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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 070208816
Report Date: 05/15/2024
Date Signed: 05/15/2024 09:08:51 AM

Document Has Been Signed on 05/15/2024 09:08 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, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612
FACILITY NAME:ZVENIGORODSKY, FAINAFACILITY NUMBER:
070208816
ADMINISTRATOR/
DIRECTOR:		ZVENIGORODSKY, FAINAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(925) 945-0454
CITY:WALNUT CREEKSTATE: CAZIP CODE:
94596
CAPACITY: 12TOTAL ENROLLED CHILDREN: 12CENSUS: 8DATE:
05/15/2024
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:30 AM
MET WITH:Faina ZvenigorodskyTIME VISIT/
INSPECTION COMPLETED:
10:30 AM
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On 5/15/24 Licensing Program Analyst (LPA) Monica Mathur conducted an unannounced Case Management inspection at Faina Zvenigorodsky's childcare home and met with Licensee, Faina and explained purpose of inspection.

During annual inspection on 4/4/24 Licensee was reminded to keep all staff files updated with required documents. Purpose of today's inspection is to verify all paperwork has been obtained and kept in files. LPA reviewed files and paperwork is complete.

Present during inspection were Licensee, 2 Assistants and 8 children (all preschool age). Adults present have background clearances and facility is in ratio compliance.

No deficiency was cited today. This report was reviewed with Licensee, Faina Zvenigorodsky. A Notice of Site Visit was issued, must be posted near the entrance for 30 days.
SUPERVISORS NAME: Sherelle Johnson
LICENSING EVALUATOR NAME: Monica Mathur
LICENSING EVALUATOR SIGNATURE: DATE: 05/15/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/15/2024
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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