384000536-2-3-2022-05-CC-BVAN-CBAVJL-20220203152856

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 384000536
Report Date: 02/03/2022
Date Signed: 02/03/2022 03:30:07 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME:	NIKCHEMNY, VIKTORIYA		FACILITY NUMBER:	384000536
ADMINISTRATOR:	NIKCHEMNY, VIKTORIYA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(415) 317-5880
CITY:	SAN FRANCISCO	STATE: CA	ZIP CODE:	94116
CAPACITY:	14	CENSUS: 9	DATE:	02/03/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	11:54 AM
MET WITH:	Viktoriya Nikchemny and Galilea Trujillo Lopez		TIME COMPLETED:	03:45 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 February 3, 2022, Licensing Program Analyst (LPA), Van, conducted an unannounced annual inspection and met with Licensee Viktoriya Nikchemny and helper Galilea Trujillo Lopez. Licensee adult daughter arrived a moment later to assist with translation. The purpose of the inspection was explained and granted entry to the home by the Licensee. Licensee has nine children in care, three infants and six preschoolers. All adults living in the home or working at the daycare have cleared criminal records. The Licensee owns the house. Daycare areas are on the ground level, including a nap room, two playrooms, a bathroom, and the backyard. Off limit areas are the entire second floor and the garage. Days and operation hours are 8:00 am – 6:00 pm, Monday – Thursday, and 8:00 am – 5:00 pm on Friday. Per Licensee, sick children will be separated from the group and wait in the backyard or nap room for the parent to pick them up. LPA and Licensee inspected the daycare areas for health and safety hazards during the inspection. LPA observed the following; The daycare area is clean, orderly, and equipped with age-appropriate toys and equipment. The home has adequate lighting and ventilation. The daycare has a working smoke alarm, carbon monoxide detector, and a fully charged fire extinguisher. First aid supplies are available for children. The backyard is clean and has age-appropriate toys and outdoor equipment in good condition. LPA observed Infants have their individual cribs. LPA informed the Licensee not to have any pillows, toys, or anything hanging above the infants' cribs. The Licensee had posted all the required forms, such as facility License, Notification of Parent's Rights, and Notification of Personal Rights. Per Licensee, there are no firearms, weapons, or pets in the home. All cleaning, disinfectants, or chemicals are stored in the bathroom, inaccessible to children.

SUPERVISOR'S NAME: Garfield Leung	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Brendon Van	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 02/03/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/03/2022

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, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME: NIKCHEMNY, VIKTORIYA	FACILITY NUMBER: 384000536
	VISIT DATE: 02/03/2022

NARRATIVE

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The Licensee states she provides breakfast, lunch, dinner, morning and afternoon snacks to children. The Licensee has a water filter/pitcher and cups available for children. Children's cups are labeled with their names. LPA observed no pools, spas, or other bodies of water on the premises. Per Licensee, fire drills are conducted and documented accordingly, and the last fire drill was conducted on July 26, 2021. During the inspection, LPA reviewed all records of children and staff that were present. LPA observed that the Licensee maintained records of each child accordingly; identification and emergency information, consent for medical treatment, and parent's rights were appropriately completed. The Licensee has maintained a record of immunization. LPA observed mandated reporter training certification, and Pediatric FirstAid & CPR for all staff are current.

LPA discussed the safe sleep regulations with Licensee 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 the 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.

Licensee 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.

SUPERVISOR'S NAME: Garfield Leung	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Brendon Van	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 02/03/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/03/2022

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, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME: NIKCHEMNY, VIKTORIYA	FACILITY NUMBER: 384000536
	VISIT DATE: 02/03/2022

NARRATIVE

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The Licensee was reminded about the Provider Information Notices (PINs) on the CCLD website. Licensee was informed that as of September 1, 2016, a person may not be employed or volunteer at a child care facility unless he or she has been immunized against influenza, pertussis, and measles or qualifies for an exemption pursuant to Health and Safety code 1596.7995 and 1597.662. LPA reviewed AB 1207 with the Licensee. As of January 1, 2018, all staff must complete Mandated Reporter Training every two years. The training can be obtained online at www.mandatedreporterca.com.

LPA encouraged the Licensee to frequently visit our website at www.ccld.ca.gov for licensing regulations and new updates. The Licensee can also email at childcareadvocatesprogram@dss.ca.gov and ask to be added to the email list for the updates.

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.

The report was reviewed and signed by the Licensee, Viktoriya Nikchemny. No deficiencies were observed in today's inspection. Today's report, 2/3/2022, and notice of site visit will be sent to the Licensee email by the close of business on 2/3/2022. Confirmation of receipt is required, and a notice of site visit must remain posted for 30 days.

SUPERVISOR'S NAME: Garfield Leung	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Brendon Van	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 02/03/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/03/2022

LIC809 (FAS) - (06/04)

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