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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434414531
Report Date: 12/04/2024
Date Signed: 12/04/2024 03:34:46 PM

Document Has Been Signed on 12/04/2024 03:34 PM - 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 JOSE CC RO, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME:LUKISH, OKSANAFACILITY NUMBER:
434414531
ADMINISTRATOR/
DIRECTOR:		LUKISH, OKSANAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(650) 390-7508
CITY:SUNNYVALESTATE: CAZIP CODE:
94089
CAPACITY: 14TOTAL ENROLLED CHILDREN: 12CENSUS: 11DATE:
12/04/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:20 PM
MET WITH:Oksana LukishTIME VISIT/
INSPECTION COMPLETED:
03:50 PM
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Licensing Program Analyst (LPA) Mel Matos met with Oksana Lukish, Licensee, for an unannounced an Annual/Random inspection. LPA notes 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. LPA was granted access to the home by the Licensee. LPA also observed eleven napping day care children (2 infants & 9 preschool) and Licensee's mother/adult assistant (Ninel Kotliarenko) in the home during today's inspection. Licensee was operating within her capacity and ratio requirements. Licensee states that she enrolls children ages 15 months to 5 years of age. LPA 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).

LPA reviewed a current Child Care Facility Roster and Fire/Disaster drill log during today's inspection. The last fire/disaster drill was completed on September 16, 2024. 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:11/11/2025). Licensee has the required vaccines (MMR, Tdap, & flu) and is current with her Mandated Reporter Training for Child Care Workers (expiration:12/30/2025). Licensee's adult assistant also has the required vaccines (MMR, Tdap, & flu) and is current with Mandated Reporter Training for Child Care Workers (expiration: 12/30/2025). Copies of updated Mandated Reporter Training for Child Care Workers and current flu vaccine for the Licensee and her adult assistant were provided to LPA during today's inspection. LPA reviewed six children's files and the files were complete with the required forms, including infant sleep logs. LPA reviewed two staff files (Licensee & adult assistant) 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.

LPA 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 wall heaters or stairs 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.

Belinda DevallTELEPHONE: (408) 598-5501
Melvin S MatosTELEPHONE: (408) 334-8554
DATE: 12/04/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/04/2024
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 JOSE CC RO, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME: LUKISH, OKSANA
FACILITY NUMBER: 434414531
VISIT DATE: 12/04/2024
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LPA 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. Licensee states that she does not have any weapons in the home. 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.

LPA discussed the safe sleep regulations with Licensee, Oksana Lukish, 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 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: Belinda DevallTELEPHONE: (408) 598-5501
LICENSING EVALUATOR NAME: Melvin S MatosTELEPHONE: (408) 334-8554
LICENSING EVALUATOR SIGNATURE:

DATE: 12/04/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/04/2024
LIC809 (FAS) - (06/04)
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