<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197417529
Report Date: 08/26/2026
Date Signed: 08/26/2026 02:41:53 PM

Document Has Been Signed on 08/26/2026 02:41 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:BALENKO & VASILYEV FAMILY CHILD CAREFACILITY NUMBER:
197417529
ADMINISTRATOR/
DIRECTOR:		BALENKO & VASILYEVFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(818) 343-2365
CITY:TARZANASTATE: CAZIP CODE:
91356
CAPACITY: 14TOTAL ENROLLED CHILDREN: 11CENSUS: 4DATE:
08/26/2026
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:50 AM
MET WITH:Tamara Balenko LicenseeTIME VISIT/
INSPECTION COMPLETED:
03:05 PM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
On 8/26/26 at 9:50 am, Licensing Program Analyst (LPA) Samantha Barba conducted an unannounced annual required inspection at 5186 Garden Grove Ave Tarzana CA 91356, Balenko & Yasilyev Family Child Care Home. Upon arrival, LPA met with Licensee Tamara Balenko (L1) to whom she explained that she was there for an annual visit. LPA provided L1 with LIC 126 Entrance Checklist Family Child Care Homes along with her business card and was granted access to the family childcare home. L1 allowed LPA to set up in the art room which is where the children work on classwork, tutor time or art classes. At 10:27 am, Co-Licensee Vladimir Yasilyev (L2) arrived with two of the morning session children. At 10:40 am, the other two morning children arrived. Per L1, the facility’s operating hours are Monday through Friday 8 am to 7 pm depending on the needs of the families and they offer Saturdays 10 am to 2pm and the children’s age ranges are from school age (5 years old) to 13 years old. Per L1, there are no firearms, guns, ammo, or weapons stored in the home.

Licensee Balenko informed LPA that they are not a regular day care. The facility offers art classes, tutoring and currently, there are 4 students who attend online school which they complete at the facility. The facility also has children who attend the public charter school nearby and come to the facility when school is over. LPA observed 4 school aged children on today’s visit. LPA was guided through a tour of the on-limit areas of the home which consisted of Bedroom #2 (aka the classroom is where online classes are attended here and tutoring), the bathroom, the dining room, the kitchen and the art room. All rooms were observed to be clean and orderly with no hazards for the children in care. The knives were observed in the kitchen cabinet to have a lock. Cleaning supplies were observed to be in a high cabinet out of reach of the children. Outdoor cleaning supplies and plant poisons, per L1, are locked in the garage which is inaccessible to the children by a locked door. PAGE 1 OF 4

Betty Bell
Samantha Barba
DATE: 08/26/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/26/2026
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 8
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)
Page: 2 of 8
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: BALENKO & VASILYEV FAMILY CHILD CARE
FACILITY NUMBER: 197417529
VISIT DATE: 08/26/2026
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
Per Licensee, areas off limits to children and parents include: the licensee’s bedroom which is made inaccessible by being closed. The garage is off limits and kept locked. The backyard has been made off-limits due to construction of the back patio. During construction, the backdoor window was broken and is now covered with wood. L1 stated they will be fixing it along with the rest of the yard. LPA asked L1 if the children napped here and she stated they did not as they are school aged children.

Licensee provides food for the children. Morning snack, lunch, PM snack , Dinner and evening snack. LPA observed children to have their own cups with fresh drinking water.



Licensee was reminded that all adults 18 and over living or working in the home, 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. Individuals residing in the home have been discussed and noted. All adults present in the home have obtained a criminal record clearance or exemption.


The following were observed and reviewed during this inspection:

The isolation area for sick children awaiting parental pick up is away from the other children whether it is in the art room, classroom or dining room but still supervised while the child awaits the parent.

Smoke and carbon monoxide detectors were tested and are operable. LPA observed the required (2A-10BC) fire extinguisher was mounted and located in the entrance of the home next to the front door and parent’s board and was serviced on May 29, 2026. LPA reminded L1 that a required (2A-10BC) fire extinguisher must be purchased or charged yearly. The home maintains telephone service via cell phone and landline. The home is observed to be clean and orderly.

Children’s records were reviewed for (LIC) 282- Affidavit Regarding Liability Insurance, Immunizations Records, LIC 700- Identification and Emergency Information, LIC 627- Consent for Medical Treatment, LIC 995A Notification of Parents’ Rights.

