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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 343625083
Report Date: 11/29/2023
Date Signed: 11/30/2023 09:17:02 AM

Document Has Been Signed on 11/30/2023 09:17 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:KALINOVSKIY, NATALYAFACILITY NUMBER:
343625083
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 0DATE:
11/29/2023
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME BEGAN:
02:15 PM
MET WITH:Natalya KalinovskiyTIME COMPLETED:
03:15 PM
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On Wednesday, November 29, 2023, Licensing Program Analyst (LPA) Amanda Sutter met with Applicant Natalya Kalinovsky for the purpose of an announced pre-licensing inspection. During today’s visit, applicant’s husband was also present in the home. All individuals subject to criminal background review have obtained a criminal record clearance. A health and safety inspection of the home was conducted on 11/20/2023. The purpose of today’s inspection is to observe the pool area and confirm that it is fenced according to regulation.

LPA observed a pool enclosed by a fence with a self-latching gate that swings away from the pool. A portion of the pool fencing is constructed using latticed wood. The licensee has added additional wood slats to ensure that the fencing is not climable. LPA observed the latticed fencing to be constructed in a way that visual of the pool area is not obstructed. Windows accessing the pool area on the far side of the house are over 5 feet high.

A notice of site visit was given and must remain posted on, or immediately adjacent to, the interior side of the main door for 30 days. Exit interview conducted and report was reviewed with the applicant Natalya Kalinovsky.

As of today 11/29/2023, facility is approved for a Small Family Child Care Home license for a capacity of 6 children with no more than 3 infants, or 4 infants only, or up to 8 children with no more than 2 infants, 1 child in Transitional Kindergarten or above and 1 child at least age 6. Infants are children under the age of 2.

SUPERVISORS NAME: Seychelle De Luca
LICENSING EVALUATOR NAME: Amanda Sutter
LICENSING EVALUATOR SIGNATURE: DATE: 11/29/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/29/2023
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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