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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197494085
Report Date: 10/23/2024
Date Signed: 10/23/2024 05:09:07 PM

Document Has Been Signed on 10/23/2024 05:09 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:SUKOVATA & TYUTYUNNIK FAMILY CHILD CAREFACILITY NUMBER:
197494085
ADMINISTRATOR/
DIRECTOR:		SUKOVATA,K & TYUTYUNNIK,O.FACILITY TYPE:
810
ADDRESS:TELEPHONE:
(818) 779-0750
CITY:VAN NUYSSTATE: CAZIP CODE:
91405
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 12DATE:
10/23/2024
TYPE OF VISIT:Required - 3 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
11:41 AM
MET WITH:OLENA TYUTYUNNIKTIME VISIT/
INSPECTION COMPLETED:
02:36 PM
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On 10/23/2024 Licensing Program Analysts (LPAs), Suzette Ornelas and Dawn Dowling conducted an unannounced Annual Required Inspection. LPAs were met by Licensee, OLENA TYUTYUNNIK who guided LPAs on a tour of the home. Days and hours of operation are Monday through Friday 7:30am-6:30pm.

LPA toured the home inside and outside and a census was taken. LPA observed 12 day care children and 4 adults. Capacity as specified on the license is being maintained.



Licensee and 3 assistants were present with 12 children, one assistant left shortly after LPAs arrived. All areas identified on the facility sketch were inspected. Licensee's home is a 4 bedroom, 3 bathroom single family home. There are no bodies of water in the facility. Child care is provided in the main living room, bedroom 1,2 and 3. The off limit areas include the licensee's bedroom, the kitchen/dining room, laundry room, restroom next to the laundry room and the garage accessible from the driveway .Children also have access to the bathroom, which is located in the hall way. Licensee reports she has no firearms or weapons in the home.

The home was inspected inside and out for safety, comfort, cleanliness, telephone service, heating and ventilation, inaccessibility to poisons, detergents, cleaning compounds, medicines, and hazardous items that can pose a danger to children. LPAs observed 1 exersaucer located inside bedroom 1 where day care children nap. LPAs advised the Licensee that the erersaucer is a prohibited item and it is not allowed at the home. Licensee removed it from inside of the home and placed it in the garage away from the day care area. Licensee stated that she will comply and will no longer use the prohibited exersaucer for child care children. The First Aid Kit was observed and complete. Per LIS the facility annual fees are current. The facility roster was observed, and current. There are age appropriate toys and napping equipment on the premises. The required fire extinguisher (2A-10BC) was serviced on 4/24/2024 needs to be serviced. Carbon monoxide detectors and smoke detectors are in operable condition and tested by licensee. Facility provides daily meals for the children. Licensee has posted as required the License, and all other required postings in a visible location.
SUPERVISORS NAME: Raul Navarro
LICENSING EVALUATOR NAME: Suzette Ornelas
LICENSING EVALUATOR SIGNATURE: DATE: 10/23/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/23/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.

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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: SUKOVATA & TYUTYUNNIK FAMILY CHILD CARE
FACILITY NUMBER: 197494085
VISIT DATE: 10/23/2024
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 Per licensee, bedroom 1 or 2 will be used as the isolation area. There are no firearms or ammunition on the premises. Home does not have a fireplace. There are currently 2 infants in care. LPAs provided safe sleep information. Licensee ensures that children in care are supervised at all times and is aware children shall not be left in parked vehicles. Car seats are used for transportation purposes only and are not used for sleeping children. LPAs reviewed 5 children's records and observed records were complete.

An emergency fire/disaster drill has not been completed and documented within the last 6 months. LPA provided licensee with a copy of a log to ensure it is completed at a minimum of every 6 months moving forward. Licensees pediatric CPR/First Aid is current. A review of records indicates that all employees and/or volunteers do not have immunization records on, all adults in the home are missing Tdap immunization. Licensee has completed the Mandated Reporter Training within 2 years (2023). All adults who reside or work in the home have a criminal record clearance or exemption. There are no excluded individuals present at this home.

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.

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.
SUPERVISORS NAME: Raul Navarro
LICENSING EVALUATOR NAME: Suzette Ornelas
LICENSING EVALUATOR SIGNATURE:

DATE: 10/23/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/23/2024
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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: SUKOVATA & TYUTYUNNIK FAMILY CHILD CARE
FACILITY NUMBER: 197494085
VISIT DATE: 10/23/2024
NARRATIVE
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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.

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.

Per Title 22, Division 12, Chapter 3, of the California Code of Regulations, 1 Type A and 1 Type B deficiencies are being cited.

Licensee was advised upon receive of this report, the report must be posted along with the notice of site visit for 30 days for parents to view. Licensee must inform the parents/guardians of children in care at the facility and to parents/guardians of children newly enrolled at the facility during the next 12 months via form LIC 9224 Acknowledgement of Receipt of Licensing Reports. If the Licensee fails to comply $100.00 civil penalty shall be assessed for each family enrolled and in attendance.

This report shall be made available to the public upon request. A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with the licensee, OLENA TYUTYUNNIK.

SUPERVISORS NAME: Raul Navarro
LICENSING EVALUATOR NAME: Suzette Ornelas
LICENSING EVALUATOR SIGNATURE:

DATE: 10/23/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/23/2024
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Document Has Been Signed on 10/23/2024 05:09 PM - It Cannot Be Edited


Created By: Suzette Ornelas On 10/23/2024 at 01:13 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: SUKOVATA & TYUTYUNNIK FAMILY CHILD CARE
FACILITY NUMBER: 197494085

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/23/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type A
Section Cited
CCR
102417(g)(10)
Operation of A Family Child Care Home
(g) The home shall be free from defects or conditions which might endanger a child. Safety precautions shall include but not limited to: (10) A baby walker shall not be allowed on the premises of a family child care home in accordance with Health and Safety Code Sections 1596.846(b) and (c).

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on [(observation) (interview) (record review)], the licensee did not comply with the section cited above in LPAs observed a prohibited exersaucer in the childsrens nap room which poses an immediate health, safety or personal rights risk to persons in care.
POC Due Date: 10/23/2024
Plan of Correction
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Licensee removed the item from the home immediately upn LPAs request and placed it in the off limits garage for the time being until disposal/removal from the property.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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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:Suzette Ornelas
LICENSING EVALUATOR SIGNATURE:
DATE: 10/23/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/23/2024


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Document Has Been Signed on 10/23/2024 05:09 PM - It Cannot Be Edited


Created By: Suzette Ornelas On 10/23/2024 at 01:13 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: SUKOVATA & TYUTYUNNIK FAMILY CHILD CARE
FACILITY NUMBER: 197494085

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/23/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
HSC
1597.622(a)(1)
General Provisions and Definitions
(1) Commencing September 1, 2016, a person shall not be employed or volunteer at a family day care home 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) (interview) (record review)], the licensee did not comply with the section cited above in all adults working with the children did not have proof of Tdap (pertussis) immunization which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 11/22/2024
Plan of Correction
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Licensee will provide proof of Tdap (Petussis) to LPA via email.

suzette.ornelas@dss.ca.gov
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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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:Suzette Ornelas
LICENSING EVALUATOR SIGNATURE:
DATE: 10/23/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/23/2024


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