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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 214200031
Report Date: 08/15/2023
Date Signed: 08/15/2023 11:40:54 AM


Document Has Been Signed on 08/15/2023 11:40 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
SAN BRUNO CHILD CARE, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066



FACILITY NAME:BYCHKOVA, VALENTINA & BYCHKOV, YURIFACILITY NUMBER:
214200031
ADMINISTRATOR:BYCHKOVA, VALENTINA & YURIFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(415) 884-9116
CITY:NOVATOSTATE: CAZIP CODE:
94949
CAPACITY:14CENSUS: 1DATE:
08/15/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:55 AM
MET WITH:Yuri BychkovaTIME COMPLETED:
12:00 PM
NARRATIVE
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On August 15, 2023 at 9:50 AM, Licensing Program Analyst (LPA) Nathan Garcia arrived at the facility to conduct an unannounced Annual Inspection and met with the Licensee, Yuri Bychkova. Purpose of the inspection was explained. There were 2 children with licensee present in the home, children observed during nap time. LPA verified the background check clearance of the adults working or living in the home. The hours of operation are Tuesday through Friday, 07:30 AM - 6:00 PM. Licensee provides, AM snacks, lunches and PM snacks, which are all prepped and served at the facility. The water provided through water services.
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Daycare areas: dining room, living room and bathroom.
Off Limit areas: Kitchen, bedrooms, and bathroom, upstairs, the rest of the house.
LPA observed that off limit areas were properly barricaded and made inaccessible to the children in care. LPA and Licensee inspected the entire childcare area for Health and Safety hazards. There are multiple carbon monoxide and smoke detectors located in each room. LPA performed the tests to check the functionality of the detectors due to children napping. One fully charged fire extinguisher of size 2A10BC was also available in the home, located in the living room. First Aid kit is fully stocked and accessible. Licensee states, there are no weapons/guns and no pools or open bodies of water. The licensee has no pets as well.
LPA observed that the house is in good repair and free of hazards with proper temperature and ventilation and lighting. The play area is clean, padded/carpeted and in good condition. LPA observed that there are variety of age-appropriate toys, books, and other learning materials available in the home. Electric outlets have proper covers and a working phone is on site. The Licensee does not have liability insurance, LIC 282 is available. LPA observed that the day care area has multiple play set materials with play sets and neatly organized.

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SUPERVISOR'S NAME: Daniel J OquendoTELEPHONE: (650) 379-9023
LICENSING EVALUATOR NAME: Nathan GarciaTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:
DATE: 08/15/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/15/2023
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
SAN BRUNO CHILD CARE, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME: BYCHKOVA, VALENTINA & BYCHKOV, YURI
FACILITY NUMBER: 214200031
VISIT DATE: 08/15/2023
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All posting requirements are met and posted near the childcare entrance. Licensee has current and valid CPR and First Aid card expiring on 01/2024. Mandated reporter training certificate is not and is a technical assistance. LPA reviewed facility records. 2 children's records were reviewed and complete. The facility conducts fire and earthquake drills with the children every 6 months. The most recent one was on 07/8/23.

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.

Per Licensee, there are no children enrolled with allergies. Incidental Medical Services (IMS) policy was discussed. For IMS information 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: on 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 www.ada.gov/childqanda.htm.



The Licensee was reminded about the Provider Information Notices (PINs) on the CCLD website. Licensee was informed that as of September 1, 2016, a person may not be employed or volunteer at a child care facility unless he or she has been immunized against influenza, pertussis, and measles or qualifies for an exemption pursuant to Health and Safety code 1596.7995 and 1597.662.

LPA reviewed AB 1207 with the Licensees. As of January 1, 2018, all staff must complete Mandated Reporter Training every two years. The training can be obtained online atwww.mandatedreporterca.com. Effective July 1, 2020, Licensees must have proof of completion of EMSA certified lead poison training if applying for a change of location or capacity change to an existing license.
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SUPERVISOR'S NAME: Daniel J OquendoTELEPHONE: (650) 379-9023
LICENSING EVALUATOR NAME: Nathan GarciaTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:

DATE: 08/15/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/15/2023
LIC809 (FAS) - (06/04)
Page: 2 of 3
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN BRUNO CHILD CARE, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME: BYCHKOVA, VALENTINA & BYCHKOV, YURI
FACILITY NUMBER: 214200031
VISIT DATE: 08/15/2023
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LPA encouraged the Licensee to visit the Licensing website at www.ccld.ca.gov for licensing regulations and new updates. The Licensee can also email at childcareadvocatesprogram@dss.ca.gov and ask to be added to the email list for the updates.

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/process.



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.

Licensee was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.



During the exit interview, the Licensee, confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.

A copy of this report was given to the Licensee and a site visit notification must be posted for 30 days.

Technical Assistance for expired mandated reporter training.

>No Deficiencies were cited today under Title 22 Division 12 of the California Code of Regulations.

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, Yuri and Valentina Bychkova
SUPERVISOR'S NAME: Daniel J OquendoTELEPHONE: (650) 379-9023
LICENSING EVALUATOR NAME: Nathan GarciaTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:

DATE: 08/15/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/15/2023
LIC809 (FAS) - (06/04)
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