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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 073401555
Report Date: 02/18/2025
Date Signed: 02/18/2025 10:54:13 AM

Document Has Been Signed on 02/18/2025 10:54 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
OAKLAND CC RO, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612
FACILITY NAME:ZVENIGORODSKY, LYUBOVFACILITY NUMBER:
073401555
ADMINISTRATOR/
DIRECTOR:		ZVENIGORODSKY, LYUBOVFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(925) 947-1215
CITY:WALNUT CREEKSTATE: CAZIP CODE:
94596
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 3DATE:
02/18/2025
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:27 AM
MET WITH:Zvenigorodsky,LyubovTIME VISIT/
INSPECTION COMPLETED:
11:10 AM
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On 02/18/25 at 8:27am Licensing Program Analysts (LPA) Mario Caro conducted an Unannounced Annual Inspection at Zvenigorodsky,Lyubov Family Day Care Home. LPA met with Licensee, explained the purpose of today’s inspection, and was granted permission to enter the facility. Days and hours of operation are Monday - Friday from 8:00 am - 6:00 pm. Present in the home were Licensee, 1 fingerprint cleared staff, 2 preschoolers, and 1 infant in care. LPA toured all ON-LIMIT areas of the home.

LPA observed sufficient materials, toys, and play equipment for the day care children in the home. Furniture and equipment, such as cribs, mats, feeding chairs, and tables were age appropriate and in good condition. The home is sanitary, orderly, and safe for the day care children. The home is equipped with central heating and ventilation. The home is a two story house with a child safe gate blocking the bottom of the stairs. The entire second floor of the home is off limits. Licensee has a working telephone in the home. LPA observed a fully charged 3A-40-BC fire extinguisher in the back right corner of the playroom and working smoke/carbon monoxide detectors in the every room. All required forms are posted and visible for public view on the back wall of the playroom near the sliding door and on a parent board on the left wall of the kitchen. The Licensee states that she does not have any weapons or pets in the home. The Licensee states that she does not transport children. Licensee's assistant has been working in the facility with the children for three months, but doesn't have proof of her Tdap and MMR immunizations which imposes a potential risk to the health, safety, or personal rights of clients. A Type B deficiency will be cited see deficiency page 809D. Licensee's assistant was missing her preventive health completion certificate a technical violation was issued. Licensee stated they usually conduct emergency drills every three months but her assistant threw away the log a technical violation was issued.
SUPERVISORS NAME: Mayla Mendoza
LICENSING EVALUATOR NAME: Mario Caro
LICENSING EVALUATOR SIGNATURE: DATE: 02/18/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/18/2025
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
OAKLAND CC RO, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612
FACILITY NAME: ZVENIGORODSKY, LYUBOV
FACILITY NUMBER: 073401555
VISIT DATE: 02/18/2025
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 Licensee received a technical violation for having a sleep sac near the infants crib which she explained she uses and thought was ok. LPA Caro showed licensee non restricting sleep sacs with legs that can be used. Licensee received a technical violation for having no employees rights in her assistants file. Licensee's assistant read and signed the document on the spot after LPA Caro printed it for the licensee.

LPA toured the INDOOR spaces of the home which is a two story house

ON LIMITS AREA Level 1: Play room, Nap rooms 1 & 2, Kitchen, Dining, Half Bathroom, Fenced children play yard at the back of the main yard.

OFF LIMITS AREA: Master Bedroom, Master Bathroom, Living room, entire 2nd floor, detached Garage, Spa area in the backyard right side (fenced), Grass area of the yard

ISOLATION AREA: the table area next to the play room

LPA reviewed Licensee's file, 1 staff file, 3 children's files, and obtained a current roster.

Supervision of children was discussed with the Licensee and he understands that he 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.

Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02-CCP. When any IMS is provided, an updated Plan of Operation that includes 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) or (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA are available at: https://www.ada.gov/resources/child-care-centers/.
SUPERVISORS NAME: Mayla Mendoza
LICENSING EVALUATOR NAME: Mario Caro
LICENSING EVALUATOR SIGNATURE:

DATE: 02/18/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/18/2025
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
OAKLAND CC RO, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612
FACILITY NAME: ZVENIGORODSKY, LYUBOV
FACILITY NUMBER: 073401555
VISIT DATE: 02/18/2025
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Licensee was reminded that all adults 18 and over living or working in the home, including employees and volunteers, 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 up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

LPA discussed the safe sleep regulations with licensee and discussed the Child Care Licensing Safe Sleep web page 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.

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.

On 02/18/25 , the California Attorney General - Megan’s Law website was searched for information on sex offenders required to register with local law enforcement under California's Megan's Law. No registered sex offenders were found at the facility addresses. Under state law, some registered sex offenders are not subject to public disclosure; therefore, they may not have been included in this search. However, the Department conducts a monthly cross reference of each address on record for all registered sex offenders against all CCLD facility addresses pursuant to information shared by California DOJ.


In the areas that were evaluated, 1 regulatory type B violation was cited for the following violation: Licensee's assistant hasn't completed her MMR and TDAP immunization's and has been working with children for three months.
SUPERVISORS NAME: Mayla Mendoza
LICENSING EVALUATOR NAME: Mario Caro
LICENSING EVALUATOR SIGNATURE:

DATE: 02/18/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/18/2025
LIC809 (FAS) - (06/04)
Page: 3 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, LYUBOV
FACILITY NUMBER: 073401555
VISIT DATE: 02/18/2025
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A NOTICE OF SITE VISIT WAS GIVEN AND MUST REMAIN POSTED FOR 30 DAYS. Exit interview conducted and report was reviewed with the licensee Zvenigorodsky, Lyubov .
SUPERVISORS NAME: Mayla Mendoza
LICENSING EVALUATOR NAME: Mario Caro
LICENSING EVALUATOR SIGNATURE:

DATE: 02/18/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/18/2025
LIC809 (FAS) - (06/04)
Page: 4 of 5
Document Has Been Signed on 02/18/2025 10:54 AM - It Cannot Be Edited


Created By: Mario Caro On 02/18/2025 at 10:07 AM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612

FACILITY NAME: ZVENIGORODSKY, LYUBOV
FACILITY NUMBER: 073401555

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/18/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
HSC
1597.622(c)
Administration of Child Day Care Licensing
(c) The family day care home shall maintain documentation of the required immunizations or exemptions from immunization, as set forth in this section, in the person's personnel record that is maintained by the family day care home.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on record review, the licensee did not comply with the section cited above in that her assistant has been working with the children for three months and hasn't completed her Tdap and MMR immunizations which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 03/18/2025
Plan of Correction
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Licensee will have her assistant schedule an appointment and get her immunizations for MMR and TDAP by POC date 03/18/2025. Licensee will submit proof to ccld by email or mail.
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:Mayla Mendoza
LICENSING EVALUATOR NAME:Mario Caro
LICENSING EVALUATOR SIGNATURE:
DATE: 02/18/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/18/2025


LIC809 (FAS) - (06/04)
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