414004257-5-24-2023-05-CC-CQUO-CS5N95-20230524101520

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 414004257
Report Date: 05/24/2023
Date Signed: 05/24/2023 10:15:28 AM

Document Has Been Signed on 05/24/2023 10:15 AM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

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

FACILITY NAME:	CHELNOKOVA, LUDMILA		FACILITY NUMBER:	414004257
ADMINISTRATOR:	CHELNOKOVA, LUDMILA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(415) 516-4451
CITY:	SAN BRUNO	STATE: CA	ZIP CODE:	94066
CAPACITY:	14	CENSUS: 8	DATE:	05/24/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	08:15 AM
MET WITH:	Ludmila Chelnokova		TIME COMPLETED:	10:30 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 May 24, 2023 at approximately 8:15am, Licensing Program Analyst (LPA) Catrina Quimbo conducted an unannounced, annual inspection. LPA met with licensee, Ludmila Chelnokova, and explained the purpose of the inspection. Present during LPA's visit included licensee, licensee's spouse and 8 preschool age children. Licensee is operating within capacity limits and ratio during LPA's visit. All adults living and/or working in the home have fingerprint clearance on file. Hours of operation are Monday to Friday 8:00am to 5:00pm. Licensee lives in the home with their spouse. The DAY CARE AREAS are located on the ground level of the home only which include the family room (main day care area), bedroom #1 (napping room), bathroom #1 and side yard. The OFF LIMIT AREAS are the laundry room (ground level), garage and entire second level of home. Entrance to facility is through main door entrance. Off limit areas are made inaccessible to children with child safety door handles. LPA inspected day care areas of home for health and safety hazards. Licensee operates home as a Russian immersion program with preschool age children only. LPA observed home to be in good repair with proper temperature and ventilation. There are a variety of toys and equipment in the home that were in good working condition. LPA observed cleaning supplies, poisons and other chemicals to be stored inaccessible in home's high shelves. LPA observed electrical outlets in day care areas to be made inaccessible with child safety covers. Flooring in day care areas is padded with sufficient cushion that was observed to be in good working condition. Bathroom for children's use was observed to be clean and in proper working condition. Bathroom is equipped with appropriate toileting equipment and appropriate sanitation products. (Continue Report on Page 2...)

SUPERVISOR'S NAME: Garfield Leung	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Catrina Quimbo	TELEPHONE: 650-266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 05/24/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/24/2023

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

FACILITY NAME: CHELNOKOVA, LUDMILA	FACILITY NUMBER: 414004257
	VISIT DATE: 05/24/2023

NARRATIVE

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Side yard is entirely enclosed and fully fenced. Side yard is equipped with a variety of outdoor toys and equipment that were observed to be in good working condition. Flooring in backyard is cushioned with artificial turf. LPA did not observe any pools, spas or bodies of water on the property.

Home is equipped with multiple fire extinguishers, fire alarm system, and multiple working carbon monoxide and smoke detectors. Licensee has required licensing documentation that was properly posted and made available for review. Licensee maintains a child care roster that was available for review. Emergency disaster drills are conducted at least once every six months and are properly logged. Last emergency drill was conducted 03/03/2023.

LPA reviewed 8 children's records which were complete. Children's records have a record of emergency identification information on file. Licensee's Pediatric First/Aid CPR is current and will expire 11/2024.

LPA reminded licensee about Mandated Reporter training available www.mandatedreporterca.com. Licensee was reminded Mandated Reporter training must be renewed every 2 years and all staff whom directly work with children must complete training.

Licensee was reminded, as of September 1, 2016, all Staff and Volunteers must provide proof of immunization against pertussis, measles, and influenza, or qualifies for an exemption, pursuant to Health and Safety code 1596.7995 and 1597.622.

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: www.ada.gov/childqanda.htm.
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SUPERVISOR'S NAME: Garfield Leung	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Catrina Quimbo	TELEPHONE: 650-266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 05/24/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/24/2023

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

FACILITY NAME: CHELNOKOVA, LUDMILA	FACILITY NUMBER: 414004257
	VISIT DATE: 05/24/2023

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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.

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.

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 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.

No deficiencies were cited today under CCR, Title 22, Div. 12.

A notice of site visit was given and must remain posted for 30 days. Failure to maintain posting requirements shall result in an immediate civil penalty of $100.

Exit interview conducted and report was reviewed with the licensee, Ludmila Chelnokova.

SUPERVISOR'S NAME: Garfield Leung	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Catrina Quimbo	TELEPHONE: 650-266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 05/24/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/24/2023

LIC809 (FAS) - (06/04)

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