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

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 343626102
Report Date: 03/06/2025
Date Signed: 03/06/2025 12:19:26 PM

Document Has Been Signed on 03/06/2025 12:19 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:BIHUSYAK, YURIYFACILITY NUMBER:
343626102
ADMINISTRATOR/
DIRECTOR:		BIHUSYAK, YURIYFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(650) 557-4646
CITY:SACRAMENTOSTATE: CAZIP CODE:
95821
CAPACITY: 14TOTAL ENROLLED CHILDREN: 5CENSUS: 5DATE:
03/06/2025
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:00 AM
MET WITH:Yuriy BihusyakTIME VISIT/
INSPECTION COMPLETED:
12:30 PM
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) Kyrsten Williams conducted an unannounced case management inspection at the above facility. LPA met with licensee, Yuriy Bihusyak and the purpose of the inspection was explained. LPA observed five children in care being supervised.

Upon interview and record review, LPA observed the facility roster is not up to date. Licensee stated previously enrolled children have been removed from facility roster. Licensee understands a current roster of children enrolled must be available and maintained for a period of three years, even after children are no longer attending. LPA has provided inspection authority to licensee.

A deficiency is cited on the subsequent page of this report (LIC809-D) under the California Code of Regulations, Title 22. The licensee was provided a copy of their Appeal Rights (LIC9058) and the licensee's signature on this form acknowledges receipt of these rights.

Exit interview conducted and report was reviewed with the licensee, Yuriy Bihusyak.
SUPERVISORS NAME: Seychelle De Luca
LICENSING EVALUATOR NAME: Kyrsten Williams
LICENSING EVALUATOR SIGNATURE: DATE: 03/06/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/06/2025
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 2
Document Has Been Signed on 03/06/2025 12:19 PM - It Cannot Be Edited


Created By: Kyrsten Williams On 03/06/2025 at 11:56 AM
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
, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

FACILITY NAME: BIHUSYAK, YURIY
FACILITY NUMBER: 343626102

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/06/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
04/04/2025
Section Cited
CCR
102417(g)(8)

1
2
3
4
5
6
7
102417 Operation of Family Child Care Home (g)(8) Each family child care home shall have a current roster of children as specified in Health and Safety Code Section 1596.841.
1
2
3
4
5
6
7
Licensee will update roster to include all previously enrolled children. Licensee has agreed to maintain faciltiy roster for a period of at least three years, even after children are no longer attending. Licensee will email completed roster to LPA by POC due date.
8
9
10
11
12
13
14
Based on interview and record review, the licensee did not comply with the section cited above as the facility roster was not current and including all children previously enrolled, which poses a potential health, safety or personal rights risk to persons in care.
8
9
10
11
12
13
14

1
2
3
4
5
6
7
1
2
3
4
5
6
7

1
2
3
4
5
6
7
1
2
3
4
5
6
7
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:Seychelle De Luca
LICENSING EVALUATOR NAME:Kyrsten Williams
LICENSING EVALUATOR SIGNATURE:
DATE: 03/06/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/06/2025


LIC809 (FAS) - (06/04)
Page: 2 of 2