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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197411145
Report Date: 06/08/2026
Date Signed: 06/08/2026 02:53:26 PM

Document Has Been Signed on 06/08/2026 02:53 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:DVORSKAYA ALTERNATIVE SCHOOLFACILITY NUMBER:
197411145
ADMINISTRATOR/
DIRECTOR:		MUKHURADZE, JINAFACILITY TYPE:
850
ADDRESS:1317 N. CRESENT HEIGHTS BLVD.TELEPHONE:
(323) 822-7999
CITY:WEST HOLLYWOODSTATE: CAZIP CODE:
90046
CAPACITY: 41TOTAL ENROLLED CHILDREN: 13CENSUS: 6DATE:
06/08/2026
TYPE OF VISIT:Required - 3 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:14 AM
MET WITH:Igor DvorskyTIME VISIT/
INSPECTION COMPLETED:
03:00 PM
NARRATIVE
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On 06/08/2026 Licensing Program Analyst (LPA) DeCondia Ferguson conducted an unannounced Required 3-Year Inspection at Dvorskaya Alternative School DBA: West Hollywood College Preparatory School located at 1317 N. Cresent Heights Blvd. Los Angeles, CA 90046 and met with Administrator Igor Dvorsky and discussed the purpose of the visit. The LIC125 Entrance Checklist was provided to help facilitate the inspection. The Administrator guided LPA on a tour of the facility inside and out. Days and hours of operation are Monday through Friday 08:00 a.m. to 06:00. Entrance to the facility is located on Fountain Blvd., on the side of the facility.

LPA observed all required postings in a prominent area. LPA observed 6 children and 2 staff, and 1 Administrator. All children are under supervision, including visual supervision, of a teacher at all times. Capacity and limitations as specified on the license are being maintained in accordance with Title 22 regulations. A walk through of the classroom and outside areas was conducted. LPA observed 3 licensed preschool classrooms on the premises. All areas identified on the Facility Sketch were inspected.

Classrooms were observed to be clean, well-organized, and free of potential hazards. Furniture was in good repair and equipped with age-appropriate furniture, toys, and materials. Trash cans in all classrooms had tight-fitting lids, and all cleaning supplies, disinfectants, and other hazardous materials were stored securely in locked cabinets, inaccessible to children. All floors were observed to be clean and safe. All materials accessible to children were observed to be toxic-free. LPA observed children’s belongings are stored in cubbies in each classroom.

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NAME OF LICENSING PROGRAM MANAGER: Raul Navarro
NAME OF LICENSING PROGRAM ANALYST: Decondia Ferguson
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 06/08/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/08/2026
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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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)
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Document Has Been Signed on 06/08/2026 02:53 PM - It Cannot Be Edited


Created By: Decondia Ferguson On 06/08/2026 at 12:12 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: DVORSKAYA ALTERNATIVE SCHOOL
FACILITY NUMBER: 197411145

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/08/2026

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
HSC
1596.8662(b)(1)
Administration of Child Day Care Licensing
(1) On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child day care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training provided pursuant to paragraphs (2) and (3) of subdivision (a), and shall complete renewal mandated reporter training every two years following the date on which he or she completed the initial mandated reporter training.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation and record review, the licensee did not comply with the section cited above in 5 of 5 personnel records did not complete the mandated reporter training, which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 06/22/2026
Plan of Correction
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Administrator will have all staff complete Mandated Reporter training and submit to the Department by planof correction date.
Type B
Section Cited
HSC
1596.7995(a)(1)
General Provisions and Definitions
(1) Commencing September 1, 2016, a person shall not be employed or volunteer at a day care center if he or she has not been immunized against influenza, pertussis, and measles. Each employee and volunteer shall receive an influenza vaccination between August 1 and December 1 of each year.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation and record review, the licensee did not comply with the section cited above in 2 of 5 personnel did not been immunization against influenza or declination on file, and 4 of 5 personnel did not have immunizations against pertussis, and measles on file, which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 06/22/2026
Plan of Correction
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Administrator will have Naira Nazaryan and Jina Mukhuradze submit verification of influenza vaccine or signed declination waiving the flue vaccine to the department by plan of correction date. Administrator will also submit immunization documentation for Naira Nazaryan, Varvara Glukhova, Oksana Yurcheneko, and Elina Karavaeva to the Department by plan of correction date
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
Raul Navarro
NAME OF LICENSING PROGRAM MANAGER:
Decondia Ferguson
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 06/08/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/08/2026


