343619082-3-1-2022-03-CC-JHOA-CC4URL-20220301144855

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 343619082
Report Date: 03/01/2022
Date Signed: 03/01/2022 02:49:05 PM

Document Has Been Signed on 03/01/2022 02:49 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
CCLD Regional Office, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833

FACILITY NAME:	MARYANOV, VALENTINA & ALEXANDER		FACILITY NUMBER:	343619082
ADMINISTRATOR:	MARYANOV, VALENTINA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(916) 348-9484
CITY:	NORTH HIGHLANDS	STATE: CA	ZIP CODE:	95660
CAPACITY:	14	CENSUS: 9	DATE:	03/01/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	12:45 PM
MET WITH:	Valentina & Alexander Maryanov		TIME COMPLETED:	03:00 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	On Tuesday, 03/01/22, Licensing Program Analyst (LPA) Jan Hoshida conducted an unannounced random annual inspection and met with Licensees Valentina & Alexander Maryanov. LPA observed there were nine day care children present in the facility during this inspection. The off-limit areas include the entire upstairs, garage (laundry room), one bedroom downstairs, the fence area in the backyard and the side yard. During the inspection, Licensees requested to put the downstairs bedroom on-limits. LPA inspected the downstairs bedroom and observed that they were in compliance with Title 22 regulations and the Health and Safety Code and approved it for use. Licensees acknowledged that children may never enter these off-limit areas. Licensees 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 to 7:00pm. LPA observed current CPR/First Aid certificate which expire on 09/2023. Licensees speak Russian and the Mandated Reporter training is not offered in the Russian language. 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 fireplace which was screened. LPA observed that cleaning materials were inaccessible. Fire extinguisher, smoke detector, and carbon monoxide detector meet regulation. Toys appear to be safe. The backyard is fenced and gated. LPA observed weapons in the home that were stored in compliance with Title 22 regulations and the Health and Safety Code. LPA discussed current COVID guidelines with Licensees. LPA checked facilities fees and confirmed that it is up to date. *REPORT CONTINUED ON NEXT PAGE*

SUPERVISOR'S NAME: Seychelle De Luca	TELEPHONE: (916) 263-5719
LICENSING EVALUATOR NAME: Jan Hoshida	TELEPHONE: (916) 917-6572
LICENSING EVALUATOR SIGNATURE:	DATE: 03/01/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/01/2022

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
CCLD Regional Office, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833

FACILITY NAME: MARYANOV, VALENTINA & ALEXANDER	FACILITY NUMBER: 343619082
	VISIT DATE: 03/01/2022

NARRATIVE

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This facility does not currently provide Incidental Medical Services- IMS. 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.

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.

Licensees were 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 licensees 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 licensees 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.

No Title 22 Deficiencies observed in the areas that were evaluated. LPA reviewed report with the Director and provided copies. Exit interview conducted and report was reviewed with the licensees Valentina & Alexander Maryanov. A notice of site visit was given and must remain posted for 30 days.

SUPERVISOR'S NAME: Seychelle De Luca	TELEPHONE: (916) 263-5719
LICENSING EVALUATOR NAME: Jan Hoshida	TELEPHONE: (916) 917-6572
LICENSING EVALUATOR SIGNATURE:	DATE: 03/01/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/01/2022

LIC809 (FAS) - (06/04)

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