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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 343623673
Report Date: 11/12/2020
Date Signed: 11/12/2020 12:07:49 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:DYACHISHIN, GALINAFACILITY NUMBER:
343623673
ADMINISTRATOR:DYACHISHIN, GALINAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(916) 390-8744
CITY:FAIR OAKSSTATE: CAZIP CODE:
95628
CAPACITY:14CENSUS: 5DATE:
11/12/2020
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
11:00 AM
MET WITH:Galina DyachishinTIME COMPLETED:
11:15 AM
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Due to COVID-19 Licensing Program Habtom (LPA) Habtom was unable to inspect the backyard based on normal practice of an unannounced inspection. LPA Habtom conducted a televisit using facetime on November 12, 2020 at 11:00 am with the licensee Galina Dyachishin & Tanya Dyachishin.

Licensing Program Analyst (LPA) Habtom did an announced inspection to review the backyard that was approved by the fire department for day care usage. During today's visit there were 5 children supervised by licensee Galina Dyachishin and daughter Tanya Dyachishin. LPA toured the yard with Tanya who explained the area approved by the fire department is the one that has access from the outside side door into the back door to the day care. The area past the gate in the side back yard is off limits and cannot be accessed by day care children. The area that is off limits is the main back yard for licensee which the fire department did not approve. LPA updated the off limits area to state the back yard past the gate.

SUPERVISOR'S NAME: Keven PetersTELEPHONE: (916) 263-5728
LICENSING EVALUATOR NAME: Lea HabtomTELEPHONE: (916) 208-2538
LICENSING EVALUATOR SIGNATURE:

DATE: 11/12/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/12/2020
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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