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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 103911939
Report Date: 01/21/2025
Date Signed: 01/21/2025 03:29:25 PM

Document Has Been Signed on 01/21/2025 03:29 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
FRESNO CC RO, 1310 E. SHAW AVE,
FRESNO, CA 93710
FACILITY NAME:KOVALENKO, TAGUHI FAMILY CHILD CAREFACILITY NUMBER:
103911939
ADMINISTRATOR/
DIRECTOR:		KOVALENKO, TAGUHIFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(818) 804-0012
CITY:FRESNOSTATE: CAZIP CODE:
93723
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 2DATE:
01/21/2025
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:50 PM
MET WITH:Taguhi KovalenkoTIME VISIT/
INSPECTION COMPLETED:
03:30 PM
NARRATIVE
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On 01/21/2025 Licensing Program Analyst (LPA) Pa Kou Vue conducted an unannounced Annual Required / Random Inspection and was met by Licensee Taguhi Kovalenko. Also present was Licensee’s adult daughter who is also Licensee’s assistant. Licensee stated days and hours of operation are Monday to Saturday 8:30AM – 10:00PM. The home has working telephone service and LPA confirmed the phone number is (818) 804-0012.

LPA toured the home inside and outside and a census was taken. LPA reviewed current facility sketch and confirmed that the living room, dining room, master bedroom and bathroom and hallway bathroom are used for providing care and are accessible to children. All other rooms are off-limits and made inaccessible by use of a baby gate and doorknob spinners.

Licensee has no pets on the premises. Licensee is aware of the safety of children around animals. Licensee understands her liability and responsibility regarding pets.

There is no swimming pool or other bodies of water on the premises.

There are no firearms or ammunitions on the premises. Licensee stated there are no firearms or ammunitions on the premises.

All poisons are kept in a locked storage area. Detergents, cleaning compounds, medication and other hazardous items are made inaccessible.

There are no fireplaces or open face heaters in the home. There is a working fire extinguisher, smoke detector, carbon monoxide detector and adequate heating and ventilation for safety and comfort.

This is a single level home and there are no stairs. Safe toys and play equipment are observed.

Continued 809-C

SUPERVISORS NAME: Juvenal Moctezuma
LICENSING EVALUATOR NAME: Pa Kou Vue
LICENSING EVALUATOR SIGNATURE: DATE: 01/21/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/21/2025
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
Document Has Been Signed on 01/21/2025 03:29 PM - It Cannot Be Edited


Created By: Pa Kou Vue On 01/21/2025 at 02:51 PM
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
, 1310 E. SHAW AVE,
FRESNO, CA 93710

FACILITY NAME: KOVALENKO, TAGUHI FAMILY CHILD CARE
FACILITY NUMBER: 103911939

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/21/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102416.1(a)
Personnel Records
(a) Personnel records shall be maintained on each employee and shall contain the following information:

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on LPA records review and interview, the licensee did not comply with the section cited above in Licensee is missing a valid mandated reporter training which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 01/31/2025
Plan of Correction
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Licensee stated she will submit a copy of a current and valid mandated reporter training to LPA via email by end of business on 01/31/2025.
Deficiency Dismissed
Type B
Section Cited
CCR
102416.1(d)
Personnel Records
(d) All personnel records shall be maintained at the child care home and shall be available to the licensing agency for review.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on LPA observation, records review and interview, the licensee did not comply with the section cited above. FCCH is missing PUB 394 Notification of Parensts' Rights, LIC9148 Earthquake Preparedness and LIC610A Emergency Disaster Plan on Parent Board which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 01/31/2025
Plan of Correction
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Licensee stated copies of the requested documents will be posted. Licensee will submit copies to LPA via email by end of business on 01/31/2025 and pictures that the requested documents are posted on parent board.
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:Juvenal Moctezuma
LICENSING EVALUATOR NAME:Pa Kou Vue
LICENSING EVALUATOR SIGNATURE:
DATE: 01/21/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/21/2025


LIC809 (FAS) - (06/04)
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Document Has Been Signed on 01/21/2025 03:29 PM - It Cannot Be Edited


Created By: Pa Kou Vue On 01/21/2025 at 02:51 PM
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
, 1310 E. SHAW AVE,
FRESNO, CA 93710

