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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 073409763
Report Date: 05/01/2026
Date Signed: 05/01/2026 03:16:18 PM

Document Has Been Signed on 05/01/2026 03:16 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:POBEREZHNA, IULIIAFACILITY NUMBER:
073409763
ADMINISTRATOR/
DIRECTOR:		IULIIA POBEREZHNAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(650) 834-1687
CITY:PLEASANT HILLSTATE: CAZIP CODE:
94523
CAPACITY: 14TOTAL ENROLLED CHILDREN: 9CENSUS: 5DATE:
05/01/2026
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
02:23 PM
MET WITH:Iuliia PoberezhnaTIME VISIT/
INSPECTION COMPLETED:
03:30 PM
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On 05/01/2026 Licensing Program Analysts (LPAs) Dana Santiago and Jamel Maiwandi met with licensee Iuliia Poberezhna and conducted an UNANNOUNCED ANNUAL VISIT. The home was toured to conduct a Health and Safety Inspection. Present during the inspection were licensee and 1 fingerprint cleared adult. LPAs disclosed the purpose of the inspection and was granted entry into the facility by licensee. This facility plans to operate Monday - Friday, 7:30 am - 5:30 pm, depending on the need for care, but will not exceed 24 hours in one day.

The home is a 4 bedroom house which consists of 4 bedrooms, 2 bathrooms, a kitchen, living room, family room, dining area and back yard.

ON LIMIT: areas are the kitchen, dining room area, living room, family room, first bedroom on the right after the kitchen (nap room), bathroom first door on the left past the living room, and the middle section of the backyard entrance used is through the nap room. Isolation area: couch in the living room. The home is sanitary, safe and orderly, with central heating and ventilation for safety and comfort.

The vents are located on the ceiling of the home. LPAs observed: fully charged fire extinguisher 3A-40-BC, working telephone, first aid supplies, working smoke and carbon monoxide detectors. There is a fireplace in the home that is barricaded with a gate. There are no pets in home. Medicines, cleaning products, and sharp objects are stored inaccessible to children in cabinets. LPAs reminded Licensee that smoking, baby walkers, bouncers, jumpers and similar items are not allowed in family childcare homes. Applicant states there are no firearms or ammunition stored in the home. LPAs observed age-appropriate toys. LPAs did not observe any medications, poisons or hazardous items that would be accessible to children.

Report continues on 809C, Page 2-------------------

NAME OF LICENSING PROGRAM MANAGER: Monica Mathur
NAME OF LICENSING PROGRAM ANALYST: Dana Santiago
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 05/01/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/01/2026
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 4
California Health & Human Services Agency
California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:
  • Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.
  • Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)
Page: 2 of 4
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: POBEREZHNA, IULIIA
FACILITY NUMBER: 073409763
VISIT DATE: 05/01/2026
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OFF LIMIT: areas are the master bedroom/bathroom second door on the left at the end of the hallway, bedroom #1 second door on the right of the hallway, and bedroom #2 third door on the back right of the hallway. The far right section of the backyard entrance accessed through dining room and the far left side of the backyard entrance accessed through the master bedroom.

Outside Space was inspected. Play equipment was observed in safe condition and free of hazards. The yard was fully fenced. Only the middle section of the backyard is on limit, it is adjacent to the bedroom/naproom. There is a jacuzzi located in the off limit area of the backyard which had been inspected 2/10/2026 by the Department. Today the jacuzzi was found to be covered and locked.

Children's files were reviewed and found to be complete. Licensee has current CPR/First Aid Certification which expires 1/2027 and has current Mandated Reporter Training which expires 1/2027. Last disaster drill was conducted 11/28/2025. Sleep checks for children under 24 months were accounted for.

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 and removing any 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.

Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02-CCP. 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: https://www.ada.gov/resources/child-care-centers/.

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.

Report continues on 809c, Page 3----------------------

NAME OF LICENSING PROGRAM MANAGER: Monica Mathur
NAME OF LICENSING PROGRAM ANALYST: Dana Santiago
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 05/01/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/01/2026
LIC809 (FAS) - (06/04)
Page: 3 of 4
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: POBEREZHNA, IULIIA
FACILITY NUMBER: 073409763
VISIT DATE: 05/01/2026
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To improve the quality and value of the new inspection process, a survey may 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 CARE tools, please send email inquiries 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/inspection-process.

During the exit interview, the Licensee Iuliia Poberezhna, confirmed that there are no Registered Sex Offenders living in the home and LPAs completed the RSO profile in FAS.

No deficiencies were cited during today's visit.


A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with the licensee Iuliia Poberezhna.
NAME OF LICENSING PROGRAM MANAGER: Monica Mathur
NAME OF LICENSING PROGRAM ANALYST: Dana Santiago
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 05/01/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/01/2026
LIC809 (FAS) - (06/04)
Page: 4 of 4