LIC809 (FAS) - (06/04)
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Document Has Been Signed on 06/08/2026 02:53 PM - It Cannot Be Edited


Created By: Decondia Ferguson On 06/08/2026 at 12:12 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: DVORSKAYA ALTERNATIVE SCHOOL
FACILITY NUMBER: 197411145

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/08/2026

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
101216(g)(2)
Personnel Requirements
(2) Each person specified in (g) above shall have a health-screening report signed by the person performing the screening. This report shall indicate the following:

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on obsservation and record review, the licensee did not comply with the section cited above in Staff #2 did not have a Health Screening Report (LIC503) in their personnel file as required, which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 06/22/2026
Plan of Correction
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Administrator will have staff #2 Naira Nazaryan submit a Health Screening report to the Department by planof correction date.
Type B
Section Cited
CCR
101216.1(c)(1)
Teacher Qualifications and Duties
(c) To be a fully qualified teacher, a teacher shall have one of the following: (1) Twelve postsecondary semester or equivalent quarter units in early childhood education or child development completed, with passing grades, at an accredited or approved college or university; and at least six months of work experience in a licensed child care center or comparable group child care program.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation and record review, the licensee did not comply with the section cited above in Staff #3 and #4 did not have documentation of educational qualifications in their personnel files, which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 06/22/2026
Plan of Correction
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Administrator will provided educational records (transcripts) of Varvara Glukhova and Oksana Yurcheneko to the Department by plan of correction date.
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
Raul Navarro
NAME OF LICENSING PROGRAM MANAGER:
Decondia Ferguson
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 06/08/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/08/2026


LIC809 (FAS) - (06/04)
Page: 4 of 12
Document Has Been Signed on 06/08/2026 02:53 PM - It Cannot Be Edited


Created By: Decondia Ferguson On 06/08/2026 at 12:12 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: DVORSKAYA ALTERNATIVE SCHOOL
FACILITY NUMBER: 197411145

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/08/2026

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
101220(a)
Child's Medical Assessments
(a) Prior to, or within 30 calendar days following the enrollment of a child, the licensee shall obtain a written medical assessment of the child. This medical assessment enables the licensee to assess whether the center can provide necessary health-related services to the child.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation and record review, the licensee did not comply with the section cited above in 4 out of 6 children records did not contain required physician's report. Therefore the licensee failed to maintain complete records for children in care which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 06/22/2026
Plan of Correction
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Administrator will obtain missing Physician's Report for identified children (Roman Jacob, Nikita Akhmetov, Geovaanni Siskovich, Ilia Antomokhim) and submit to the Department by plan of correction date
Type B
Section Cited
CCR
101220.1(g)


This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation and record review, the licensee did not comply with the section cited above in 2 out of 6 children's records did not contain documentation of required immunizations which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 06/22/2026
Plan of Correction
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Administrator will obtain missing immunization records from identified children (Roman Jacob, Geovaanni Siskovich) and submit to Department by plan of correction date.
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
Raul Navarro
NAME OF LICENSING PROGRAM MANAGER:
Decondia Ferguson
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 06/08/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/08/2026


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: DVORSKAYA ALTERNATIVE SCHOOL
FACILITY NUMBER: 197411145
VISIT DATE: 06/08/2026
NARRATIVE
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Telephone service, heating, lighting and ventilation were evaluated and found to be adequate. Administrator states there are no firearms stored on the premises. No bodies of water were observed on the premises.

During the facility inspection, the Administrator informed LPA that children utilize a nap area located in the same building in a separate area near the outdoor play area. LPA observed the area used for napping purposes: however, the area was not identified on the facility sketch maintained by the facility or the Department. LPA was unable to verify whether the area had been previously approved by the Department. The Administrator was advised that all areas used by children in care should be reflected on the facility sketch and submitted to the Department. LPA advised Administrator to update the facility sketch to accurately identify all areas used by children, including the nap area located in the adjacent building; to submit an updated facility sketch to the El Segundo North Regional Office if the nap are has not previously been approved by the Department; and ensure that any rooms or buildings used for child care activities are approved for use and meet applicable licensing requirements.

