<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434414531
Report Date: 08/25/2023
Date Signed: 08/25/2023 10:56:08 AM


Document Has Been Signed on 08/25/2023 10:56 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
CCLD Regional Office, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131



FACILITY NAME:LUKISH, OKSANAFACILITY NUMBER:
434414531
ADMINISTRATOR:LUKISH, OKSANAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(650) 390-7508
CITY:SUNNYVALESTATE: CAZIP CODE:
94089
CAPACITY:14CENSUS: 7DATE:
08/25/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
08:30 AM
MET WITH:Oksana LukishTIME COMPLETED:
11:15 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
Licensing Program Analysts (LPAs) Mel Matos and Jessica Bongardt met with Oksana Lukish, Licensee, for an unannounced Required – 1 year annual inspection. LPAs note that the Licensee resides in the Plaza Del Rey Mobile Home Park in Space 546 which is located on Calle Dorita inside the mobile home complex. Visitor parking is available throughout the complex. LPAs were granted access to the home by the Licensee. LPAs also observed seven preschool children and Licensee's spouse (Maksym Lukish), and mother/adult assistant (Ninel Kotliarenko) in the home during today's inspection. Licensee was operating within her capacity and ratio requirements. LPAs observed the required postings, including the facility license, near the front entrance to the home. Days and hours of operation are Monday - Friday from 8:00 AM to 6:00 PM. The adults residing in the home are: Licensee, Licensee's spouse, Licensee's mother, and Licensee's adult son (Dmytro Lukish).

LPAs reviewed a current Child Care Facility Roster and Fire/Disaster drill log during today's inspection. The last fire/disaster drill was completed on June 21, 2023. Licensee states that she does not have liability insurance for the day care and issues the Affidavit Regarding Liability Insurance for Family Child Care Home (LIC 282) to all enrolled families. Licensee has current CPR and First Aid certifications (expiration:11/13/2023). Licensee has the required vaccines (MMR, Tdap, & flu) and is current with her Mandated Reporter Training for Child Care Workers (expiration:12/25/2023). Licensee's adult assistant and spouse also has the required vaccines (MMR, Tdap, & flu) and is current with Mandated Reporter Training for Child Care Workers. LPAs reviewed seven children's files and the files were complete with the required forms. LPAs reviewed three staff files and the files were complete with the required forms. Licensee states that a child will be isolated in the living room area if necessary due to illness or communicable disease.

LPAs toured the indoor and outdoor areas of the home during today's inspection. Licensee has a working telephone in the home. The home is clean, orderly, (including heating/air conditioning/ventilation), and safe for the day care children. There are safe & age appropriate toys, play equipment, and materials for the children in the home. There are no stairs inside the home. LPA did not observe any wall heaters inside the home. Off limit areas inside the home: master bedroom, master bathroom, bedrooms #2 & #3, barricaded fireplace unit (located in the living room area), four locked kitchen drawers, eleven locked kitchen cabinet doors, and two locked bathroom vanity doors. Off limit area outside the home: front yard, locked storage shed, and one barricaded air conditioner unit.

SUPERVISOR'S NAME: Diana StephensonTELEPHONE: (408) 324-2158
LICENSING EVALUATOR NAME: Melvin S MatosTELEPHONE: (408) 334-8554
LICENSING EVALUATOR SIGNATURE:
DATE: 08/25/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/25/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 2


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME: LUKISH, OKSANA
FACILITY NUMBER: 434414531
VISIT DATE: 08/25/2023
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
26
27
28
29
30
31
32
LPAs observed a fully charged 2A10BC fire extinguisher, working smoke/carbon monoxide detectors, and fenced backyard. There is a swimming pool within the complex (located near the front entrance to the complex) that is adequately fenced with a self-latching gate. The Licensee states that she does not have any weapons in the home. The Licensee has two indoor cats that are vaccinated and licensed. LPA reminded the Licensee that pet food and water must be inaccessible whenever day care children are present. All detergents, cleaning compounds, medications, and other similar items are inaccessible to children. All poisons are stored in the locked storage shed, located outdoors.

Licensee states that she does not administer any medications to the day care children. Licensee states that she provides meals (breakfast, snacks, and lunch) to the day care children. Licensee understands that any food brought from home shall be labeled with each child's name and properly stored. Licensee has a first aid kit in the home which includes a touch less thermometer. Licensee states that nobody smokes and she understands that smoking is prohibited in the home.

Supervision of children was discussed with the Licensee and she understands that she must be present in the home during day care hours and ensure that the children are supervised at all times. Licensee understands her capacity/ratio options and she understands that she cannot have more than 14 children present in the home without two qualified adults present. Licensee states that does not transport any day care children. Licensee understands that children shall not be left unattended in parked vehicles and that car seats shall only be used for transportation and shall not be used for sleeping.

Oksana Lukish, Licensee, was reminded that all adults 18 and over living or working in the home, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, 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 for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.

LPAs discussed the safe sleep regulations with licensee [or facility representative] and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-andresources/safe-sleep as an additional resource. LPAs also informed licensee [or facility representative] 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 informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

Exit interview conducted and report was reviewed with the Licensee, Oksana Lukish. No deficiencies issued during today's inspection.

A notice of site visit was given and must remain posted for 30 days.
SUPERVISOR'S NAME: Diana StephensonTELEPHONE: (408) 324-2158
LICENSING EVALUATOR NAME: Melvin S MatosTELEPHONE: (408) 334-8554
LICENSING EVALUATOR SIGNATURE:

DATE: 08/25/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/25/2023
LIC809 (FAS) - (06/04)
Page: 2 of 2