343618406-5-22-2019-03-CC-JHOA-BCEN97-20190522101528

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 343618406
Report Date: 05/21/2019
Date Signed: 05/22/2019 10:15:56 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:	YUSHCHUK, TATYANA		FACILITY NUMBER:	343618406
ADMINISTRATOR:	YUSHCHUK, TATYANA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(916) 248-9499
CITY:	RANCHO CORDOVA	STATE: CA	ZIP CODE:	95670
CAPACITY:	14	CENSUS: 11	DATE:	05/21/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	12:10 PM
MET WITH:	Tatyana Yushchuk		TIME COMPLETED:	02:45 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), Jan Hoshida, met with Licensee, Tatyana Yushchuk, for an unannounced random annual inspection and toured areas of the home accessible to children in care. Off-limit areas include laundry room, garage and shed. Licensee acknowledged that children may never enter these off-limit areas. The census included 11 children with one child under the age of two. Also present was Licensee’s daughter/assistant. Licensee stated there are no new residents in the home since licensure. All adult residents have criminal record clearances. The hours of operation are Monday through Friday from 7:00am-7:00pm. LPA observed current CPR/First Aid certificates which expire on 9/2020. LPA discussed recent changes in licensing requirements, including the posting of licensing inspection notices and reports and Parent Notification Requirements. LPA reviewed some children’s files. LPA observed fire drills were conducted at least once every six months and documented. LPA observed that there were no hazardous items accessible to children. LPA observed that cleaning materials were inaccessible. Licensee stated there are no weapons in the home. Fire extinguisher, smoke detector and carbon monoxide detector meet regulation. Toys appear to be safe. The backyard is fenced and gated. There are no bodies of water observed. 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) *REPORT CONTINUED ON NEXT PAGE*

SUPERVISOR'S NAME: Bettina Engelman	TELEPHONE: (916) 263-5820
LICENSING EVALUATOR NAME: Jan Hoshida	TELEPHONE: (916) 917-6572
LICENSING EVALUATOR SIGNATURE:	DATE: 05/21/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/21/2019

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: YUSHCHUK, TATYANA	FACILITY NUMBER: 343618406
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 05/21/2019

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 06/21/2019 Section Cited HSC 1597.622(c)	1 2 3 4 5 6 7	The family day care home shall maintain documentation of the required immunizations or exemptions from immunization, as set forth in this section, in the person’s personnel record that is maintained by the family day care home.	1 2 3 4 5 6 7	Licensee stated they shall submit proof of immunization for pertussis, measles, and influenza for assistant. Licensee shall maintain documentation of immunization for herself and all assistants. Proof of correction shall be sent to LPA by POC date: 6/21/2019.
	8 9 10 11 12 13 14	This was not met as evidenced by: LPA did not observe required immunizations for assistant. This poses a potential risk to the health & safety of the children in care.	8 9 10 11 12 13 14
Type B 06/21/2019 Section Cited HSC 1596.8662(b)(1)	1 2 3 4 5 6 7	On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child care provider...or employee of a licensed child day care facility shall complete the mandated reporter training...shall complete renewal mandated reporter training every two years...	1 2 3 4 5 6 7	Licensee stated they will provide proof of Mandated Reporter Training for assistant to LPA by POC date: 6/21/2019.
	8 9 10 11 12 13 14	This was not met as evidenced by: LPA did not observe Mandated Reporter training for assistant. This poses a potential risk to teh health & safety of the children in care.	8 9 10 11 12 13 14

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

SUPERVISOR'S NAME: Bettina Engelman	TELEPHONE: (916) 263-5820
LICENSING EVALUATOR NAME: Jan Hoshida	TELEPHONE: (916) 917-6572
LICENSING EVALUATOR SIGNATURE:	DATE: 05/21/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/21/2019

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: YUSHCHUK, TATYANA	FACILITY NUMBER: 343618406
	VISIT DATE: 05/21/2019

NARRATIVE

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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 the new Mandated Reporter Training with Licensee. Beginning January 1, 2018, Health and Safety Code 1596.8662 requires all licensed providers, applicants, directors and employees to complete training as specified on their mandated reporter duties and to renew their training every two years. Volunteers are encouraged but not required to take the training. In addition, existing Licensees must meet requirements by March 30, 2018. This training requirement may be met by using the Department’s Office of Child Abuse Prevention (OCAP) online training modules. The OCAP modules are free of cost and available at: HTTP://WWW.MANDATEDREPORTERCA.COM/. The training is currently provided in English. AB1207 Training. LPA observed that Licensee's assistant/daughter did not have the Mandated Reporter Training certification.

Licensee speaks Russian and currently the new Mandated Reporter Training is not offered in the Russian language.

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

LPA provided the Community Care Licensing’s website www.ccld.ca.gov, so the Licensee can obtain updated licensing information, new regulations and access forms. LPA advised Licensee of their responsibility to stay current in regards to new regulations. LPA also included the email address for the children's advocacy program to stay current on new laws CHILDCAREADVOCATESPROGRAM@DSS.CA.GOV

In the areas that were evaluated, deficiencies were observed at the time of the visit and cited on LIC 809-D. An exit interview was conducted and report was reviewed with Licensee who stated they understand today’s inspection. Notice of Site Visit was posted and Licensee understands it must remain posted for 30 days.

SUPERVISOR'S NAME: Bettina Engelman	TELEPHONE: (916) 263-5820
LICENSING EVALUATOR NAME: Jan Hoshida	TELEPHONE: (916) 917-6572
LICENSING EVALUATOR SIGNATURE:	DATE: 05/21/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/21/2019

LIC809 (FAS) - (06/04)

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