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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 343617760
Report Date: 10/28/2021
Date Signed: 11/01/2021 10:34:17 AM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833
FACILITY NAME:VEDERIS, LYUBOVFACILITY NUMBER:
343617760
ADMINISTRATOR:VEDERIS, LYUBOVFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(916) 214-6499
CITY:NORTH HIGHLANDSSTATE: CAZIP CODE:
95660
CAPACITY:14CENSUS: 3DATE:
10/28/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
12:45 PM
MET WITH:Lyubov VederisTIME COMPLETED:
02:15 PM
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On Thursday, October 28, 2021, at 12:45 PM, Licensing Program Analyst (LPA) Tanya Washington conducted an unannounced Required 1 year annual inspection and met with Licensee, Lyubov Vederis. Upon arrival three children were in care of Licensee, also present in the home is Licensee's adult daughter. The hours of operation are Monday through Friday from 6:00 AM to 6:00 PM. The visit was conducted in Russian language.

The off-limit areas include master bathroom and garage. Licensee acknowledged that children may never enter these off-limit areas. Licensee stated there are no new residents in the home since licensure.

LPA observed current CPR/First Aid certificates for Licensee and her spouse which expire on 08/2022. LPA reviewed three children’s files who were in care during today's inspection and two other files of children who were not in care today. LPA observed that there were no hazardous items accessible to children. LPA observed fireplace which was blocked and Licensee stated that she does not use it during day care hours. LPA observed that cleaning materials were inaccessible. Fire extinguisher, smoke detector, and carbon monoxide detector meet regulation. Toys appear to be safe. The backyard is fenced. LPA discussed current COVID guidelines with Licensee. There is an empty in-ground pool surrounded by chain link fence, the fence is six feet in height and has slats through the links. The gate is self closing and self latching.

LPA observed a current fire drill log and children’s roster. Proof of AB1207 mandated reporter training is not applicable as Applicant has limited English proficiency. LPA explained that the OCAP modules are free of cost and available at: http://www.mandatedreporterca.com/.

REPORT CONTINUED ON LIC809C

SUPERVISOR'S NAME: Roxana SaraviaTELEPHONE: (916) 263-5744
LICENSING EVALUATOR NAME: Tanya WashingtonTELEPHONE: 916-879-1209
LICENSING EVALUATOR SIGNATURE:

DATE: 10/28/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/28/2021
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, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833
FACILITY NAME: VEDERIS, LYUBOV
FACILITY NUMBER: 343617760
VISIT DATE: 10/28/2021
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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.

This facility does not currently provide Incidental Medical Services- IMS. 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 provided Licensee the Safe Sleep PIN 20-24 CCP and Infant Individual Sleeping Plan (LIC 9227). Licensee stated that she does not currently have any children under that age of two years old.
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.

LPA checked facilities fees and confirmed that it is up to date.



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.

In the areas that were evaluated, no Tittle 22 deficiencies were observed. A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with the licensee Lyubov Vederis.

SUPERVISOR'S NAME: Roxana SaraviaTELEPHONE: (916) 263-5744
LICENSING EVALUATOR NAME: Tanya WashingtonTELEPHONE: 916-879-1209
LICENSING EVALUATOR SIGNATURE:

DATE: 10/28/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/28/2021
LIC809 (FAS) - (06/04)
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