The designated isolation area for ill children is located in the Director’s office/staff restroom which are equipped with a mat and are continuously supervised by staff. Adequate provisions were observed for the isolation and supervision of sick children.



LPA observed tamper-resistant electrical outlets installed throughout the facility. The facility is equipped with operational smoke and carbon monoxide detectors, tested during the inspection, in compliance with Title 22, Section 101238(b). Fire extinguishers (2A:10BC) were observed throughout the facility with a current service date of 04/22/206 in accordance with Title 22, Section 101238(b)(1). The First Aid kit was complete in accordance with Title 22, Section 101226. The fire drill log was reviewed and found to be current in accordance with Title 22, Section 101237. Last drill was conducted 05/04/2026.

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NAME OF LICENSING PROGRAM MANAGER: Raul Navarro
NAME OF LICENSING PROGRAM ANALYST: Decondia Ferguson
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 06/08/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/08/2026
LIC809 (FAS) - (06/04)
Page: 6 of 12
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: DVORSKAYA ALTERNATIVE SCHOOL
FACILITY NUMBER: 197411145
VISIT DATE: 06/08/2026
NARRATIVE
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The facility maintains operational flush toilets for children and staff in accordance with licensing requirements. During the inspection, bathroom and toileting areas were evaluated. Sinks are constructed of cleanable materials and maintained in a sanitary condition, with surfaces resistant to moisture and slipping hazards. LPA observed that the number of toilets and sinks is sufficient to meet the center’s licensed capacity. Toilets and sinks are age-appropriate in height and size to accommodate children in care and are readily accessible to children in care. Restrooms were adequately stocked with toilet paper and paper towels, and tight-fitting trash can lid. Bathroom areas were observed to be clean, with adequate lighting and ventilation. A separate staff restroom is available and inaccessible to children in care.

Cleaning compounds, medications, and other hazardous items were observed to be inaccessible to children in accordance with Title 22, Section 101238(a). No poisons were observed in the classrooms or bathrooms.
Based on observations made during the inspection, the facility is in compliance and meets Title 22 requirements for toilet and handwashing facilities.

Kitchen, food preparation, and food storage areas were observed to be clean and maintained in a sanitary condition in accordance with Title 22, Section 101227 (Food Service). Per the Administrator, the center provides daily meals for children (lunch, snack and dinner). Per Administrator meals are brought in and prepared in a private house with a specialized kitchen. The menu is posted and provided to parents at the beginning of the year. The kitchen is inaccessible to children and was observed to be clean and well-maintained. Refrigerators maintain safe temperatures, and cleaning agents, detergents, and other hazardous substances are securely stored separately from food supplies using cabinets with safety latches. Solid waste containers were observed to have tight-fitting covers and be in good repair.

Drinking water was observed to be readily available indoors and outdoors. Water is available to children through a filtered water system provided through bottled water supplier Aquverse and 4oz cups.

First Aid supplies were observed and were well stocked. Per Administrator, Incidental Medical Services (IMS) are not provided. Per Administrator there are no children with allergies or who require the use of an Epi Pen. Per Administrator non-prescription medications are not administered at the facility.



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NAME OF LICENSING PROGRAM MANAGER: Raul Navarro
NAME OF LICENSING PROGRAM ANALYST: Decondia Ferguson
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 06/08/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/08/2026
LIC809 (FAS) - (06/04)
Page: 7 of 12
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: DVORSKAYA ALTERNATIVE SCHOOL
FACILITY NUMBER: 197411145
VISIT DATE: 06/08/2026
NARRATIVE
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The childcare center outdoor play area is fully enclosed and fenced. Outdoor play equipment was observed to be maintained in a safe condition and free of hazards. The outdoor activity surface was observed to be safe and free of debris. Per Administrator, staff clean the yard daily. Required cushioning material was present beneath and around climbing structures to absorb falls in accordance with Title 22, California Code of Regulations, Section 101238 (Buildings and Grounds). There is adequate shade in the play yard. LPA and LPM advised that no children shall be left without the supervision of a teacher at any time. Availability of outdoor drinking water was observed and provided via filtered water system provided through bottled water supplier Aquverse and 4oz cups.

