195700088-10-31-2024-58-CC-SORS-DAKPPY-20241031113020

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 195700088
Report Date: 10/31/2024
Date Signed: 10/31/2024 11:30:29 AM

Document Has Been Signed on 10/31/2024 11:30 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
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME:	AZHEUSKI & AZHEUSKAYA FAMILY CHILD CARE		FACILITY NUMBER:	195700088
ADMINISTRATOR/ DIRECTOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY: 8	TOTAL ENROLLED CHILDREN: 6	CENSUS: 4	DATE:	10/31/2024
TYPE OF VISIT:	Case Management - Licensee Initiated	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	08:15 AM
MET WITH:	ANDREI AZHEUSKI & ALESIA AZHEUSKAYA		TIME VISIT/ INSPECTION COMPLETED:	11:29 AM

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On 10/31/2024 Licensing Program Analyst (LPA) Suzette Ornelas conducted an unannounced visit for the purpose of an increase of capacity inspection at 14760 ARCHWOOD STREET VAN NUYS CA 91045. The purpose of the meeting was to ensure that health, safety and personal rights as required by Title 22 Regulations governing California Family Child Care homes will be met by the Licensees, ANDREI AZHEUSKI & ALESIA AZHEUSKAYA who guided LPA on a tour of the facility.

The facility has been licensed for Small (8) Family Child Care home license since July of 2023. The licensee is applying for an increase of capacity; Large Family Child Care Home license for a maximum capacity of 14. The Fire clearance was granted on 10/04/2024 by LA City Fire Prevention Bureau. Present during today's inspection were Licensees (2), Assistant, Licensees mother and 4 children. The day care operates Monday through Friday from 7:30 AM to 6:00 PM. Family members residing in the home include 4 adults. Adults living in the home have criminal record clearance and are associated to the License. The licensees have completed preventive health and safety/Childhood Nutrition/ Lead Exposure Prevention and Mandated Reporter training. The licensee has current pediatric CPR/First Aid training completed on 09/2024.

Home is a 1-story dwelling with 5 bedrooms, 4 bathrooms, one living room with access to the attached garage, one kitchen/dining room and family room. The home has locked gates on both sides of the home leading to the backyard.

The property was inspected inside and out for safety, comfort, cleanliness, telephone service, heating and ventilation, poisons, detergents/cleaning compounds, medication and hazardous items that can pose a danger to children. LPA observed age appropriate safe toys, equipment, crib and napping equipment in the home.

Children will utilize Living Room for child care activities /nap as needed and nap in Room 1 and 2. Licensee provides meals and snacks. Applicant stated there are no weapons or firearms in the home. LPA did not observe any during this inspection. There is a fireplace in the home that has been screened and made inaccessible to children in care.

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SUPERVISORS NAME: Raul Navarro
LICENSING EVALUATOR NAME: Suzette Ornelas
LICENSING EVALUATOR SIGNATURE:	DATE: 10/31/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/31/2024

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
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME: AZHEUSKI & AZHEUSKAYA FAMILY CHILD CARE	FACILITY NUMBER: 195700088
	VISIT DATE: 10/31/2024

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The outdoor area/back yard is fenced in. Licensee is stating that when children are having outside time she will ensure 100% supervision and never leave children unattended. There is a pool, spa or other bodies of water on the premises that has a fence that is at least 5 feet high, has 2 gates that open away from the pool and self latch. LPA provided licensees with information on Water Certification Course obtainable from the Red Cross Website and a safety plan signed by parents and kept in children's file for water play. Gates remain locked at all times. Children's outdoor play equipment and toys are age appropriate and in good repair.

Licensee has the required documents posted on the parent board. LPA reviewed children's files. The bathroom was inspected for inaccessibility of chemicals/toxins and other potential hazards to children in care. The Fire Extinguisher (2-A:10-B:C) is mounted on the wall in the living room. There is a working smoke/Carbon Monoxide detectors located inside the unattached play room and inside the home. The licensee has installed the fire alarm that is required for large Family Child Care Homes. An emergency fire/disaster drill has been completed and documented within the last 6 months

Licensee was informed of responsibility to report suspected Child Abuse by calling the Child Abuse Hot-line at 1-800-540-4000. Also call the Community Care Licensing office and follow up with a written Unusual Incident/Injury Report (LIC 624B)

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.