FACILITY NAME: KOVALENKO, TAGUHI FAMILY CHILD CARE
FACILITY NUMBER: 103911939

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/21/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102419(d)(1)
Admission Procedures and Authorized Representatives Rights
(d) At the time of acceptance of each child into care, the licensee shall provide the child's parent or authorized representative with a copy of the notice Family Child Care Home Notification of Parent's Rights, LIC 995A (8/06), the Caregiver Background Check Process, LIC 995E (6/05), and the Family child Care Consumer Awareness Information, LIC 9212 (10/05). (1) The licensee shall request the child's parent or authorized representative to sign and date the bottom portion of the notice form LIC 995A (8/06), which acknowledges that the parent or
authorized representative has received and read the LIC 995A. The bottom portion of this form
must be kept in the child’s file as proof that the parent or authorized representative has been
notified of his or her rights and received a copy of the Caregiver background Check Process, LIC
995E (6/05), and the Family Child Care Consumer Awareness Information, LIC 9212 (10/05).

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on LPA records review and interview, the licensee did not comply with the section cited above in child 01 is missing LIC995A which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 01/31/2025
Plan of Correction
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Licensee stated she will submit a copy of the requested form to LPA via email by end of business day on 01/31/2025.

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:Juvenal Moctezuma
LICENSING EVALUATOR NAME:Pa Kou Vue
LICENSING EVALUATOR SIGNATURE:
DATE: 01/21/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/21/2025


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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
FRESNO CC RO, 1310 E. SHAW AVE,
FRESNO, CA 93710
FACILITY NAME: KOVALENKO, TAGUHI FAMILY CHILD CARE
FACILITY NUMBER: 103911939
VISIT DATE: 01/21/2025
NARRATIVE
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Licensee ensures that children in care are always supervised and is aware children shall not be left in parked vehicles. Car seats are used for transportation purposes only and are not used for sleeping children. The outdoor play area in the backyard is fenced and there are no hazards to children present. Capacity as specified on the license is being maintained.

LPA reviewed a sample of children’s files and observed files were not complete with emergency information as required. LPA conducted children’s records review and interview with Licensee. Child 01 is missing LIC995A. Licensee’s Mandated Reporter Training expired. Licensee’s pediatric CPR/First Aid certification expires on 12/2026. A review of records indicates that all employees and/or volunteers have immunization records on file for influenza, pertussis and measles. FCCH is missing PUB 394 Notification of Parents' Rights, LIC9148 Eaarthquake Preparedness and LIC610A Emergency Disaster Plan on Parent Board.

LPA discussed the Community Care Licensing website www.ccld.ca.gov which will provide access to resources such as forms, regulations Provider Information Notices (PINs), and Quarterly Updates. LPA discussed Reporting Requirements as outlined in the regulations (Section 102416.2).

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.

LPA discussed safe sleep regulations with Licensee and discussed the Childcare Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-andresources/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.

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/.

Continued 809-C

SUPERVISORS NAME: Juvenal Moctezuma
LICENSING EVALUATOR NAME: Pa Kou Vue
LICENSING EVALUATOR SIGNATURE:

DATE: 01/21/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/21/2025
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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
FRESNO CC RO, 1310 E. SHAW AVE,
FRESNO, CA 93710
FACILITY NAME: KOVALENKO, TAGUHI FAMILY CHILD CARE
FACILITY NUMBER: 103911939
VISIT DATE: 01/21/2025
NARRATIVE
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Licensee was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain childcare by connecting them to childcare providers and Resource and Referral Agencies (R&Rs) throughout California.

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.

Exit interview conducted and report was reviewed with Licensee Taguhi Kovalenko. During the exit interview, the Licensee confirmed that there are no Registered Sex Offenders living in the facility and LPA verified the RSO profile in FAS.

Per Title 22, Division 12, Chapter 3 of the California Code of Regulations, the following deficiencies are being cited: (see 809-D for further details).

Licensee was provided appeal rights.

This report shall be made available to the public upon request. LIC 9213 A Notice of Site Visit is provided and required to be posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

SUPERVISORS NAME: Juvenal Moctezuma
LICENSING EVALUATOR NAME: Pa Kou Vue
LICENSING EVALUATOR SIGNATURE:

DATE: 01/21/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/21/2025
LIC809 (FAS) - (06/04)
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