The program uses a paper sign-in/out system. Children were properly documented during the inspection, and licensing posters and required documentation were observed to be posted appropriately.

Children’s records were reviewed for Admission Agreement, LIC 700- Identification and Emergency Information, LIC 627- Consent for Medical Treatment, LIC 995A Notification of Parents’ Rights, LIC 613-Personal Rights, LIC 702-Health History, and LIC 701 Physicians Report, and Immunization Records.

During record review LPA observed 4 out of 6 children’s records did not contain required physician's report and 2 out of 6 children's records did not contain documentation of required immunizations. A Type B citation for CCR 101220(a) and 101220.1(g) – Child’s Medical Assessment was issued.

Staff records were reviewed for Education, LIC-501: Personnel Record, LIC 508-Criminal Record Statement, LIC 9052- Employee Rights, LIC503- Health Screening, Proof of immunization against measles, pertussis and influenza or influenza declination, TB clearance or risk assessment, LIC 9108-Statement Acknowledging Requirement to Report Child Abuse and current Mandated Reporter Training Certificate. There is at least one person trained in CPR and Pediatric First Aid and at least one person with one hour of training in the importance of childhood nutrition during this inspection. All staff present had current criminal record clearances on file.

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NAME OF LICENSING PROGRAM MANAGER: Raul Navarro
NAME OF LICENSING PROGRAM ANALYST: Decondia Ferguson
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 06/08/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/08/2026
LIC809 (FAS) - (06/04)
Page: 8 of 12
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: DVORSKAYA ALTERNATIVE SCHOOL
FACILITY NUMBER: 197411145
VISIT DATE: 06/08/2026
NARRATIVE
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The following Type B citations were issued for staff records:

During record review, LPA observed 5 of 5 personnel records did not complete the mandated reporter training provided pursuant to paragraphs (2) and (3) of subdivision (a) and shall complete renewal mandated reporter training every two years following the date on which he or she completed the initial mandated reporter training. A Type B Citation for CCR 102416.1(a) Personnel Records.

During record review LPA observed 2 of 5 personnel did not been immunization against influenza or declination on file, and 4 of 5 personnel did not have immunizations against pertussis, and measles on file. A Type B Citation for HSC 1597.622(a)(1) General Provisions and Definitions was issued.

During record review of staff file review, Staff #2 did not have a Health Screening Report (LIC503) in their personnel file as required. A Type B Citation for CCR 101216(g)(2) Staff Records was issued

During record reviews of staff files, staff #3 and #4 did not have documentation of educational qualifications in their personnel files. Therefore, the licensee failed to maintain personnel records containing verification of staff qualifications. A Type B Citation was issued for CCR 101216.1(c)(1) Staff Records was issued.

The Administrator was reminded that CPR/First Aid and Mandated Reporter training must be renewed every two years.

Administrator was made aware that it is their responsibility to know the regulations as well as anyone who assists in providing care. LPA discussed the Community Care Licensing website www.ccld.ca.gov which provides access to resources such as forms, regulations, Provider Information Notices (PINS), and Quarterly Updates. LPA discussed Reporting Requirements as outlined in the regulations (Section 101212).

Administrator was advised that inaccessibility of hazards must be constantly reassessed depending on the children in care. Licensing must have the facility’s phone number at all times; if the phone number is changed, licensing must be notified. Regulation prohibits the smoking of tobacco on the premises. Administrator states there is no smoking in the facility.

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NAME OF LICENSING PROGRAM MANAGER: Raul Navarro
NAME OF LICENSING PROGRAM ANALYST: Decondia Ferguson
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 06/08/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/08/2026
LIC809 (FAS) - (06/04)
Page: 9 of 12
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: DVORSKAYA ALTERNATIVE SCHOOL
FACILITY NUMBER: 197411145
VISIT DATE: 06/08/2026
NARRATIVE
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The following were also discussed with the Administrator:

Criminal Record Clearance: Administrator was reminded that all adults 18 and over, 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 Child Care Center. 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.

Lead Testing:
Assembly Bill (AB) 2370, Chapter 676, Statutes of 2018, requires all licensed Child Care Centers (CCCs) constructed before January 1, 201 0, to test their water (used for drinking and food preparation) for lead contamination before January 1, 2023, and then every 5-years after the date of the first test as specified in Health and Safety Code section 1597.16.