PAGE 2 OF 4
NAME OF LICENSING PROGRAM MANAGER: Betty Bell
NAME OF LICENSING PROGRAM ANALYST: Samantha Barba
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 08/26/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/26/2026
LIC809 (FAS) - (06/04)
Page: 3 of 8
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: BALENKO & VASILYEV FAMILY CHILD CARE
FACILITY NUMBER: 197417529
VISIT DATE: 08/26/2026
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
Staff records were reviewed for approved Pediatric First Aid and CPR certification, LIC 508-Criminal Record Statement, LIC 9052- Employee Rights, Proof of immunizations against measles, pertussis (missing from file) and influenza or influenza declination, TB clearance or risk assessment (missing from file), LIC 9108- Statement Acknowledging Requirement to Report Child Abuse and current Mandated Reporter Training Certificate (missing but LPA provided website WWW.MANDATEDREPORTERTRAINING.COM for childcare providers).
— Pediatric First Aid and CPR expire: 10/2027
— Mandated Reporter AB1207 expires: Not available. Will send proof when complete.
L1 was reminded of their responsibility to report suspected child abuse. Mandatory Forms for the children’s files and provider’s files were discussed.
During inspection all children were observed to be treated with dignity and respect, they were observed to be receiving safe, healthful, and comfortable accommodations, furnishings and equipment, and free from corporal and/or unusual punishment.

Incidental Medical Services (IMS) policy was discussed. Does not provided medical services for children in care. For IMS information see Evaluator Manual – Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. 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 Center and the ADA, available at: http://www.ada.gov/childqanda.htm . A1 stated that they do not provide medical services and parents are aware they will call 911 to respond. They do not administer medication either, the parents are able to come to do it if need be.

Although the facility does not offer care for children under 5 years of age, L1 was made aware that state law prohibits baby walkers, bouncy seats, exersaucers and any other items that fall into that category. Licensee was reminded that all infants must be placed on their backs when sleeping to prevent S.I.D.S. (Sudden Infant Death Syndrome), and that the Provider is required to wash hands after every diaper change and to never shake a baby to prevent the Shaken Baby Syndrome.

PAGE 3 OF 4
NAME OF LICENSING PROGRAM MANAGER: Betty Bell
NAME OF LICENSING PROGRAM ANALYST: Samantha Barba
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 08/26/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/26/2026
LIC809 (FAS) - (06/04)
Page: 4 of 8
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: BALENKO & VASILYEV FAMILY CHILD CARE
FACILITY NUMBER: 197417529
VISIT DATE: 08/26/2026
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
 LPA also informed L1 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. Licensee was also reminded that only children eating may be in highchairs and that car seats are utilized only for transportation.
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.

Licensee was advised the Notice of Site Visit must be posted at the entrance of the facility for a period of 30 days. If a serious violation is cited, (Type A violation), a copy of the licensing report (LIC809 or LIC9099) must also be posted for 30 days. If these requirements are not met, civil penalties in the amount of $100 per violation will be assessed. Licensee was made aware they may file an appeal, in writing 15 business days from the date of receiving the penalty assessment.

During the exit interview, the licensee confirmed that there are no Registered Sex Offenders living in the facility and LPA searched the Megan’s Law website on 8/26/26 and confirmed no RSO in the home.

The facility was not found in compliance per Title 22 regulations, there will be deficiencies cited today, 8/26/2026.



To improve the quality and value of the new inspection process, a survey will 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 tools, please send them by email 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/process.

Appeal rights and Notice of site visit were provided and must remain posted for 30 days. Report was reviewed with interpreter services in Russian. Interpreter #68006035 Nasiba.

Exit interview conducted and report was reviewed with Licensee Tamara Balenko.

PAGE 4 OF 4

NAME OF LICENSING PROGRAM MANAGER: Betty Bell
NAME OF LICENSING PROGRAM ANALYST: Samantha Barba
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 08/26/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/26/2026
LIC809 (FAS) - (06/04)
Page: 5 of 8
Document Has Been Signed on 08/26/2026 02:41 PM - It Cannot Be Edited


Created By: Samantha Barba On 08/26/2026 at 01:49 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: BALENKO & VASILYEV FAMILY CHILD CARE
FACILITY NUMBER: 197417529

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/26/2026

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102418(a)
Immunizations
(a) Prior to admission to a family day care home, children shall be immunized against diseases as required by the California Code of Regulations, Title 17, beginning with Section 6000.

This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
Based on record review and interview with licensee, the licensee did not comply with the section cited above in 6 of 6 childrens' records which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 09/16/2026
Plan of Correction
1
2
3
4
Per licensee, licensee will double check files to make sure they are not mixed up and willl have parents send copy of children's immunization records along with TB information and transfer the information onto the Immunization Records From LPA provided.
Section Cited
Deficient Practice Statement
1
2
3
4
POC Due Date:
Plan of Correction
1
2
3
4
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
Betty Bell
NAME OF LICENSING PROGRAM MANAGER:
Samantha Barba
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 08/26/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/26/2026


LIC809 (FAS) - (06/04)
Page: 6 of 8