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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 343626421
Report Date: 12/03/2024
Date Signed: 12/03/2024 12:51:59 PM

Document Has Been Signed on 12/03/2024 12:51 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:ANDRONIC, TATIANAFACILITY NUMBER:
343626421
ADMINISTRATOR/
DIRECTOR:		FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 0DATE:
12/03/2024
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:20 PM
MET WITH:Tatiana AndronicTIME VISIT/
INSPECTION COMPLETED:
01:10 PM
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On December 3, 2024, Licensing Program Analyst (LPA) Michelle Perez met with licensee Tatiana Andronic for the purpose of a change of location inspection. Previous license was 343624414. Operational hours will be 7:30 AM to 5:30PM Monday through Friday.

A health and safety inspection has been conducted inside and out. This facility is a single-story home. There are three bedrooms. One of the bedrooms has a connected room, that will be used for the children's childcare room. There is a front room, dining room, living room and kitchen upon entry. The backyard will be utilized. The off-limit areas will be master room/ master bathroom, bedroom #2, garage and laundry room. Off-limits areas will remain inaccessible to children by closed doors and/or supervision. There are no toxic and hazardous items within reach of children. Functioning smoke and carbon monoxide detectors were observed. Correct sized fire extinguisher was observed. There is a fireplace that is barricaded. EMSA certified certificate for Preventative Health and Safety training, Applicant's pediatric CPR and First Aid training is valid until 10/2026. Mandated reporter expires 10/2026. Applicant stated that there are no weapons in the home. Supervision was discussed and applicant understands that children must be 100% supervised in unfenced yards. Immediate Civil Penalty regulation and deficiencies were reviewed.
SUPERVISORS NAME: Amanda Blesi
LICENSING EVALUATOR NAME: Michelle Perez
LICENSING EVALUATOR SIGNATURE: DATE: 12/03/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/03/2024
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: ANDRONIC, TATIANA
FACILITY NUMBER: 343626421
VISIT DATE: 12/03/2024
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This facility does not plan to provide Incidental Medical Services (IMS). For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. When any IMS is provided, a Plan for Providing 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 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm

Licensee is familiar with the LIC311D, Forms/Records to Keep in Family Child Care Homes, children’s forms/records, facility forms/records, and information to be posted.


Applicant was encouraged to visit the department website at WWW.CDSS.CA.GOV for information regarding childcare updates, forms, self-assessment guides, regulations and legislation pertaining to family childcare homes.

Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other important information communication platform.
To receive important license related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-care-licensing/subscribe and select the Child Care option to receive email communication.

Effective today 12/3/2024- this facility is approved for a small family childcare home license to serve a capacity of 6 children with no more than 3 infants or 4 infants only. Or with a capacity of 8 children: no more than 2 infants, 1 child in kindergarten or elementary school and 1 child at least age 6. Exit interview conducted.
SUPERVISORS NAME: Amanda Blesi
LICENSING EVALUATOR NAME: Michelle Perez
LICENSING EVALUATOR SIGNATURE:

DATE: 12/03/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/03/2024
LIC809 (FAS) - (06/04)
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