384001602-5-14-2019-05-CC-BVAN-BC6V4W-20190514160702

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 384001602
Report Date: 05/14/2019
Date Signed: 05/14/2019 04:07:08 PM

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:	BARAN, GALYNA		FACILITY NUMBER:	384001602
ADMINISTRATOR:	BARAN, GALYNA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(415) 819-5546
CITY:	SAN FRANCISCO	STATE: CA	ZIP CODE:	94122
CAPACITY:	14	CENSUS: 11	DATE:	05/14/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	02:10 PM
MET WITH:	Galyna Baran		TIME COMPLETED:	04:20 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 Analyst (LPA) Van performed an unannounced random annual inspection at the above facility. LPA met with licensee Galyna Baran, the purpose of the inspection was explained. Present at the home are licensee, two aides, and 11 children. The facility is operating within licensed capacity and within ratio on this day. LPA inspects inside of the facility for health and safety hazards. Hours of operations are Monday – Friday from 8:00AM – 5:30PM. The child care areas are the street level and the second level areas are off limits. The first level has a barrier to prevent access by children to the upper level. Licensee states that sick children will be separated from the group and will be waiting in the project room for parents to pick up. LPA did not observe any bodies of water on the facility. Per licensee there are no firearms or weapons in the home. Cleaning supplies and chemicals are inaccessible to children, they are stored under the kitchen sink and locked away with child proof locks. The home is equipped with a carbon monoxide detector, a smoke detector, and a fully charged fire extinguisher that meets minimum size requirements. The home is clean and in well repair. There are sufficient amounts of age appropriate furniture, toys and reading materials available to children, the backyard also have varieties of climbing structures and toys. There are an adequate lightning, ventilation, and comfortable temperature in the home. Licensee states she provides breakfast, lunch and snacks to children. Continue on the next page......

SUPERVISOR'S NAME: Garfield Leung	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Brendon Van	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 05/14/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/14/2019

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: BARAN, GALYNA	FACILITY NUMBER: 384001602
	VISIT DATE: 05/14/2019

NARRATIVE

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Continuation from previous page..........

LPA reviewed children’s and staff’s files. Children files had immunization records and signed parent’s rights notification forms. First Aid/CPR certification is presented. Licensee First Aid/CPR expired on 7/19. LPA observes the last fire/earthquake drill was performed on 8/13/18. California Child Abuse Mandated Reporter Training is presented, all staffs had completed the training on 3/2019. And all staffs had immunization records on file. Discipline policy was discussed. Licensee states her discipline method will be talking to the child.

LPA reminds licensee 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. LPA also reminds licensee to conduct fire drill and earthquake drill at least once every six months.

No deficiencies are cited on this day. A copy of this report is reviewed with licensee, along with a notice of site visit which is to be posted for 30 days. Records to be maintained are explained to licensee. Licensee is informed for quarterly update on licensing information, go to CCLD website: www.ccld.ca.gov

SUPERVISOR'S NAME: Garfield Leung	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Brendon Van	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 05/14/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/14/2019

LIC809 (FAS) - (06/04)

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