Incidental Medical Services (IMS) are not currently being provided. Licensee is aware that an IMS plan is required to be submitted to the licensing office if they provide any of these services. Information regarding Americans with Disability Act (ADA) can be obtained by contacting US Department of Justice toll free ADA Information line at (800) 514-0301(voice), (800) 514-0383 (TDD) and website link https://www.ada.gov/childqanda.htm.
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SUPERVISORS NAME: Raul Navarro
LICENSING EVALUATOR NAME: Suzette Ornelas
LICENSING EVALUATOR SIGNATURE:	DATE: 10/31/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/31/2024

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
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME: AZHEUSKI & AZHEUSKAYA FAMILY CHILD CARE	FACILITY NUMBER: 195700088
	VISIT DATE: 10/31/2024

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Mandated Reporter Required. Licensee was made aware of AB 1207, commencing January 1, 2018, requires all licensed providers, Applicants, directors and employees to complete training as specified on their mandated reporter duties and to renew their training every two years. Volunteers are encouraged but not required to take the training. Website: www.mandatedreporterca.com Health & Safety Code 1596.8662.

Licensing Reports Given to Parents Required. Upon receipt by the licensee, licensees are to provide to parents/guardians the following: Copies of any licensing reports that document a Type A citation- this includes facility visits and substantiated complaint investigations; copy of licensing documents pertaining to a conference conducted by a local licensing agency management representative and the licensee of this family child care home in which issues of noncompliance are discussed or copies of a summary of an accusation indicating the Department's intent to revoke the facility's license. Copies of any of the above licensing documents the licensee has received in the prior 12 months shall be provided to parents/guardians of newly enrolled child at the facility. Assembly Bill 633.
The licensee may find additional information and forms on the Department’s website at www.ccld.ca.gov including information on the Live Scan application (LIC 9163). Appointments can be made for Live Scan at 1-800-315-4507.
To receive important license 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.

LPAs and Licensee discussed the Community Care Licensing website www.ccld.ca.gov which will provide access to Provider Information Notices (PINs), Quarterly Updates, COVID-19 Information and Resources, Mandated Reporter Training, Safe Sleep in Child Care, Lead Poisoning Facts, Forms and Regulations.

No Deficiencies are being cited on this date. Capacity increase is pending managerial review.
Exit interview conducted and report was reviewed with Licensees, ANDREI AZHEUSKI & ALESIA AZHEUSKAYA.

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SUPERVISORS NAME: Raul Navarro
LICENSING EVALUATOR NAME: Suzette Ornelas
LICENSING EVALUATOR SIGNATURE:	DATE: 10/31/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/31/2024

LIC809 (FAS) - (06/04)

Page: 4 of 4

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME: AZHEUSKI & AZHEUSKAYA FAMILY CHILD CARE	FACILITY NUMBER: 195700088
	VISIT DATE: 10/31/2024

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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.

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.

During the exit interview, the Licensee, confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.

Shaken Baby Syndrome Awareness & SIDS. Applicant was reminded never shake a baby to prevent Shaken Baby Syndrome. LPA discussed Safe Sleep Regulations with Applicant: one crib or play yard for each infant in care; cribs and play yards are kept free from all loose articles and objects while infants are sleeping; no objects hanging above or attached to the crib or play yard. Infants are not swaddled while in care. Provider physically checks on sleeping infants every fifteen minutes and documents any signs of distress, which includes but is not limited to flushed skin color, increase in body temperature, restlessness and labored breathing. Infants can be visually observed through an open door if sleeping in a separate room. Individual Infant Sleeping Plan is completed and in file for each infant up to 12 months of age. Infants up to 12 months of age are placed on their backs for sleeping. Applicant was also reminded that only children eating may be in high chairs and that car seats are utilized only for transportation.

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SUPERVISORS NAME: Raul Navarro
LICENSING EVALUATOR NAME: Suzette Ornelas
LICENSING EVALUATOR SIGNATURE:	DATE: 10/31/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/31/2024

LIC809 (FAS) - (06/04)

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