384001060-2-25-2020-05-CC-BVAN-BM5PJ8-20200225102107

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 384001060
Report Date: 02/25/2020
Date Signed: 02/25/2020 10:21:20 AM

COMPREHENSIVE INSPECTION

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:	CHERDAK, JULIYA		FACILITY NUMBER:	384001060
ADMINISTRATOR:	CHERDAK, JULIYA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(415) 850-0306
CITY:	SAN FRANCISCO	STATE: CA	ZIP CODE:	94116
CAPACITY:	14	CENSUS: 11	DATE:	02/25/2020
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	08:40 AM
MET WITH:	Juliya Cherdak		TIME COMPLETED:	10:40 AM

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 2/25/2020 at 8:40 am, Licensing Program Analyst (LPA), Van conducted an unannounced random annual inspection and met with Licensee, Juliya Cherdak. The purpose of the inspection was explained and was granted entry to the home by the licensee. Present in the home is a helper and 11 children with the licensee. LPA, along with the licensee, inspected the daycare for health and safety hazards. This is a three-unit building, and the daycare is on the ground level. Daycare areas are including a big playroom, a bathroom, and the backyard. Off limit areas are the entire second and third-level floor and the garage, and all were inaccessible to children. LPA observed the following during the inspection: The daycare area is clean, orderly, and equipped with age-appropriate toys and equipment for the children. The home has sufficient lighting and ventilation, has a working telephone and a fully charged fire extinguisher. During the inspection, LPA tested the carbon monoxide and smoke detector, and both detectors were operating. There are no bodies of water on the premises. All disinfectants, detergents, or cleaning products are stored in the bathroom and are inaccessible to daycare children. The licensee states there are firearms in the home, per the licensee, ammunition and firearms are stored and locked separately. Licensee and helper have valid Pediatric FirstAid CPR on file. Per the licensee, fire drills are conducted once a month, and a record of the drill was documented accordingly, and the last fire drill was performed on 2/3/2020. LPA observed licensee had posted all the required forms (i.e., License, Notification of Parent's Rights, Notification of Personal Rights, and Emergency Disaster Plan).

SUPERVISOR'S NAME: Garfield Leung	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Brendon Van	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 02/25/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/25/2020

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

FACILITY NAME: CHERDAK, JULIYA	FACILITY NUMBER: 384001060
	VISIT DATE: 02/25/2020

NARRATIVE

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LPA reviewed the children's records and licensee's records. LPA observed that the licensee maintained records of each child accordingly; identification and emergency information, consent for medical treatment, and parent’s rights are properly completed. The licensee has a record of immunization and certificates of completion of mandated reporter training.

During the inspection,
*Incidental Medical Services (IMS) policy was discussed.
*Licensee was reminded about having all Staff and Volunteers provide proof of immunization against influenza, pertussis, and measles or qualifies for an exemption.
*Licensee was reminded about the Provider Information Notices (PINs) on the CCLD website.
*Licensee was reminded about Mandated Reporter Training available on CCLD website (www.ccld.ca.gov or www.mandatedreporterca.com)
* LPA discussed the Family Child Care Home checklist with the licensee and provided the checklist to the licensee as a reference for future inspection guide.

No deficiencies were observed in today’s inspection. A copy of this report was reviewed and provided to the licensee. This report will be kept in the facility file and will be made available for public review upon request. Notice of Site Visit was observed to be posted and shall 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: 02/25/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/25/2020

LIC809 (FAS) - (06/04)

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