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

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 070208816
Report Date: 04/04/2024
Date Signed: 04/04/2024 12:05:36 PM

Document Has Been Signed on 04/04/2024 12:05 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
OAKLAND CC RO, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612
FACILITY NAME:ZVENIGORODSKY, FAINA & SEMYONFACILITY NUMBER:
070208816
ADMINISTRATOR/
DIRECTOR:		ZVENIGORODSKY, FAINAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(925) 945-0454
CITY:WALNUT CREEKSTATE: CAZIP CODE:
94596
CAPACITY: 12TOTAL ENROLLED CHILDREN: 11CENSUS: 6DATE:
04/04/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:45 AM
MET WITH:Faina ZvenigorodskyTIME VISIT/
INSPECTION COMPLETED:
12:30 PM
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 4/4/2024, Licensing Program Analysts (LPAs) Brindha Govindasamy and Monica Mathur conducted an unannounced Annual Inspection at Faina & Semyon Zvenigorodsky Family Day Care Home. LPAs met with Licensee, Faina Zvenigorodsky and explained the purpose of today’s inspection. LPAs was granted permission to enter the facility. Present in the home were Licensees, 2 Assistants and 6 day care children (6 preschool age children). Days and hours of operation are Monday - Friday from 8:00 AM- 6:00 PM.

LPAs toured the INDOOR spaces of the home with Licensee
In Use Areas: 3 bedrooms, 2 bathrooms, kitchen, dining, living area
Off Limit Areas: Entire 2nd Floor, Laundry Room
OUTDOOR space was inspected.
In Use Areas: Fenced, enclosed play yard
Off Limit Areas: Back yard
The outdoor space and play equipment were observed to be maintained in safe condition and free of hazards. Heavy structure was secured to the ground. The yard was fenced and there were no bodies of water.
LPAs observed sufficient materials, toys, and play equipment for the day care children in the home. Children were engaged in various activities under the supervision of the Licensee and Helpers. All detergents, cleaning compounds, medications, and other similar items are inaccessible to children. Furniture and equipment were age appropriate and in good condition. The home is sanitary, orderly, and safe for the day care children. LPA did not observe any wall heaters or fireplace in the home. The stairs in the home is gated and made inaccessible to children to access the second floor. The Licensee has a working telephone in the home.

Continue to page 2

SUPERVISORS NAME: Sherelle Johnson
LICENSING EVALUATOR NAME: Brindha Govindasamy
LICENSING EVALUATOR SIGNATURE: DATE: 04/04/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/04/2024
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 5
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
OAKLAND CC RO, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612
FACILITY NAME: ZVENIGORODSKY, FAINA & SEMYON
FACILITY NUMBER: 070208816
VISIT DATE: 04/04/2024
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
Page 2
LPA observed a fully charged 3A40BC fire extinguisher and working smoke/ carbon monoxide detectors. The Licensee states that she does not have any weapons or pets in the home. Last fire/disaster drill was completed on 02/2024. All required postings were observed posted on a wall.

Children's, Licensee and Assistant's files reviewed. Licensee’s Mandated Reporter Training expires on 6/26/2025. Certifications for CPR/First Aid expire on 05/2025.

Supervision of children was discussed with the Licensee and she understands that she must be present in the home during 80% of the operating hours of the day care and ensure that the children are supervised at all times. During today's inspection licensee agreed to drop co-licensee (spouse). She will be the sole licensee.

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 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.


Continue to page 3
SUPERVISORS NAME: Sherelle Johnson
LICENSING EVALUATOR NAME: Brindha Govindasamy
LICENSING EVALUATOR SIGNATURE:

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

DATE: 04/04/2024
LIC809 (FAS) - (06/04)
Page: 2 of 5
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
OAKLAND CC RO, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612
FACILITY NAME: ZVENIGORODSKY, FAINA & SEMYON
FACILITY NUMBER: 070208816
VISIT DATE: 04/04/2024
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
Page 3
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.

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.



In the areas that were evaluated, no regulatory violations were observed. Technical Violations were given for staff immunization records and Mandated Reporter.

A NOTICE OF SITE VISIT WAS GIVEN AND MUST REMAIN POSTED FOR 30 DAYS. Exit interview conducted and report was reviewed with the licensee Faina Zvenigorodsky.
SUPERVISORS NAME: Sherelle Johnson
LICENSING EVALUATOR NAME: Brindha Govindasamy
LICENSING EVALUATOR SIGNATURE:

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

DATE: 04/04/2024
LIC809 (FAS) - (06/04)
Page: 3 of 5