For child care center licenses issued after July 1, 2022, the licensee shall test their water for lead within 180 days of licensure pursuant to Written Directives section 101700 (PIN 21-21.1-CCP.).

LPA verified during file review that the lead testing was not completed/conducted in accordance to the Written Directives (Interim Licensing Standards) outlined in PIN 21-21.1-CCP. Per Administrator, water is provided through bottled water supplier Aquverse using a filtered water system. Administrator states building was constructed in the 1950's and filtered water has been used for more than 15 years.

LPA referred Administrator Igor Dvorsky to the Department website for lead: Lead Toxicity Prevention and Water Testing Information (https://www.cdss.ca.gov/inforesources/child-care-licensing/water-testing-information)

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NAME OF LICENSING PROGRAM MANAGER: Raul Navarro
NAME OF LICENSING PROGRAM ANALYST: Decondia Ferguson
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 06/08/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/08/2026
LIC809 (FAS) - (06/04)
Page: 10 of 12
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: DVORSKAYA ALTERNATIVE SCHOOL
FACILITY NUMBER: 197411145
VISIT DATE: 06/08/2026
NARRATIVE
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Safe Sleep: LPA discussed the safe sleep regulations with Administrator Igor Dvorsky 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 Administrator 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): 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/.

MyChildCarePlan.org: The Administrator 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.

Assembly Bill 633: Upon receipt of a citation for a Type A Deficiency, the Administrator shall post the licensing report for 30 days in addition to the Notice of Site Visit & provide copies of the licensing report (LIC 809D/9099D) to parents/guardians of children in care at the facility by the close of business the following day or the next day child returns to the facility. The same report must be provided to parents/guardians of children newly enrolled at the facility during the next 12 months & licensee will obtain a signed Acknowledgement of Licensing Reports (LIC 9224) from parent/guardian & place it in each child's file.

Senate Bill 792: This bill, commencing September 1, 2016, prohibits a person from being employed or volunteering at a child care facility or family day care if he or she has not been immunized against influenza, pertussis and measles.


Page 7
NAME OF LICENSING PROGRAM MANAGER: Raul Navarro
NAME OF LICENSING PROGRAM ANALYST: Decondia Ferguson
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 06/08/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/08/2026
LIC809 (FAS) - (06/04)
Page: 11 of 12
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: DVORSKAYA ALTERNATIVE SCHOOL
FACILITY NUMBER: 197411145
VISIT DATE: 06/08/2026
NARRATIVE
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New Immunization Requirement: Law enacted by SB 277, beginning January 1, 2016, personal beliefs exemptions will no longer be an option for the vaccines that are currently required for entry into child care or school in California. Personal beliefs exemptions already on file will remain valid until the child reaches the next immunization checkpoint.

New Appeal Process: A licensee may file an appeal, in writing 15 business days from the date of receiving the penalty assessment. All appeals must be sent to: Community Care Licensing 300 Continental Blvd., 290A El Segundo, CA 90245

Assembly Bill 1207: California Child Care Workers; Mandated Training Requirement. Beginning January 1, 2018, all licensed providers, applicants, directors and employees must complete Mandated Reported Training prior to March 30, 2018 and renew training every two years at: www.mandatedreporterca.com.

Nutrition Requirement: Beginning January 1, 2016, AB 290 will require for each new license issued, at least one director or teacher at each child care center or family child care home to have at least one hour of training in the importance of childhood nutrition. This applies to anyone submitting a new application, relocating their facility, selling their facility or transferring their license. Please note this training cannot be completed online or by home study programs. The training must be taken from an Emergency Medical Services Authority (EMSA) approved training program OR an accredited college or university.

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 fees to the department were past due. During visit Licensee paid fees and provided LPA with a copy of the receipt.

Exit interview conducted and report was reviewed with the Administrator Igor Dvorsky.

A notice of site visit was given and must remain posted for 30 days. Appeal Rights provided.

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NAME OF LICENSING PROGRAM MANAGER: Raul Navarro
NAME OF LICENSING PROGRAM ANALYST: Decondia Ferguson
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 06/08/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/08/2026
LIC809 (FAS) - (06/04)
Page: 12 of 12