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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376616073
Report Date: 10/20/2020
Date Signed: 10/20/2020 12:16:51 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108
FACILITY NAME:CARMEL, GALINA FAMILY CHILD CAREFACILITY NUMBER:
376616073
ADMINISTRATOR:GALINA CARMELFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(858) 780-0287
CITY:SAN DIEGOSTATE: CAZIP CODE:
92129
CAPACITY:14CENSUS: 8DATE:
10/20/2020
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:50 AM
MET WITH:Galina Carmel TIME COMPLETED:
12:05 PM
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3) On October 20, 2020 at 09:50am, Licensing Program Analyst (LPA) Selina Siao conducted an unannounced virtual Face Time required inspection with the Licensee. The home was toured and inspected to ensure an environment safe for the care and supervision of children. Present at the facility were the Licensee, her helper Svetlana Andriyenko and 8 day care children including three older infants that are older than 12 months. Licensee's son Michail Stepanenko is also at the home in his room upstairs and he assisted with translation. Licensee and her helper's primary language is Russian. The home has a fully charged fire extinguisher, smoke and carbon monoxide detector that meet requirements and are operational. All hazardous items were latched/locked and secured out of reach of children. A review of staff records on this date indicates that all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse clearances. Licensee and her helper First Aid and CPR certifications are not from an EMSA approved trainer therefore they will need to retake the course. Immunization for MMR and TDAP were reviewed today. Facility has an updated roster and fire drill log available for review. Licensee last conducted a drill with the children in care on 04/20/2020 and she understands that she needs to conduct another fire drill with the children in care. Licensee has been completing the FCCH self-assessment guide on 04/27/2020, 07/27/2020 and 10/16/2020 per agreed in the Non-compliance conference on 10/29/2019.

Licensee has provided adequate space for the children to eat, sleep and play within the home. Areas uses for childcare includes family room which is the main day care area, bathroom located on the first door on the right side of the hallway and two bedrooms located at the hallway for napping. There is a bedroom for younger children to nap and another bedroom is for older children to nap. Off limits areas includes the living room, kitchen, formal dining area and upstairs. All off limit areas are inaccessible through use of safety gates. The facility has sufficient toys and equipment available. Licensee's son stated that the home doesn't have any weapon. There is a fenced backyard available for outdoor activities and the gate for the pool swings away from the pool and it self-latches.
SUPERVISOR'S NAME: Monica CuddyTELEPHONE: (619) 767-2249
LICENSING EVALUATOR NAME: Selina SiaoTELEPHONE: (619) 767-2217
LICENSING EVALUATOR SIGNATURE:

DATE: 10/20/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/20/2020
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108
FACILITY NAME: CARMEL, GALINA FAMILY CHILD CARE
FACILITY NUMBER: 376616073
VISIT DATE: 10/20/2020
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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

The following items were discussed with provider: Licensee was reminded that corporal punishment, smoking, exersaucers, bouncy seats, walkers, and jumpers are not allowed in day care. Licensee was provided with information about Heat Related Illness, Sudden Infant Death Syndrome (SIDS), Never Shake a Baby, safe sleep for infants, best practice on supervision, latest car seat poster and effects of lead exposure and reporting responsibilities were discussed. The ABC’S of Safe Sleep: Sleep is Safest: Alone, on their Back in an empty Crib on a firm mattress.

Child Care Providers can now sign up for Quarterly Updates and PINS through the DSS website at www.ccld.ca.gov . LPA discussed California Megan's Law and LPA provided: www.meganslaw.ca.gov.

See LIC809D for deficiency:

Appeal Rights (1/16) were discussed and provided. Facility was advised to post the Notice of Site Visit and failure to keep the posting will result in $100 civil penalty. Analyst read the report to licensee's son Michail Stepanenko during the tele-inspection so he could translate to licensee. A copy of the report will be e-mailed to licensee's son and was advised that acknowledgement of the receipt of the report is to be received within twenty-four hours.
SUPERVISOR'S NAME: Monica CuddyTELEPHONE: (619) 767-2249
LICENSING EVALUATOR NAME: Selina SiaoTELEPHONE: (619) 767-2217
LICENSING EVALUATOR SIGNATURE:

DATE: 10/20/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/20/2020
LIC809 (FAS) - (06/04)
Page: 2 of 3
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108

FACILITY NAME: CARMEL, GALINA FAMILY CHILD CARE
FACILITY NUMBER: 376616073
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/20/2020
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
11/30/2020
Section Cited

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Additional Heath and Safety Training
Licensee of a family day care homes shall ensure that at least one staff member who has a current course completion card in pediatric first aid and pediatric CPR issued by the American Red Cross, the American Heart Association, or by a training program that has been approved by the Emergency Medical Services Authority.
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This requirement is not met as evidence by that licensee and her helper's CPR and First Aid course were taken at National CPR Foundation and they are not EMSA approved. This poses a potential health and safety risk to clients in care.
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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: Monica CuddyTELEPHONE: (619) 767-2249
LICENSING EVALUATOR NAME: Selina SiaoTELEPHONE: (619) 767-2217
LICENSING EVALUATOR SIGNATURE:
DATE: 10/20/2020
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/20/2020
LIC809 (FAS) - (06/04)
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