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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 343618278
Report Date: 01/22/2020
Date Signed: 01/22/2020 02:23:48 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:PILUYEVA, OLGAFACILITY NUMBER:
343618278
ADMINISTRATOR:PILUYEVA, OLGAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(916) 362-3754
CITY:SACRAMENTOSTATE: CAZIP CODE:
95827
CAPACITY:14CENSUS: 3DATE:
01/22/2020
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
12:45 PM
MET WITH:Olga PiluyevaTIME COMPLETED:
02:35 PM
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LPA Pitts met with licensee Olga Piluyeva for the purpose of an annual random inspection. Licensee operates seven days a week for 24 hours; Licensee understands that no child can stay for more than 24 consecutive hours. Licensee has comfortable accommodations to meet the sleeping needs of each child. The facility’s annual fees are current. Upon arrival, Licensee, Licensee's spouse, and 3 day care child was present, during the inspection. 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-limits areas include the entire upper level of the home and the garage. LPA observed a working phone, 3A40BC fire extinguisher, first aid kit and functioning smoke and carbon monoxide detectors. The stairs are not required to be barricaded at this time, as current children enrolled are 5 years of age and above. 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 were observed. Licensee stated that the fireplace in the home is not in use during day care hours.

Licensee does not currently provide Incidental Medical Services (IMS). For IMS information, licensee was advised to see Evaluator Manual - Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. 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.

Report continued on 809-c
SUPERVISOR'S NAME: Bettina EngelmanTELEPHONE: (916) 263-5820
LICENSING EVALUATOR NAME: Rosie PittsTELEPHONE: (916) 263-5744
LICENSING EVALUATOR SIGNATURE:

DATE: 01/09/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/09/2020
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, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833
FACILITY NAME: PILUYEVA, OLGA
FACILITY NUMBER: 343618278
VISIT DATE: 01/22/2020
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A sample of staff and children's records were reviewed. Required postings, a current roster, disaster drill log and proof of immunization's were observed. Current EMSA Certified pediatric CPR and first aid certification was verified and expires: 3/2020. AB 1207 Mandated Reporter Training was verified and expires 04/18/2020. The OCAP modules are free of cost and available at: http://www.mandatedreporterca.com/ The licensee understands that the training must be completed every two years and proof of completion must remain in the facility’s file. LPA provided Licensee with documents needed when children in the home turn 18.

LPA discussed and provided Safe Sleep in Child Care and Effects of Lead Exposure brochures. LPA advised Licensee to distribute the brochures to parents. 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 the licensee. A notice of site visit was provided and should remain posted for 30 days for parental review. Licensee was 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 3 years for public review upon request.

In the areas that were evaluated, no Title 22 deficiencies were cited.
SUPERVISOR'S NAME: Bettina EngelmanTELEPHONE: (916) 263-5820
LICENSING EVALUATOR NAME: Rosie PittsTELEPHONE: (916) 263-5744
LICENSING EVALUATOR SIGNATURE:

DATE: 01/22/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/22/2020
LIC809 (FAS) - (06/04)
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