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

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 343618406
Report Date: 10/08/2024
Date Signed: 10/08/2024 03:44:27 PM

Document Has Been Signed on 10/08/2024 03:44 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
SACRAMENTO CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME:YUSHCHUK, TATYANAFACILITY NUMBER:
343618406
ADMINISTRATOR/
DIRECTOR:		YUSHCHUK, TATYANAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(916) 248-9499
CITY:RANCHO CORDOVASTATE: CAZIP CODE:
95670
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 4DATE:
10/08/2024
TYPE OF VISIT:POCUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:45 AM
MET WITH:Tatyana YushchukTIME VISIT/
INSPECTION COMPLETED:
09:30 AM
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
Licensing Program Analyst (LPA) Erwina Pascual-Golamco met with Licensee, Tatyana Yushchuk to conducted a Plan Of Correction inspection. There was a Type A deficiency cited on 10/02/24. Purpose of inspection was explained.

Type A
CCR
102416.5(e)
102416.5(e) If no assistant provider is present at a Large Family Child Care Home, then the licensee shall comply with the capacity requirements for a Small Family Child Care Home as specified in subsections (b) and (c).

As of today, 10/08/24, LPA observed 4 children in care with licensee and adult assistant. Licensee is in compliance with ratio.

No deficiencies cited in today's inspection, exit interview was conducted, and Notice of Site visit was provided and shall be posted where visible to parents for 30 days
SUPERVISORS NAME: Natalie Dunaway
LICENSING EVALUATOR NAME: Erwina Pascual-Golamco
LICENSING EVALUATOR SIGNATURE: DATE: 10/08/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/08/2024
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 1