073408390-8-21-2023-02-CC-CWAS-CUWNK3-20230821103117

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 073408390
Report Date: 08/21/2023
Date Signed: 08/21/2023 10:31:24 AM

Document Has Been Signed on 08/21/2023 10:31 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:	AFINOGENOVA, ALLA		FACILITY NUMBER:	073408390
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY: 8	TOTAL ENROLLED CHILDREN: 8	CENSUS: 4	DATE:	08/21/2023
TYPE OF VISIT:	Case Management - Licensee Initiated	UNANNOUNCED	TIME BEGAN:	08:40 AM
MET WITH:	Alla Afinogenova		TIME COMPLETED:	11:00 AM

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On 08/21/2023 at 8:40 AM, Licensing Program Analyst (LPA) Christina Watts conducted an announced case management – licensee initiated for Alla Afinogenova's small family child care home. LPA met with licensee and guided analyst on a tour of the facility. During today's inspection, there were 4 children in care (2 preschool aged children and 2 infants) and 8 children enrolled. Family members residing in the home are licensee and licensee's daughter. Licensee and all adults in the home and caring for children have Criminal Record Clearance. Facility hours of operations are Monday - Friday from 8:00 AM - 5:00 PM.

Licensee completed her Pediatric CPR/First Aid which expires 02/2025 and Mandated Reporter certificate which expires 02/2025. Licensee has documentation maintained for Measles, Pertussis Immunization's, Influenza Opt-Out statement for the current flu season. The licensee provided proof of control of property. There is a working telephone in the home. Fire clearance request was approved on 07/12/2023 by Contra Costa County Fire Protection District.

This is a two story home which consists of 3 bedrooms, 3 bathrooms, kitchen/dining room, living room, family room, upstairs loft, laundry room, attached garage and backyard.
The children on limits areas: Living room, family room, bedroom on the right side (nap room), bathroom inside bedroom, half bathroom and left area of backyard. Applicant will be utilizing the family room as the main room for her day care.
Areas off limits include: the entire second floor which includes 2 bedrooms, 1 bathroom and upstairs loft, middle and right area of backyard, laundry room and attached garage.
The LPA toured all areas used by children during this visit.

*CON'T ON PAGE 2*

SUPERVISORS NAME: Sherelle Johnson
LICENSING EVALUATOR NAME: Christina Watts
LICENSING EVALUATOR SIGNATURE:	DATE: 08/21/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/21/2023

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
CCLD Regional Office, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612

FACILITY NAME: AFINOGENOVA, ALLA	FACILITY NUMBER: 073408390
	VISIT DATE: 08/21/2023

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*PAGE 2*

Per licensee, there are no firearms in the home. LPA observed the fireplace in the family room which is made inaccessible to children in care. LPA observed a fully charged 3A40BC fire extinguisher, working smoke and carbon monoxide detector. Medicines, cleaning products, sharp objects are stored inaccessible to children. LPA reminded that smoking, baby walkers, bouncers, jumpers and similar items are not allowed in family child care homes. LPA observed stairs in the home that are made inaccessible to children in care

OUTDOOR SPACE: LPA toured the outdoor area and observed a fully fenced and safe backyard for children in care. Facility only uses the left area of backyard for outdoor activity. LPA observed age appropriate toys for children to play with. LPA did not observe any bodies of water.

LPA discussed and reminded licensee day care needs to be operated within the limitations and capacity of a Large Family Child Care Home with regards to ratios and that Licensee has to be present in the day care for 80% of the operation hours. All documents have been reviewed for the increase of capacity application. The Licensee was reminded that an assistant is needed with a large family child care home license, and whenever an assistant is not present, the licensee will comply with the capacity requirements for a small family child care home. To receive important licensed related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-carelicensing/subscribe and select the Child Care option to receive email communication.

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.

Licensee was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

CON'T ON PAGE 3*

SUPERVISORS NAME: Sherelle Johnson
LICENSING EVALUATOR NAME: Christina Watts
LICENSING EVALUATOR SIGNATURE:	DATE: 08/21/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/21/2023

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, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612

FACILITY NAME: AFINOGENOVA, ALLA	FACILITY NUMBER: 073408390
	VISIT DATE: 08/21/2023

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*PAGE 3*

Effective as of 08/21/2023, increase of capacity application has been approved.

During today's inspection, there were no violation observed.

Exit interview conducted and report was reviewed with the licensee, Alla Afinogenova. A notice of site visit was given and must remain posted for 30 consecutive days.

SUPERVISORS NAME: Sherelle Johnson
LICENSING EVALUATOR NAME: Christina Watts
LICENSING EVALUATOR SIGNATURE:	DATE: 08/21/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/21/2023

LIC809 (FAS) - (06/04)

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