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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 384004270
Report Date: 10/04/2023
Date Signed: 10/04/2023 12:24:32 PM

Document Has Been Signed on 10/04/2023 12:24 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
SAN BRUNO CHILD CARE, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME:SHKOLNIK, LYUBA & NEMIROVSKAYA, YANINAFACILITY NUMBER:
384004270
ADMINISTRATOR:SHKOLNIK, LYUBAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(415) 902-6880
CITY:SAN FRANCISCOSTATE: CAZIP CODE:
94116
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 11DATE:
10/04/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
08:45 AM
MET WITH:Victoria Kalinkina and Lyuba ShkolnikTIME COMPLETED:
12:30 PM
NARRATIVE
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On October 4, 2023., Licensing Program Analyst (LPA) Van conducted an annual inspection at Licensees Lyuba Shkolnik and Yanina Nemirovskaya’s facility. LPA was greeted by the Licensee’s helper, Victoria Goloborodko. LPA explained the purpose of the inspection to the Licensee’s helper and was given access to the property. Upon entering the home, LPA observed the helper supervising 9 preschool-age children by herself. The facility did not meet the license capacity and limitation. During the inspection, Licensee Lyuba Shkolnik came home. Approximately 30 minutes later, the co-licensee Yanina Nemirovskaya also came home. All adults living or working in the house had undergone a criminal background check. The physical layout of the property remained unchanged, with the same off-limits and childcare areas. Daycare areas are on the ground floor, room #1, room #2, room #3, 2 bathrooms, backyard, and the kitchen. OFF limit areas the entire second floor and garage. The hours of operation are Monday to Friday, 7:30 am - 6:00 pm. All restricted daycare areas have been appropriately blocked off from the children.

LPA inspected the Licensee's childcare areas for any potential health and safety concerns. The childcare environment was clean, organized, and conducive to age-appropriate activities such as imaginary and manipulative play. The home was equipped with proper heating, lighting, and ventilation, and no defects or situations that could endanger children in care were detected. Additionally, the facility had a fully charged fire extinguisher, smoke and carbon monoxide detectors, and a functional phone. The fireplace was observed barricaded using a children's bookshelf. A fully stocked first aid kit was also available for any children in need. According to the Licensees, no firearms, weapons, or pets were on the premises, and no baby walkers, bouncers, or similar equipment were used in the daycare. The Licensees were informed that smoking is prohibited in family childcare facilities.
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SUPERVISORS NAME: Garfield Leung
LICENSING EVALUATOR NAME: Brendon Van
LICENSING EVALUATOR SIGNATURE: DATE: 10/04/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/04/2023
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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Document Has Been Signed on 10/04/2023 12:24 PM - It Cannot Be Edited


Created By: Brendon Van On 10/04/2023 at 10:45 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
, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME: SHKOLNIK, LYUBA & NEMIROVSKAYA, YANINA
FACILITY NUMBER: 384004270

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/04/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type A
Section Cited
CCR
102416.5(e)
Staffing Ratio and Capacity
(e) If no assistant provider is present at a Large Family Child Care Home, then the licensee shall comply with the capacity requirements for a Small Family Child Care Home as specified in subsections (b) and (c).

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation and record review, the Licensee did not comply with the section cited above. Upon entering the home, LPA observed the licensee helper was supervising nine preschool-age by herself, while both licensees were not at home. The Licensee did not follow her license limitations, which pose an immediate health, safety, or personal rights risk to persons in care.
POC Due Date: 10/05/2023
Plan of Correction
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The Licensees must adhere to their License's limitations and requirements. When the assistant is left alone, the Licensees shall comply with the capacity requirements for a Small Family Child Care Home. A written plan will be created by the licensee and submitted to LPA.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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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:Garfield Leung
LICENSING EVALUATOR NAME:Brendon Van
LICENSING EVALUATOR SIGNATURE:
DATE: 10/04/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/04/2023


