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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434415675
Report Date: 05/31/2022
Date Signed: 05/31/2022 12:10:56 PM


Document Has Been Signed on 05/31/2022 12:10 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
CCLD Regional Office, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131



FACILITY NAME:BASHIROVA, LIUDMILAFACILITY NUMBER:
434415675
ADMINISTRATOR:BASHIROVA, LIUDMILAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(408) 657-3157
CITY:SARATOGASTATE: CAZIP CODE:
95070
CAPACITY:14CENSUS: 9DATE:
05/31/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
08:50 AM
MET WITH:Liudmila BashirovaTIME COMPLETED:
12:25 PM
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On 5/31/2022, Licensing Program Analyst (LPA) Pete Hernandez met with Licensee, Liudmila Bashirova, and conducted an unannounced Required 1 year inspection. LPA explained the nature of today's inspection to her. In the home during today's inspection were Licensee, her husband Dimitry Semenov, their minor child, Helper Yuliya Malobava, and 9 preschool age children. There are two adults: applicant, her husband and two minor, one is over 14 living in the home.

Days and hours of operation are Monday thru Friday from 9:00 AM to 6:00 PM. Licensee carries day care insurance.

LPA reviewed 9 children's files and toured the indoor and outdoor areas of the home during today's inspection. Off limit areas in the home: room 2, room 3, master bedroom, master bathroom, one bathroom, kitchen, and garage. Off limit areas outside the home: locked storage shed. LPA observed a properly fenced self - closing swimming pool. Licensee stated that with day care children, she would like to have the pool in use. Licensee understands that children shall be supervised at all times when using the backyard. Licensee has a fully charged 3A40BC fire extinguisher, working smoke detector, working carbon monoxide detector, and fire pull stations. The back yard is fenced backyard. Applicant stated that there are weapons in the home. LPA observed one firearm locked up in safe separate from ammunition. Cleaning products, medications and sharp objects were inaccessible to children. LPA informed Licensee that smoking, baby walkers, bouncers, jumpers and similar items are not allowed in family child care homes.
REPORT CONTINUED ON THE FOLLOWING PAGE (PAGE #2 - REPORT DATED 5/31/2022:
SUPERVISOR'S NAME: Joel SeguraTELEPHONE: (408) 324-2155
LICENSING EVALUATOR NAME: Pietro HernandezTELEPHONE: (408) 598-9250
LICENSING EVALUATOR SIGNATURE:
DATE: 05/31/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/31/2022
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 4


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: BASHIROVA, LIUDMILA
FACILITY NUMBER: 434415675
VISIT DATE: 05/31/2022
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CONTINUATION OF PREVIOUS PAGE (PAGE #1 - REPORT DATED 5/31/2022):

LPA informed the Licensee of the applicable civil penalties for those adults who have not received fingerprint clearances, are not associated to the license and who come in contact with or provide care and supervision to the children. Penalty amounts: $100.00 per person per day, minimum of $100.00 to a maximum of $500.00 per person for an initial violation and a minimum of $100.00 to a maximum of $3000.00 per person for any subsequent violation within a 12 month period.

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: http://www.ada.gov/childqanda.htm

The Licensee states that she does not transport children and understands that children cannot be left in parked vehicles unattended at any time. Licensee understands that children's personal rights should not be violated; including no corporal punishment. Isolation of sick child, requirements for reporting suspected child abuse, unusual incidents/injuries, heat-related illnesses, and requirements for assistant/substitute were also discussed.


Supervision of children was discussed with the Licensee. Licensee understands that she must be present in the home at least 80 percent of the hours the day care is in operation and ensure that the children are supervised at all times. The Licensee understands her capacity options. The Licensee states that she does not transport children and understands that children cannot be left in parked vehicles unattended at any time. Licensee understands that children's personal rights should not be violated; including no corporal punishment. Isolation of sick child, requirements for reporting suspected child abuse, unusual incidents/injuries, heat-related illnesses, and requirements for assistant/substitute were also discussed.
SUPERVISOR'S NAME: Joel SeguraTELEPHONE: (408) 324-2155
LICENSING EVALUATOR NAME: Pietro HernandezTELEPHONE: (408) 598-9250
LICENSING EVALUATOR SIGNATURE:

DATE: 05/31/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/31/2022
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, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME: BASHIROVA, LIUDMILA
FACILITY NUMBER: 434415675
VISIT DATE: 05/31/2022
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Last fire drill was conducted on 4/10/2022. LPA informed Licensee that fire/disaster drills must be practiced at least once every six months and documented. Licensee is compliant.

Licensee's Mandated Reporter certificate is not current and scheduled to expired 8/12/21.
Licensee's Helper Yuliya Malobava does not have a Mandated Reporter Certificate available.

Licensee has a current CPR/ First Aid Certificate that expires 8/14/23.

LPA went over Reg 102425(j) and (j)(2)(D) regarding infant care and LIC 9227 (Infant Sleeping Plan). LPA Provided a copy. The provider shall supervise infants while they are sleeping.

LPA observed all required postings on the wall next to the front door.

Type A language: Upon the issuance of Type A citations, a copy of the Facility Evaluation Report LIC809 has to be posted on the wall and a copy to be given to all parents of currently and newly enrolled children for next 12 months. In addition, copy of LIC9224 Statement Acknowledging Receipt of Licensing Reports need to be signed and kept in child files.

A deficiency is being cited based on the LPA observation, interviews conducted, and record review in accordance with the California Code of Regulations, Title 22. A copy of this report and appeals rights were discussed and left with the Licensee, Liudmila Bashirova, whose signature on this form confirm receipt of these documents.

A NOTICE OF SITE VISIT WAS ISSUED, POSTED NEAR THE ENTRANCE TO THE FACILITY, AND MUST REMAIN POSTED FOR 30 DAYS.
SUPERVISOR'S NAME: Joel SeguraTELEPHONE: (408) 324-2155
LICENSING EVALUATOR NAME: Pietro HernandezTELEPHONE: (408) 598-9250
LICENSING EVALUATOR SIGNATURE:

DATE: 05/31/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/31/2022
LIC809 (FAS) - (06/04)
Page: 3 of 4
Document Has Been Signed on 05/31/2022 12:10 PM - It Cannot Be Edited

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: BASHIROVA, LIUDMILA
FACILITY NUMBER: 434415675

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/31/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
HSC
1596.8662(b)(1)
Administration of Child Day Care Licensing
(1) On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child day care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training provided pursuant to paragraphs (2) and (3) of subdivision (a), and shall complete renewal mandated reporter training every two years following the date on which he or she completed the initial mandated reporter training.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on LPA's observation, interview, and record review, the licensee did not comply with the section cited above. Licensee and her Helper (S1) did not have current mandated reporter Certificates which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 07/11/2022
Plan of Correction
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Licensee and Assistant Provider will complete the training and send a copy of the Certificate of Completion to Licensing Office. LPA provided the web address https://www.mandatedreporterca.com to access the required training.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME: Joel SeguraTELEPHONE: (408) 324-2155
LICENSING EVALUATOR NAME: Pietro HernandezTELEPHONE: (408) 598-9250
LICENSING EVALUATOR SIGNATURE:
DATE: 05/31/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/31/2022
LIC809 (FAS) - (06/04)
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