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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 195700370
Report Date: 12/12/2024
Date Signed: 12/12/2024 02:40:09 PM

Document Has Been Signed on 12/12/2024 02:40 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
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME:SKRYPNYK & SHEVCHUK FAMILY CHILD CAREFACILITY NUMBER:
195700370
ADMINISTRATOR/
DIRECTOR:		A.SKRYPNYK & L.SHEVCHUKFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(818) 946-4979
CITY:CANOGA PARKSTATE: CAZIP CODE:
91303
CAPACITY: 14TOTAL ENROLLED CHILDREN: 11CENSUS: 9DATE:
12/12/2024
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
02:11 PM
MET WITH:Anton SkrypnykTIME VISIT/
INSPECTION COMPLETED:
02:55 PM
NARRATIVE
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Licensing Program Analysts (LPAs) Tatiana Bickham and Dawn Dowling conducted an unannounced Case Management Visit to this facility. While conducting an alternate visit at Srkypnyk & Schevchuk Family Child Care on 12/12/24, the following deficiencies were observed.

At 1:30 PM LPAs observed 9 children napping in the converted garage. Licensee's were informed during pre-licensing inspection children can not eat or nap in the garage. Also noted on the child-care's fire clearance it states "no napping or eating in the garage." Licensee stated they are aware they cannot use the garage for napping and stated it was only temporary.

The following deficiencies were observed to be in violation of California code of Regulations, Title 22, Division 12 (refer to 809D).

Upon receipt of this report, the Licensee shall post the Notice of Site Visit and any Licensing report
documenting a type “A” deficiency. The report and the Notice of Site Visit shall be posted for 30 consecutive
days. Failure to maintain posting as required, will result in an immediate $100 civil penalty. A copy of this
report shall be provided to the parent/guardian of children currently enrolled by the next business day or
immediately upon return. A copy of this report shall also be provided to the parent/guardian of any newly
enrolled children for the next 12 months (1 year). The Acknowledgement of Receipt (LIC 9224 form must be
maintained in each child’s file immediately upon receipt from parent. Licensee was provided with a copy of
the Acknowledgement of Receipt of Licensing Reports (LIC 9224) Form during this visit.

A notice of site visit was given and must remain posted for 30 days.
Exit interview was conducted and report was reviewed with the Director and Appeals Rights provided.
SUPERVISORS NAME: Raul Navarro
LICENSING EVALUATOR NAME: Tatiana Bickham
LICENSING EVALUATOR SIGNATURE: DATE: 12/12/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/12/2024
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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Document Has Been Signed on 12/12/2024 02:40 PM - It Cannot Be Edited


Created By: Tatiana Bickham On 12/12/2024 at 02:22 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
, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME: SKRYPNYK & SHEVCHUK FAMILY CHILD CARE
FACILITY NUMBER: 195700370

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/12/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
12/13/2024
Section Cited
CCR
102423(2)(a)

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2- Each child receiving services from a family child care home shall have certain rights that shall not be waived or abridged by the licensee regardless of consent or authorization from the child's authorized representative. These rights include, but are not limited to, the following: (a) To receive safe, healthful, and comfortable accommodations, furnishings, and equipment
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Licensee agrees to move all napping equipment from the garage. Licensee agrees to write a short statement that they understands this Regulation and agrees not to use the garage for eating or napping, or primary day care. Statement to be submitted by 12/16/24. Napping equipment to be moved by 12/13/24.
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This requirement was not met as evidenced by: LPAs observed 9 children napping inside of the garage.
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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:Raul Navarro
LICENSING EVALUATOR NAME:Tatiana Bickham
LICENSING EVALUATOR SIGNATURE:
DATE: 12/12/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/12/2024


LIC809 (FAS) - (06/04)
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