343622904-1-24-2024-03-CC-EPGO-CZSV8T-20240124151317

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 343622904
Report Date: 01/24/2024
Date Signed: 01/24/2024 03:13:26 PM

Document Has Been Signed on 01/24/2024 03:13 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
SACRAMENTO CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

FACILITY NAME:	TIMOFEYEVA, VERA		FACILITY NUMBER:	343622904
ADMINISTRATOR:	TIMOFEYEVA, VERA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(916) 829-0332
CITY:	RANCHO CORDOVA	STATE: CA	ZIP CODE:	95670
CAPACITY:	14	CENSUS: 13	DATE:	01/24/2024
TYPE OF VISIT:	Required - 3 Year	UNANNOUNCED	TIME BEGAN:	01:20 PM
MET WITH:	Vera Timofeyeva		TIME COMPLETED:	03:30 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 Analysts Erwina Pascual-Golamco (LPA) and Stephanie Piring conducted an unannounced annual inspection and met with Licensee, Vera Timofeyeva, All individuals subject to criminal background review have obtained a criminal record clearance. LPA observed 13 children in care with licensee and cleared assistant. Facility hours of operation are Monday through Friday 7:00 AM – 6:00 PM. LPA observed that the annual facility fees are current. Licensee was reminded that all adults 18 and over living or working in the home, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, 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 for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated. Off-limit areas include: BEDROOMS (1, 3 & 4), LAUNDRY ROOM, AND GARAGE. Licensee acknowledged that children may never enter these off-limit areas. The fireplace is fenced or barricaded. LPA conducted a health and safety inspection and observed that the facility is clean, orderly, with heating and ventilation for safety and comfort. The facility has equipment and age-appropriate materials for children. LPA observed the required documents were posted where visible to parents. LPA observed that there were no hazardous items—such as cleaning compounds, medications, or sharp objects that are accessible to children. The 2A-10-BC fire extinguisher appeared to be in working condition and is accessible. LPA observed the smoke and carbon monoxide detectors are functioning. Licensee stated there are no weapons or firearms on the premises. The backyard is fenced, and licensee acknowledged that in areas that are not fenced, 100% supervision is required. LPA did not observe bodies of water on the premises. continued on LIC809-C...

SUPERVISOR'S NAME: Natalie Dunaway	TELEPHONE: (916) 584-3508
LICENSING EVALUATOR NAME: Erwina Pascual-Golamco	TELEPHONE: (916) 206-1524
LICENSING EVALUATOR SIGNATURE:	DATE: 01/24/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/24/2024

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

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

FACILITY NAME: TIMOFEYEVA, VERA	FACILITY NUMBER: 343622904
	VISIT DATE: 01/24/2024

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
26
27
28
29
30
31
32

LPA observed a current children's roster and fire drill log which was last conducted on 07/2023. LPA reviewed sample of children’s files and LPA provided assistance regarding required documentation. LPA observed the CPR/First Aid certificate was valid until 10/24. Mandated Reporter Training (MRT) certificate was valid until 10/24. Licensee was reminded both CPR/First Aid and MRT Child Care portion must be completed every two years. LPA reviewed staff and facility files and observed the required documentation.

Licensee is aware of and practicing safe sleep regulations. As an additional resource, LPA discussed the safe sleep regulations with licensee and the Child Care Licensing Safe Sleep webpage at
https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-andresources/safe-sleep. LPA also informed 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 PIN 22-02-CCP. 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: https://www.ada.gov/resources/child-care-centers/.

Licensee was informed of the https://mychildcareplan.org/; a consumer education website that helps families obtain childcare by connecting them to childcare providers and Resource and Referral Agencies (R&Rs) throughout California.

Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other important information communication platform. LPA reminded licensee about the quarterly updates provided by the Childcare Advocates Program. To receive important license 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.
continued on LIC809-C...

SUPERVISOR'S NAME: Natalie Dunaway	TELEPHONE: (916) 584-3508
LICENSING EVALUATOR NAME: Erwina Pascual-Golamco	TELEPHONE: (916) 206-1524
LICENSING EVALUATOR SIGNATURE:	DATE: 01/24/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/24/2024

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
SACRAMENTO CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

FACILITY NAME: TIMOFEYEVA, VERA	FACILITY NUMBER: 343622904
	VISIT DATE: 01/24/2024

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
26
27
28
29
30
31
32

To improve the quality and value of the new inspection process, a survey may 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 CARE tools, please send email inquiries 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/inspection-process.

Licensee confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS on 01/23/24.

A Title 22 Deficiency is being cited based on today's inspection and is reflected on LIC 809-D. A notice of site visit was given to licensee and must remain posted on, or immediately adjacent to, the interior side of the main door for 30 days. Exit interview was conducted, appeal rights were provided, and report was reviewed with the licensee, Vera Timofeyeva.

SUPERVISOR'S NAME: Natalie Dunaway	TELEPHONE: (916) 584-3508
LICENSING EVALUATOR NAME: Erwina Pascual-Golamco	TELEPHONE: (916) 206-1524
LICENSING EVALUATOR SIGNATURE:	DATE: 01/24/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/24/2024

LIC809 (FAS) - (06/04)

Page: 3 of 4

Document Has Been Signed on 01/24/2024 03:13 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
SACRAMENTO CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

FACILITY NAME: TIMOFEYEVA, VERA	FACILITY NUMBER: 343622904
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 01/24/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

102421(c)

Child's Records

(c) In any case in which the licensee cares for an additional child pursuant to Section 102416.5(b) for a Small Family Child Care Home or Section 102416.5(d) for a Large Family Child Care Home, the licensee shall maintain, in the child’s record, a copy of documentation verifying the child’s enrollment and attendance at kindergarten, including transitional kindergarten, or elementary school as required in Section 102416.5(g). This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on observation, interview, and record review, the licensee did not comply with the section cited above in 1 out of 13 children in care did not have documentation verifying the child’s enrollment and attendance at kindergarten, including transitional kindergarten, or elementary school as required in Section 102416.5(g) which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 02/01/2024
	Plan of Correction
1 2 3 4	Licensee stated she will obtain documentation from child representative and place in child's file. Licensee will email LPA by 4PM POC due date for ducumentation, but if she needs more time she will inform and email LPA.

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

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 Dunaway	TELEPHONE: (916) 584-3508
LICENSING EVALUATOR NAME: Erwina Pascual-Golamco	TELEPHONE: (916) 206-1524
LICENSING EVALUATOR SIGNATURE:	DATE: 01/24/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/24/2024

LIC809 (FAS) - (06/04)

Page: 4 of 4