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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197495152
Report Date: 09/22/2022
Date Signed: 09/22/2022 01:13:35 PM

Document Has Been Signed on 09/22/2022 01:13 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:GARKAVENKO FAMILY CHILD CAREFACILITY NUMBER:
197495152
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 0DATE:
09/22/2022
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME BEGAN:
09:49 AM
MET WITH:Anna GarkavenkoTIME COMPLETED:
01:25 PM
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On 09/22/202Licensing Program Analysts (LPA) Laticia Thompson conducted an announced Pre-Licensing inspection to Garkavenko FCCH. This is an application for a Small Family Child Care Home. The applicant will provide care for children-ages 1 through 10 years of age. The family child care home will operate Monday-Friday 6am-6pm. Upon arrival, LPA met with applicant Anna Garkavenko and husband Yevgeniy Levin whom guided LPA on a tour of the home indoor and outdoor space.

Per facility sketch and tour of the home, the following was observed and discussed with the applicant during the inspection:

Home is a 1 story dwelling located on the corner of Welby and Sale. The home consists of 4 bedrooms, one living room, one dining room, and 2 bathrooms there is no garage. The garage has been separated and addressed as separate dwelling. There is a large fence separating the converted section of the home with a separate address located at 22535 Welby Way. The property address is not visible from outside of the gate. There is a camera doorbell located on the gate of the property.
SUPERVISORS NAME: Lisa Rios
LICENSING EVALUATOR NAME: Laticia S Thompson
LICENSING EVALUATOR SIGNATURE: DATE: 09/22/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/22/2022
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: GARKAVENKO FAMILY CHILD CARE
FACILITY NUMBER: 197495152
VISIT DATE: 09/22/2022
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Immediately entering the front gate there is a front play yard area. The outside play area is located in the front of the home with artificial grass turf for cushioning, a large covering for shading. LPA observed age-appropriate toys and play equipment that are clean, free from defects or dangerous conditions. There is a cubby area located on the front porch area before entering the home.

Upon entering the front door of the home on the right side of the entrance there is room that will be used for providing care to children. This area will be used for primary care during operating hours such as eating, napping and educational activities. LPA observed a smoke detector that is operable. LPA observed age appropriate toys, learning material and storage areas. There are 6 mats/cots for napping children located in the closet in the room. There is a bathroom area within this room that will be used for children in care. There is an additional area in the bathroom area with a washer and dryer. There is also a back door that leads to the side of the home which will be off limits. LPA did not observe any hazardous material in these areas.

In the hallway area when entering the home there is a safety gate preventing access to the living room.

There is a hallway area to the left that leads to the additional bedrooms and bathroom. The carbon monoxide detector is located on the wall in operable condition. These will be off limits during operating hours. Applicant will keep the door leading into the off-limit area locked during operating hours.
SUPERVISORS NAME: Lisa Rios
LICENSING EVALUATOR NAME: Laticia S Thompson
LICENSING EVALUATOR SIGNATURE:

DATE: 09/22/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/22/2022
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: GARKAVENKO FAMILY CHILD CARE
FACILITY NUMBER: 197495152
VISIT DATE: 09/22/2022
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There are 3 bedrooms and one bathroom in the off-limits area. LPA did not observe any visual safety risk in the off-limits bedrooms. LPA observed the off-limit bathroom contained hygiene and cosmetic products. LPA explained to applicant the importance of this area being inaccessible during operating hours.

There are 3 bedrooms and one bathroom in the off-limits area. LPA did not observe any visual safety risk in the off-limits bedrooms. LPA observed the off-limit bathroom contained hygiene and cosmetic products. LPA explained to applicant the importance of this area being inaccessible during operating hours.

The kitchen is located to the right when entering through the safety gate, this area will be off limits. The kitchen stove has safety knob coverings. All bottom cabinets and drawers have safety latches preventing access.

The Living-room is located within the kitchen and dinning area this area will be used as an at needs basis. There is a fire extinguisher A:40-B:C that is fully charge located on the wall in the living room area. LPA observed a receipt of purchase dated 09/01/2022.There is a fireplace in the living room area that’s gated and secured preventing access. There is a smoke detector in the dinning area that is operable. The dining area will be off limits. The dinning are has French doors that lead into the backyard area. The French doors have a safety latch located at the top of the doors preventing access to the backyard.
SUPERVISORS NAME: Lisa Rios
LICENSING EVALUATOR NAME: Laticia S Thompson
LICENSING EVALUATOR SIGNATURE:

DATE: 09/22/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/22/2022
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: GARKAVENKO FAMILY CHILD CARE
FACILITY NUMBER: 197495152
VISIT DATE: 09/22/2022
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The backyard has patio area and a swimming pool that is off limits. LPA inspected the pool and found it to be within compliance of regulations. There is a metal gate surrounding the entire pool and good repair. The gate is at least five feet high, not easily climbable. The gate swings away from the pool, self latching, self closing and has a padded lock to prevent access without a key. The openings of the railing does not exceed 4 inches, the bottom on a hard surface and is no more than 4 inches form the ground.

Home is neat and organized
Applicant will ensure that there is a cell phone during operating hours.
All adults living in the home have criminal background clearance.
Applicant states there are no firearms in the home


Applicant will provide proof of corrections for the following by 09/29/2022:

Safety door knobs will be placed on door that leads to the side yard and French door that leads to the pool area.
Purchase a first aid kit
Remove knives from kitchen counter and place an area inaccessible to children.
SUPERVISORS NAME: Lisa Rios
LICENSING EVALUATOR NAME: Laticia S Thompson
LICENSING EVALUATOR SIGNATURE:

DATE: 09/22/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/22/2022
LIC809 (FAS) - (06/04)
Page: 4 of 6
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: GARKAVENKO FAMILY CHILD CARE
FACILITY NUMBER: 197495152
VISIT DATE: 09/22/2022
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Family Child Care Homes

Applicant 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

LPA discussed the safe sleep regulations with licensee [or facility representative] 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 [facility representative] 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

SUPERVISORS NAME: Lisa Rios
LICENSING EVALUATOR NAME: Laticia S Thompson
LICENSING EVALUATOR SIGNATURE:

DATE: 09/22/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/22/2022
LIC809 (FAS) - (06/04)
Page: 5 of 6
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: GARKAVENKO FAMILY CHILD CARE
FACILITY NUMBER: 197495152
VISIT DATE: 09/22/2022
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Exit interview conducted and report was reviewed with the applicant. A copy was provided, Licensure will be issued pending corrections and manager approval.
SUPERVISORS NAME: Lisa Rios
LICENSING EVALUATOR NAME: Laticia S Thompson
LICENSING EVALUATOR SIGNATURE:

DATE: 09/22/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/22/2022
LIC809 (FAS) - (06/04)
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