304313601-8-18-2020-06-CC-KDEI-BSLTFQ-20200818144152

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 304313601
Report Date: 07/22/2020
Date Signed: 08/18/2020 02:42:01 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME:	SHATERNIK, OKSANA		FACILITY NUMBER:	304313601
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY:	8	CENSUS: 7	DATE:	07/22/2020
TYPE OF VISIT:	Case Management - Licensee Initiated	ANNOUNCED	TIME BEGAN:	10:00 AM
MET WITH:	Licensee Shaternik Oksana		TIME COMPLETED:	12:00 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	Licensing Program Analyst (LPA) Ketki Desai conducted a Case Management – Licensee initiated (Capacity increase) inspection today. LPA met with License Shaternik Oksana via Face time and her elder son Mr., Vladyslav Shaternik, assisted during the inspection, as the Licensee only speaks Russian. Both guided analyst on a tour of the facility. The inspection is being conducted via Face time due to pandemic situation and it was pre-scheduled inspection. Per Licensee, family members residing in the home are 3 adults and two minors. All the three adults obtained their background checks. The Licensee is requesting a Large family childcare home license. Per Licensee, operating hours will be Monday to Friday, 8:00AM to 6:00PM. Licensee states that she will care for children ages 2 to 6 years of age. During today’s inspection there were 7 children including Licensee’s daughter present in the home, received care and supervision from the assistant who is live scanned and has met the requirements of an assistant. All areas identified on the facility sketch were inspected, including but not limited to, off limit areas. This is a two story home that consists of 3 bedrooms, 3 restrooms, 2 living rooms, kitchen, backyard and garage. There is a stairway in the home which is made inaccessible by placing a child safety gate. Per Licensee , the children will use the restroom located in the hallway on the first level next to the living area the designated Day care area, the first level of the home, with 2 living area, a napping area and back yard are the designated areas for the Day care activities. (1)

SUPERVISOR'S NAME: Thuy Ho	TELEPHONE: (714) 287-8515
LICENSING EVALUATOR NAME: Ketki Desai	TELEPHONE: (714) 743-8635
LICENSING EVALUATOR SIGNATURE:	DATE: 07/22/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/22/2020

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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME: SHATERNIK, OKSANA	FACILITY NUMBER: 304313601
	VISIT DATE: 07/22/2020

NARRATIVE

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There is a napping room at the end of the living area which is separated by a curtained section. Both the living area has age appropriate activities and educational materials for children. The Napping area shall be used also an isolation area.
Areas that will be used by children were inspected for safety, comfort, cleanliness, telephone service (cell phone), ventilation and heating. The home has a center air and heat. There is a fireplace in the day care area, which has been covered with painted cardboard serving as a barrier. There is locked door leading to the kitchen area which remains inaccessible to children.
There is dining section in the living room for children to have their snacks and meals.
Detergents, cleaning compounds, medicines, sharp objects and hazardous items that can pose a danger to children are inaccessible in areas designated for children. The Licensee states (that there are no poisons on the premises).

Based on the Facility Sketch submitted, areas off limits to children and parents are: Entire second level of the home,(four bedrooms and two bathrooms) Kitchen, garage and laundry room are equipped with locked doors. Kitchen cabinets have child safety locks and all sharp objects are stored in a locked cabinet. Licensee states Kitchen door shall be remain locked and closed during the hours of operation.

OUTDOOR PLAY AREA: Back yard is fenced from all the sides, it also has a shaded patio area and grassy area where outdoor toys along with a covered sand box, there is no climbing structures. There were no hazardous observed.

Per applicant, there are no pets, firearms, weapons or bodies of water on the premises.

The value on the 2A10BC fire extinguisher indicates fully charged, as indicated on service tag observed. Smoke and carbon monoxide detectors were tested and are operable.

There are toys available for children. Wooden cots and mats are used during napping time, linens and blankets are provided by the Licensee.

The Licensee provides food for children in care. If food is not provided and food is brought from the children’s homes; container shall be labeled with child’s name and properly stored or refrigerated.
(2)

SUPERVISOR'S NAME: Thuy Ho	TELEPHONE: (714) 287-8515
LICENSING EVALUATOR NAME: Ketki Desai	TELEPHONE: (714) 743-8635
LICENSING EVALUATOR SIGNATURE:	DATE: 07/22/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/22/2020

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
CCLD Regional Office, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME: SHATERNIK, OKSANA	FACILITY NUMBER: 304313601
	VISIT DATE: 07/22/2020

NARRATIVE

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The following items were also discussed with licensee during this inspection.

All homes shall conduct fire and disaster drills at least once every six months and document the drills.

PETS: There are No pets on the premises.

POSTING REQUIREMENTS: Emergency Disaster Plan, Parent’s Rights Poster and the Facility License are observed to be posted.

PROHIBITED: Infant Walkers, Johnny Jumpers, Saucer Chairs, Trampolines and/or any other item that falls into these categories are not permitted in a family childcare facility.

SMOKING IS PROHIBITED IN A LICENSED FAMILY CHILD CARE HOME.

UPDATE: H&S 1597.622: Commencing September 1, 2016, a person shall not be employed or volunteer at a family day care home if he or she has not been immunized against influenza, pertussis, and measles. The licensee have submitted the proof of immunizations.

Incidental Medical Services (IMS): As per Licensee, currently there are no enrolled children receiving these services.

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.htm

LPA advised the licensee how to access forms, regulations and quarterly updates online at: www.ccld.ca.gov.

LPA consulted and explained Child Abuse Reporting, Updated Patent’s Rights Poster with Complaint Hotline information, Never Shake a Baby, Sudden Infant Death Syndrome (SIDS), and Safe Sleeping practices.
(3)

SUPERVISOR'S NAME: Thuy Ho	TELEPHONE: (714) 287-8515
LICENSING EVALUATOR NAME: Ketki Desai	TELEPHONE: (714) 743-8635
LICENSING EVALUATOR SIGNATURE:	DATE: 07/22/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/22/2020

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
CCLD Regional Office, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME: SHATERNIK, OKSANA	FACILITY NUMBER: 304313601
	VISIT DATE: 07/22/2020

NARRATIVE

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Capacity Handout (Small & Large) was provided via email to the licensee

Any unusual incidents or injuries must be reported to the Department within 24 hours via telephone and within seven (7) days in writing. (use LIC624B for written report). Licensees shall reveal each facility license number in all advertisements, publications, or announcements made with the intent to attract clients.

Currently, the licensee is in compliance with California Code of Regulations Title 22 for operating a Family Child Care home.

A new license for operating a Large Family Child Care Home shall be issued upon approval.

The report is being emailed to the Licensee, due to Covid 19 pandemic and LPA has requested a written acknowledgement of the report being read.

Appeal Rights were also emailed to the Licensee.

No deficiency cited during today's tele-inspection

SUPERVISOR'S NAME: Thuy Ho	TELEPHONE: (714) 287-8515
LICENSING EVALUATOR NAME: Ketki Desai	TELEPHONE: (714) 743-8635
LICENSING EVALUATOR SIGNATURE:	DATE: 07/22/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/22/2020

LIC809 (FAS) - (06/04)

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