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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 384004270
Report Date: 06/21/2021
Date Signed: 06/21/2021 03:00:29 PM

Document Has Been Signed on 06/21/2021 03:00 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
CCLD Regional Office, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME:SHKOLNIK, LYUBA & NEMIROVSKAYA, YANINAFACILITY NUMBER:
384004270
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 0CENSUS: 5DATE:
06/21/2021
TYPE OF VISIT:Case Management - Licensee InitiatedANNOUNCEDTIME BEGAN:
01:00 PM
MET WITH:Lyuba ShkolnikTIME COMPLETED:
03:15 PM
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For a case management inspection, licensing Program Analyst (LPA), Van, met with the Licensee, Lyuba Shkolnik. The purpose of the inspection was to increase capacity from a Small to a Large Family Child Care Home. Currently, the Licensee has the Small Family Child care license issued a little over a year ago. Present at the daycare were five preschoolers and a helper. All Adult residents have the fingerprint clearance on file. Days and Hours of operation are M -F, 7:30 AM- 6 PM. A fire clearance was granted from the Fire Department on 6/2/21 for the increase.

LPA and the Licensee inspected the home for Health and Safety Hazards. The Applicant owns a single-family home consisting of two floors with four bedrooms and 5 ½ bathrooms. The Applicant lives with her husband, mom, and two minor daughters. Daycare areas are on the ground floor, per the facility sketch submitted by the Applicant, room #1, room #2, room #3, 2 bathrooms, backyard, and the kitchen. OFF limit areas the entire second floor and garage. The home is clean and in good repair with sufficient lighting and ventilation. The Licensee has installed multiple smoke and carbon monoxide combo detectors throughout the house. There is a fully charged fire extinguisher that meets the minimum size requirement. LPA observed that the house has age-appropriate toys and equipment available for children in care. All harmful objects, including chemicals, disinfectants, and sharp objects, are made inaccessible to children. There are no bodies of water in the facility. Per Licensee, there were no firearms, weapons, or pets in the home.

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SUPERVISORS NAME: Garfield Leung
LICENSING EVALUATOR NAME: Brendon Van
LICENSING EVALUATOR SIGNATURE: DATE: 06/21/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/21/2021
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
CCLD Regional Office, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME: SHKOLNIK, LYUBA & NEMIROVSKAYA, YANINA
FACILITY NUMBER: 384004270
VISIT DATE: 06/21/2021
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LPA observed Licensee had posted all the required forms (i.e., License, Notification of Parent's Rights, Notification of Personal Rights, and Emergency Disaster Plan). Also, there are hand washing, cough etiquette, and COVID-19 posters that are all posted up. The first aid kit is fully stocked and accessible. The Licensee is aware that all adults 18 years and older living in the home, including helpers, or assistants must have a criminal record clearance. Also, all adults must be associated with the facility by submitting a LIC 9182 form with a copy of a CA Driver's License or CA ID before having any contact with children in care.

Capacity limits of a Large License were reviewed with the Licensee. The Licensee was reminded that when operating at a Large capacity, there must be a Helper present.

The Licensee was informed that as of September 1, 2016, a person may not be employed or volunteer at a childcare facility unless he or she has been immunized for pertussis, measles, and influenza or qualifies for an exemption pursuant to Health and Safety Code 1596.7995 and 1597.662.

The Licensee was reminded about Mandated Reporter training. Training must be completed every two years by the Licensee and all staff hired. Training can be taken online at www.mandaterreporterca.com.

LPA recommended approval for a Large Family Child Care License as of 6/21/2021.

The report was reviewed and signed by the Licensee, Lyuba Shkolnik. Today's report, 6/21/2021, and notice of site visit will be sent to the Licensee at Lyuba.shkolnik@gmail.com by the close of business on 6/21/21. Confirmation of receipt is required.
SUPERVISORS NAME: Garfield Leung
LICENSING EVALUATOR NAME: Brendon Van
LICENSING EVALUATOR SIGNATURE:

DATE: 06/21/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/21/2021
LIC809 (FAS) - (06/04)
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