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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 343618278
Report Date: 12/06/2022
Date Signed: 12/06/2022 02:57:52 PM


Document Has Been Signed on 12/06/2022 02:57 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVER CITY (SACTO)CC, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833



FACILITY NAME:PILUYEVA, OLGAFACILITY NUMBER:
343618278
ADMINISTRATOR:PILUYEVA, OLGAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(916) 208-9596
CITY:SACRAMENTOSTATE: CAZIP CODE:
95827
CAPACITY:14CENSUS: 0DATE:
12/06/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
02:20 PM
MET WITH:Olga PiluyevaTIME COMPLETED:
03:15 PM
NARRATIVE
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On December 6, 2022 at approximately 2:20 PM, Licensing Program Analyst (LPA) Mandie Goodwin met with Licensee Olga Piluyeva, for the purpose of an unannounced required 1-year inspection. 3 other adults were present in the home today. All individuals subject to criminal background review have obtained a criminal record clearance. During inspection no daycare children were present. Licensee’s minor children were present in the home. Per licensee she provides care for her grandchildren, who are all school age and one other child who is school-aged. Licensee operates seven days a week for 24 hours. Licensee understands that no child can stay for more than 24 consecutive hours. The home has two stories, and LPA discussed the requirements of gating the stairs if children under age 5 enroll in the child care program.

Licensee guided LPA on a tour of the facility and a health and safety inspection was conducted in all areas accessible to children. The off-limits areas include the garage, and entire upstairs. Licensee acknowledged that daycare children must never enter these off-limit areas. LPA observed the required postings, a fully charged fire extinguisher, and smoke and carbon monoxide detectors. Per Licensee, there are no weapons in the home. No bodies of water were observed today. Toxic and hazardous items are inaccessible to children. Outdoor play space is fully fenced and outdoor equipment is in good repair. Play equipment is securely affixed to the ground.

LPA reviewed a sample of children’s files, which included an emergency card, immunization records, consent to medical, parents rights notification, and liability insurance. Licensee’s file was observed to be complete. LPA observed licensee’s CPR and First Aid card which expires in January 2024. Mandated Reporter is not offered in licensee’s first language. LPA reviewed and provided the Family Child Care Home Entrance Checklist.

(Report continues LIC809-C)
SUPERVISOR'S NAME: Seychelle De LucaTELEPHONE: (916) 263-5719
LICENSING EVALUATOR NAME: Mandie GoodwinTELEPHONE: (916) 639-2867
LICENSING EVALUATOR SIGNATURE:
DATE: 12/06/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/06/2022
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
RIVER CITY (SACTO)CC, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833
FACILITY NAME: PILUYEVA, OLGA
FACILITY NUMBER: 343618278
VISIT DATE: 12/06/2022
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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 submitting 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

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.

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.

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.

During today’s inspection, no deficiencies were observed. A notice of site visit was given and must remain posted for 30 days. Exit interview was conducted and report was reviewed with the Licensee.

SUPERVISOR'S NAME: Seychelle De LucaTELEPHONE: (916) 263-5719
LICENSING EVALUATOR NAME: Mandie GoodwinTELEPHONE: (916) 639-2867
LICENSING EVALUATOR SIGNATURE:

DATE: 12/06/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/06/2022
LIC809 (FAS) - (06/04)
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