME: Monique Jessica AyalaTELEPHONE: (661) 202-3365
LICENSING EVALUATOR SIGNATURE:

DATE: 03/20/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/20/2020
LIC809 (FAS) - (06/04)
Page: 4 of 4