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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 343618543
Report Date: 06/13/2023
Date Signed: 06/13/2023 12:33:58 PM


Document Has Been Signed on 06/13/2023 12:33 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, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827



FACILITY NAME:GALUSHKINA, TATYANAFACILITY NUMBER:
343618543
ADMINISTRATOR:GALUSHKINA, TATYANAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(916) 207-1395
CITY:ANTELOPESTATE: CAZIP CODE:
95843
CAPACITY:14CENSUS: 3DATE:
06/13/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
10:10 AM
MET WITH:Tatyana Galushkina, LicenseeTIME COMPLETED:
12:45 PM
NARRATIVE
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On June 13, 2023, an unannounced annual/random inspection was made today by LPA Barragan. Present at time of inspection were licensee and 3 day care children. LPA Barragan spoke with Tatyana Galushkina, Licensee.

LPA tour of the home was conducted the inspection, inside and outside, as shown on the facility sketch is conducted. Licensee states there are no weapons or firearms in the home. There was no spas or pools in the home. LPA's observed poisons, cleaning compound's, and medications inaccessible to children. However, the Licensee had four knifed in a draw in clients reach. The knifes were not kept inaccessible to the children in care. Additionally, the Licensee had a propane tank which was not out of reach of the children. There was a fireplace in the home, but it is inaccessible to the children. Fire extinguisher, Carbon Monoxide Detector and Smoke Detector meets regulations. Currently, Licensee does not have any pets. There are stairs in the home; however, there was a toddler gate to restrict access to the upstairs. Toys and play equipment that were observed appeared to be safe. There is a working telephone. Adequate supervision is being provided during this inspection. Children are supervised when outside in any unfenced play area. There was 0 infant under 12 months old present.

The home is a two story home. Off-limit areas consisted of: Entire second floor, garage, laundry room and shed in the backyard. Licensee was notified that prior to any changes of an on-limit to an off-limit area, or vice versa, the department must be notified.

Pediatric CPR/FA is current with expiration date of 02/24. A child roster is maintained. Fire and disaster drills have been conducted every six months and documented. Last drill documented was 05/08/2023. Three child's records were reviewed during this inspection.
CONTINUED....
SUPERVISOR'S NAME: Natalie DunawayTELEPHONE: (916) 263-5714
LICENSING EVALUATOR NAME: Eduardo BarraganTELEPHONE: (916) 263-5744
LICENSING EVALUATOR SIGNATURE:
DATE: 06/13/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/13/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 4


Document Has Been Signed on 06/13/2023 12:33 PM - It Cannot Be Edited

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, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827


FACILITY NAME: GALUSHKINA, TATYANA
FACILITY NUMBER: 343618543

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/13/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102417(g)(4)
Operation of A Family Child Care Home
(g) The home shall be free from defects or conditions which might endanger a child. Safety precautions shall include but not limited to: (4) Poisons, detergents, cleaning compounds, medicines, firearms and other items which could pose a danger if readily available to children shall be stored where they are inaccessible to children.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, the licensee did not comply with the section cited above due to the Licensee had four knifed in a draw in clients reach. The knifes were not kept inaccessible to the children in care. Additionally, the Licensee had a propane tank which was not out of reach of the children, which poses a potential health, and safety risk to persons in care.
POC Due Date: 07/13/2023
Plan of Correction
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The Licensee placed the 4 Knifes in a cabinet out of children's reach and placed the propane take in a shed that's off limits and locked.
Type B
Section Cited
HSC
1597.622(c)
Administration of Child Day Care Licensing
(c) 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.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation and record review, the licensee did not comply with the section cited above due to the Licensee not maintaining documents for her immunization. Which poses a potential health, and safety risk to persons in care.
POC Due Date: 07/13/2023
Plan of Correction
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The Licensee stated that she will obtain documentation of her immunization's and submit proof to LPA Barragan by 07/13/23, through email. LPA Barragan's email is Eduardo.Barragan@dss.ca.gov
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: Natalie DunawayTELEPHONE: (916) 263-5714
LICENSING EVALUATOR NAME: Eduardo BarraganTELEPHONE: (916) 263-5744
LICENSING EVALUATOR SIGNATURE:
DATE: 06/13/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/13/2023
LIC809 (FAS) - (06/04)
Page: 2 of 4


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, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME: GALUSHKINA, TATYANA
FACILITY NUMBER: 343618543
VISIT DATE: 06/13/2023
NARRATIVE
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LPA's discussed AB 633, Parent Notification Requirements, and the posting of licensing inspection notices and reports. Hours of operation are 7 AM to 10 PM; Monday thru Sunday and other hours as arranged. Licensee states she does transport children.

Licensee Tatyana Galushkina, 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 Tatyana Galushkina, 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 Tatyana Galushkina, 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.


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 .No children currently on medication.

LPA provided the Community Care Licensing 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 regard 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.
SUPERVISOR'S NAME: Natalie DunawayTELEPHONE: (916) 263-5714
LICENSING EVALUATOR NAME: Eduardo BarraganTELEPHONE: (916) 263-5744
LICENSING EVALUATOR SIGNATURE:

DATE: 06/13/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/13/2023
LIC809 (FAS) - (06/04)
Page: 3 of 4
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, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME: GALUSHKINA, TATYANA
FACILITY NUMBER: 343618543
VISIT DATE: 06/13/2023
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To receive important licensed- related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-care-licensing/subscribe and select the Child Care option to receive email communication.

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.

Two citations were administered during this inspection.

A notice of site visit was given and must remain posted for 30 days.

Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

Exit interview conducted and report was reviewed with the Tatyana Galushkina, Licensee. Appeal rights were provided to Tatyana Galushkina, Licensee, as well.

SUPERVISOR'S NAME: Natalie DunawayTELEPHONE: (916) 263-5714
LICENSING EVALUATOR NAME: Eduardo BarraganTELEPHONE: (916) 263-5744
LICENSING EVALUATOR SIGNATURE:

DATE: 06/13/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/13/2023
LIC809 (FAS) - (06/04)
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