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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 343622904
Report Date: 02/22/2023
Date Signed: 02/22/2023 12:43:11 PM


Document Has Been Signed on 02/22/2023 12:43 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:TIMOFEYEVA, VERAFACILITY NUMBER:
343622904
ADMINISTRATOR:TIMOFEYEVA, VERAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(916) 829-0332
CITY:RANCHO CORDOVASTATE: CAZIP CODE:
95670
CAPACITY:14CENSUS: 9DATE:
02/22/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
11:30 AM
MET WITH:Vera TimofeyevaTIME COMPLETED:
01:00 PM
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Licensing Program Analysts (LPAs) Erwina Pascual-Golamco and Michelle Pascual met with Licensee, (L1) Vera Timofeyeva, for an unannounced annual / one year inspection. During the inspection there was a census of 9 CHILDREN being supervised by the L1 and an assistant. All individuals subject to criminal background review have obtained a criminal record clearance. Facilities hours of operation are M-F 7am to 6pm.

Health and safety inspection were conducted in the areas accessible to children. The off-limit areas include: LAUNDRY ROOM, GARAGE, BEDROOMS 2, 3 & 4, HALL BATHROOM. L1 understands that children may never enter these off-limits areas. The house has a working telephone, fully charged fire extinguisher, smoke detector and carbon monoxide detector that meet regulations. LPAs observed all required postings. LPAs observed home was safe, orderly, and free of hazards. LPAs advised L1 that if there are any poisons at the home, all poisons must be inaccessible to children, locked with a key lock or combination lock. LPAs observed a fireplace within the home and it is screened/barricaded. L1 stated that there are no firearms or bodies of water on the premises.

LPAs observed children's roster and fire drill log, the last fire drill was conducted January 2023. L1 has current CPR/First aid, which expires October 2024. L1’s Mandated Reporter Training expires October 2024. L1 understands both trainings must be completed every two years. LPAs reviewed records of children’s files, all which contained the required documentation.

SUPERVISOR'S NAME: Natalie DunawayTELEPHONE: (916) 584-3508
LICENSING EVALUATOR NAME: Erwina Pascual-GolamcoTELEPHONE: (916) 206-1524
LICENSING EVALUATOR SIGNATURE:
DATE: 02/22/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/22/2023
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: TIMOFEYEVA, VERA
FACILITY NUMBER: 343622904
VISIT DATE: 02/22/2023
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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 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

L1 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.

L1 is aware of and/or practicing safe sleep regulations (102425 Infant Safe Sleep).

No deficiencies were cited during today’s inspection.

Exit interview conducted and report was reviewed with the L1. A notice of site visit was provided and must remain posted for 30 days

SUPERVISOR'S NAME: Natalie DunawayTELEPHONE: (916) 584-3508
LICENSING EVALUATOR NAME: Erwina Pascual-GolamcoTELEPHONE: (916) 206-1524
LICENSING EVALUATOR SIGNATURE:

DATE: 02/22/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/22/2023
LIC809 (FAS) - (06/04)
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