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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 343618077
Report Date: 06/18/2021
Date Signed: 06/18/2021 01:01:46 PM

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:MARKEVICH, NADEZHDAFACILITY NUMBER:
343618077
ADMINISTRATOR:MARKEVICH, NADEZHDAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(916) 369-8960
CITY:SACRAMENTOSTATE: CAZIP CODE:
95827
CAPACITY:14CENSUS: 1DATE:
06/18/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
11:40 AM
MET WITH:Nadezhda MarkevichTIME COMPLETED:
12:30 PM
NARRATIVE
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On Friday, June 18, 2021, LPA Pitts met with licensee Nadezhda Markevich for the purpose of an annual random inspection. The facilities’ hours of operation are 6:00 AM to 10:00 PM Monday – Friday. Upon arrival, Licensee, 1 day care child, licensee's assistant and Licensee's adult child was also present . All individuals subject to criminal background review have obtained a criminal record clearance. A health and safety evaluation was conducted in all areas accessible to children. Off-limit areas include Master bedroom/bathroom, side yard and garage; LPA observed a working phone, 2A10BC fire extinguisher, first aid kit and functioning smoke and carbon monoxide detectors. Per licensee, there are no weapons in the home. No children were observed in parked cars. There are no accessible bodies of water on the premises. Toxic and hazardous items are inaccessible to children. Safe toys and comfortable accommodations were observed. The fireplace in the home is appropriately barricaded to prevent access by children.


Staff records were reviewed. Required postings, a current roster, disaster drill log, proof of immunization's were observed. Current in person EMSA CPR and First Aid certification was verified and expires 10/2022. Proof of AB1207 mandated reporter training is not applicable to as Applicant has limited English proficiency. LPAs explained that the OCAP modules are free of cost and available at: http://www.mandatedreporterca.com/.
A sample of children’s records were reviewed.

Report continued on 809-C
SUPERVISOR'S NAME: Seychelle De LucaTELEPHONE: (916) 263-5719
LICENSING EVALUATOR NAME: Rosie PittsTELEPHONE: 916-862-1086
LICENSING EVALUATOR SIGNATURE:

DATE: 06/18/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/18/2021
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: MARKEVICH, NADEZHDA
FACILITY NUMBER: 343618077
VISIT DATE: 06/18/2021
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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 discussed Effects of Lead Exposure, PIN 20-24-CCP Safe Sleep Regulations, and COVID-19 Safety guidelines. LPA provided the following link:http://www.cdss.ca.gov/inforesources/Community-Care-Licensing/subscribe for the Licensee to subscribe to the distribution list and receive Quarterly Updates.


This facility evaluation report was reviewed and discussed with Licensees. A Notice of Site Visit was provided and should remain posted for 30 days for parental review. Licensees were encouraged to visit the Department website at WWW.CCLD.CA.GOV for child care updates, current forms, legislation and regulation information. A copy of this report will remain on file for a period of three years for public review upon request. The licensee's signatures on this form acknowledges receipt of this form.

In the areas that were evaluated, No Title 22 Deficiency cited.

SUPERVISOR'S NAME: Seychelle De LucaTELEPHONE: (916) 263-5719
LICENSING EVALUATOR NAME: Rosie PittsTELEPHONE: 916-862-1086
LICENSING EVALUATOR SIGNATURE:

DATE: 06/18/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/18/2021
LIC809 (FAS) - (06/04)
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