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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 115408162
Report Date: 08/11/2022
Date Signed: 08/11/2022 02:38:05 PM

Document Has Been Signed on 08/11/2022 02:38 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
CCLD Regional Office, 520 COHASSET RD., SUITE 170
CHICO, CA 95926
FACILITY NAME:SCHYKERYNEC, EMMY FAMILY CHILD CARE HOMEFACILITY NUMBER:
115408162
ADMINISTRATOR:SCHYKERYNEC, EMMYFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(650) 839-3450
CITY:ORLANDSTATE: CAZIP CODE:
95963
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 0DATE:
08/11/2022
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME BEGAN:
02:00 PM
MET WITH:Emmy SchykerynecTIME COMPLETED:
02:50 PM
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A prelicensing inspection was conducted today by Licensing Program Analyst (LPA), Emilia Grisak in response to a change of location application that was received by the Department on 7/13/22. LPA met with licensee Emmy Schykerynec. The licensee is requesting a license for a capacity of 14. A fire clearance was granted on 8/7/22 for a capacity of 14. The facility will operate Monday-Friday, 7am to 5:30pm. The residence is a three bedroom/two bath single story home. There are two adults and three minors currently living in the home.

The home and yard were toured, and the facility sketch was verified. The following areas will be off limits to children: outdoor shed and two bedrooms. These areas have been made inaccessible by means of door knob covers and lock. There were no poisons present and licensee was advised they must be locked if present. The home is equipped with a working smoke detector and fire extinguisher rated at least 2A10BC. There is no fireplace present. The children will use the backyard as the outdoor play area and the backyard is completely fenced. There is no pool, spa, pond, fountain, or any other body of water on the premises.

Licensee was reminded that all adults 18 and over living in the home, persons who provide care and supervision to children, and staff who have contact with children, 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.
SUPERVISORS NAME: Erin Virrueta
LICENSING EVALUATOR NAME: Emilia Grisak
LICENSING EVALUATOR SIGNATURE: DATE: 08/11/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/11/2022
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, 520 COHASSET RD., SUITE 170
CHICO, CA 95926
FACILITY NAME: SCHYKERYNEC, EMMY FAMILY CHILD CARE HOME
FACILITY NUMBER: 115408162
VISIT DATE: 08/11/2022
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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 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.

Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other important information communication platform.
To receive important licensed-related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-care-licensing/subscribe and select the Child Care option to receive email communication.

The facility is ready to be licensed.

Exit interview conducted and report was reviewed with the licensee Emmy Schykerynec.
SUPERVISORS NAME: Erin Virrueta
LICENSING EVALUATOR NAME: Emilia Grisak
LICENSING EVALUATOR SIGNATURE:

DATE: 08/11/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/11/2022
LIC809 (FAS) - (06/04)
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