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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 343618828
Report Date: 05/31/2024
Date Signed: 05/31/2024 11:10:01 AM

Document Has Been Signed on 05/31/2024 11:10 AM - 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:VORONTSOV, LYUDMILAFACILITY NUMBER:
343618828
ADMINISTRATOR/
DIRECTOR:		VORONTSOV, LYUDMILAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(916) 331-5084
CITY:SACRAMENTOSTATE: CAZIP CODE:
95841
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 0DATE:
05/31/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:30 AM
MET WITH:Lyudmila VorontsovTIME VISIT/
INSPECTION COMPLETED:
11:30 AM
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On Friday, May 31, 2024, at approximately 10:30 AM, Licensing Program Analyst (LPA) Michelle Perez met with Licensee, Lyudmila Vorontsov, for the purpose of an inspection.

All individuals subject to criminal background review have obtained a criminal record clearance. Upon arrival, no day care children were present in the home. Licensee has not had children in care since July 2022- but wishes to remain open and active. Licensee stated she plans to retire in April 2024.

Operating hours are from 6:00 AM through the evening hours, for 24-hours but will not provide care to one family for 24-hours. Open Saturday and Sunday.

LPA initiated a health and safety inspection of all areas accessible to children. Off-limits areas include three bedrooms, garage and garden area.

LPA observed a working phone, fire extinguisher, and functioning smoke and carbon monoxide detectors.

Licensee stated there are no weapons in the home.
SUPERVISORS NAME: Keven Peters
LICENSING EVALUATOR NAME: Michelle Perez
LICENSING EVALUATOR SIGNATURE: DATE: 05/31/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/31/2024
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
SACRAMENTO CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME: VORONTSOV, LYUDMILA
FACILITY NUMBER: 343618828
VISIT DATE: 05/31/2024
NARRATIVE
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Toxic and hazardous items (detergents, cleaning compounds, medications, sharp utensils, items that could pose a danger to children in care) are properly stored and inaccessible to children.

The fireplace located in the living room is inaccessible to children, there are no stairs in the home. The outdoor play space is fenced. The Licensee understands that in unfenced outdoor areas, 100% supervision of children is required.

There are no bodies of water on the premises. Safe toys and play equipment are observed.

LPA did not review any children's files as no children have been enrolled since July 2022. A roster is being maintained. LPA observed a current fire and disaster drill log. Preventative health training, current pediatric CPR and First Aid certification was verified for the Licensee (expires 09/2025). Proof of AB1207 mandated reporter training is not applicable to as Licensee has limited English proficiency. LPA explained that the OCAP modules are free of cost and available at: http://www.mandatedreporterca.com/

Incidental Medical Services (IMS) policy was discussed. When any IMS is provided, an updated Plan of Operation that includes 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 for TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the Americans with Disabilities Act, available at: http://www.ada.gov/childqanda.htm

LPA discussed the Safe Sleep regulations in Child Care

SUPERVISORS NAME: Keven Peters
LICENSING EVALUATOR NAME: Michelle Perez
LICENSING EVALUATOR SIGNATURE:

DATE: 05/31/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/31/2024
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
SACRAMENTO CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME: VORONTSOV, LYUDMILA
FACILITY NUMBER: 343618828
VISIT DATE: 05/31/2024
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Licensee was encouraged to visit the Department website at http://ccld.ca.gov for child care updates, current forms, legislation and regulation information.

In the areas that were evaluated, there were no deficiencies at this time.


LPA provided a Notice of Site Visit and the Licensee acknowledges that this notice shall remain posted for 30 days for parental review.

The Licensee's signature on this form acknowledges receipt of this form
SUPERVISORS NAME: Keven Peters
LICENSING EVALUATOR NAME: Michelle Perez
LICENSING EVALUATOR SIGNATURE:

DATE: 05/31/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/31/2024
LIC809 (FAS) - (06/04)
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