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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 573607435
Report Date: 02/11/2020
Date Signed: 02/11/2020 10:28:14 AM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2525 NATOMAS PARK DR. STE 250
SACRAMENTO, CA 95833
FACILITY NAME:GANCHENKO, YELENAFACILITY NUMBER:
573607435
ADMINISTRATOR:GANCHENKO, YELENAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(916) 372-7745
CITY:W. SACRAMENTOSTATE: CAZIP CODE:
95605
CAPACITY:14CENSUS: 3DATE:
02/11/2020
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
09:40 AM
MET WITH:Licensee, Yelena GanchenkoTIME COMPLETED:
10:35 AM
NARRATIVE
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Licensing Program Analyst (LPA) Chayntel Hunter met with Licensee Yelena Ganchenko and her husband for the purpose of an unannounced annual random inspection. All individuals subject to criminal background review have obtained a criminal record clearance. Census at the time of inspection was 3 children. Licensee's operating hours are Monday through Saturday from 1:00 AM. to 6:00 PM.

A health and safety inspection was conducted in all areas accessible to children. Off-limits areas include: First story, Second story, laundry room, kitchen, garage and right side yard. Off limit areas are being made inaccessible to children by gates. LPA observed the required postings, a working phone, 2A10BC fire extinguisher, and functioning smoke and carbon monoxide detectors. LPA observed a restroom and verified that hazardous and toxic items were inaccessible to children in care. LPA observed bedroom with cribs and low to ground beds for children to nap. Licensee stated there are weapons in the home and LPA verified the weapons and ammunition are stored in separate locked cabinets. There is no fireplace in the daycare room. Outdoor play space is fenced. The play equipment appears to be in good repair.

Children's files were reviewed. Emergency information and required immunization records were on file. LPA observed a current roster. Licensee's immunization records for measles (MMR), pertussis (Tdap), and the flu are available in the facility file. Current in-person EMSA pediatric CPR and First Aid certification was verified and expires 09/2020 and Child Care Provider Mandated Reporter was discussed. The training is currently only provided in English at mandatedreporterca.com

LPA verified the annual fees are current.

Report continues on 809-C.
SUPERVISOR'S NAME: Sharon OgbodoTELEPHONE: (916) 263-5721
LICENSING EVALUATOR NAME: Chayntel HunterTELEPHONE: (916) 917-8620
LICENSING EVALUATOR SIGNATURE:

DATE: 02/11/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/11/2020
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, 2525 NATOMAS PARK DR. STE 250
SACRAMENTO, CA 95833
FACILITY NAME: GANCHENKO, YELENA
FACILITY NUMBER: 573607435
VISIT DATE: 02/11/2020
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This provider is not currently providing IMS services to children in care. 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.

LPA provided the Child Care Advocates Program email address: childcareadvocatesprogram@dss.ca.gov, so Licensee can request to be added to the distribution list to receive Quarterly Updates.

This facility evaluation report was reviewed and discussed with Licensee. A Notice of Site Visit was provided and should remain posted for 30 days for parental review. Licensee was encouraged to visit the Department website at WWW.CCLD.CA.GOV for child care updates, current forms, legislation and regulation information. A copy of this report will remain on file for a period of three years for public review upon request. Licensee's signature on this form acknowledges receipt of this form. Appeal rights were provided.



In the areas that were evaluated, no deficiencies were cited during today’s inspection.
SUPERVISOR'S NAME: Sharon OgbodoTELEPHONE: (916) 263-5721
LICENSING EVALUATOR NAME: Chayntel HunterTELEPHONE: (916) 917-8620
LICENSING EVALUATOR SIGNATURE:

DATE: 02/11/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/11/2020
LIC809 (FAS) - (06/04)
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