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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 343618828
Report Date: 08/19/2021
Date Signed: 08/19/2021 01:53:03 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:VORONTSOV, LYUDMILAFACILITY NUMBER:
343618828
ADMINISTRATOR:VORONTSOV, LYUDMILAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(916) 331-5084
CITY:SACRAMENTOSTATE: CAZIP CODE:
95841
CAPACITY:14CENSUS: 0DATE:
08/19/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
01:05 PM
MET WITH:Lyudmila VorontsovTIME COMPLETED:
02:15 PM
NARRATIVE
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On Thursday, August 19th, 2021, at 1:05 PM, Licensing Program Analyst (LPA) Tanya Washington met with Licensee, Lyudmila Vorontsov, for the purpose of an Annual Required inspection. Today's inspection was conducted in Russian language. All individuals subject to criminal background review have obtained a criminal record clearance. Upon arrival, no daycare children were present in the home.

Operating hours are from 6:00 AM to 9:00 PM, Monday through Friday and Saturday's upon request.

At 1:15 PM, LPA initiated a health and safety inspection of all areas accessible to children. Off-limits areas include three bedrooms, garage and garden area.

LPA observed a working phone, fire extinguisher, and functioning smoke and carbon monoxide detectors.

Licensee stated there are no weapons in the home.

Toxic and hazardous items (detergents, cleaning compounds, medications, sharp utensils, items that could pose a danger to children in care) are properly stored and inaccessible to children.

The fireplace located in the living room is inaccessible to children, there are no stairs in the home. The outdoor play space is fenced. The Licensee understands that in unfenced outdoor areas, 100% supervision of children is required.

There are no bodies of water on the premises. Safe toys and play equipment are observed. *Continued on LIC809-C
SUPERVISOR'S NAME: Roxana SaraviaTELEPHONE: (916) 263-5744
LICENSING EVALUATOR NAME: Tanya WashingtonTELEPHONE: 916-879-1209
LICENSING EVALUATOR SIGNATURE:

DATE: 08/19/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/19/2021
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: VORONTSOV, LYUDMILA
FACILITY NUMBER: 343618828
VISIT DATE: 08/19/2021
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At 1:40 PM, LPA began to review children’s files and other documentation. A current roster is being maintained. LPA observed a current fire and disaster drill log. Preventative health training, current pediatric CPR and First Aid certification was verified for the Licensee (expires 09/26/2021). Proof of AB1207 mandated reporter training is not applicable to as Licensee has limited English proficiency. LPA explained that the OCAP modules are free of cost and available at: http://www.mandatedreporterca.com/.

Incidental Medical Services (IMS) policy was discussed. When any IMS is provided, an updated Plan of Operation that includes 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 for TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the Americans with Disabilities Act, available at: http://www.ada.gov/childqanda.htm

LPA discussed the Safe Sleep in Child Care and current COVID-19 guidelines for Sacramento County.

Licensee was encouraged to visit the Department website at http://ccld.ca.gov for child care updates, current forms, legislation and regulation information.



In the areas that were evaluated, there were no deficiencies at this time.

At 2:00 PM, LPA reviewed and discussed this facility evaluation report with the Licensee.



LPA provided a Notice of Site Visit and the Licensee acknowledges that this notice shall remain posted for 30 days for parental review.

The Licensee's signature on this form acknowledges receipt of this form.
SUPERVISOR'S NAME: Roxana SaraviaTELEPHONE: (916) 263-5744
LICENSING EVALUATOR NAME: Tanya WashingtonTELEPHONE: 916-879-1209
LICENSING EVALUATOR SIGNATURE:

DATE: 08/19/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/19/2021
LIC809 (FAS) - (06/04)
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