LIC809 (FAS) - (06/04)
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Document Has Been Signed on 10/04/2023 12:24 PM - It Cannot Be Edited


Created By: Brendon Van On 10/04/2023 at 10:45 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
, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME: SHKOLNIK, LYUBA & NEMIROVSKAYA, YANINA
FACILITY NUMBER: 384004270

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/04/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
HSC
1597.622(a)(1)
General Provisions and Definitions
(1) Commencing September 1, 2016, a person shall not be employed or volunteer at a family day care home if he or she has not been immunized against influenza, pertussis, and measles. Each employee and volunteer shall receive an influenza vaccination between August 1 and December 1 of each year.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, interview, and record review, the licensees and helpers did not have proof of complete immunization records or have them available for review during the inspection. This poses a potential safety hazard to children in care.
POC Due Date: 10/20/2023
Plan of Correction
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Before commencing employment, Licensees must ensure that all immunization records are complete and on file. Both the Licensees and their helpers' required immunization records must be included in the personnel file by the due date of 10/20/2023. A follow-up visit will be conducted to ensure that any deficiencies have been corrected.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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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:Garfield Leung
LICENSING EVALUATOR NAME:Brendon Van
LICENSING EVALUATOR SIGNATURE:
DATE: 10/04/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/04/2023


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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
SAN BRUNO CHILD CARE, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME: SHKOLNIK, LYUBA & NEMIROVSKAYA, YANINA
FACILITY NUMBER: 384004270
VISIT DATE: 10/04/2023
NARRATIVE
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LPA observed four playpens in the napping room. The Licensees were reminded by LPA of specific guidelines that must be followed when it comes to playpens and cribs. Specifically, it is advised not to keep any toys or pillows inside or any objects hanging above the cribs/playpens. The mattresses used should be designed specifically for the cribs/playpens, and bed sheets must be tightly fitted. LPA also informed the Licensee that checking on the infant every 15 minutes during naptime is mandatory. It is necessary to document these checks and keep them in the infant's file for review by the Department.

The licensees stated that fire and earthquake drills are conducted on a monthly basis, with the last drills completed on October 2, 2023.

LPA reviewed all records pertaining to the children under the licensees’ care. The licensees were observed to maintain accurate records for each child, including vaccination records and parental rights forms. LPA further noted that each child had a complete emergency information card on file, which contained vital information such as the child's full name, phone number, and the location of a parent or authorized person who may be contacted in an emergency. In addition, the records also contained the name and phone number of the child's doctor and the parent's permission for the licensee to consent to emergency medical care if needed.

After reviewing personnel records, it was discovered that both Licensees and their helpers did not maintain their complete immunization records. The Licensees were missing their MMR, Tdap, and influenza records, while their helpers were missing TB clearance on record.

During the inspection, LPA reviewed with the Licensees the LIC 311D, Forms/Records to Keep in the Family Child Care Homes, children's forms/records, facility forms/records, and all required postings such as License/Parent's Rights poster/Emergency Disaster Plan and Earthquake Preparedness checklist. The entrance Checklist was also provided to the Licensee. In addition, License capacity and limitation were also reviewed with the Licensees. LPA informed the Licensees that if care is provided to the 13th and 14th child, who must be school-aged, parent notification is required.
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SUPERVISORS NAME: Garfield Leung
LICENSING EVALUATOR NAME: Brendon Van
LICENSING EVALUATOR SIGNATURE:

DATE: 10/04/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/04/2023
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
SAN BRUNO CHILD CARE, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME: SHKOLNIK, LYUBA & NEMIROVSKAYA, YANINA
FACILITY NUMBER: 384004270
VISIT DATE: 10/04/2023
NARRATIVE
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Licensee was reminded that all adults 18 and over living or working in the home, including employees and volunteers, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a licensed Family Child Care Home. A civil penalty of $100.00 minimum/day up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

LPA discussed the safe sleep regulations with the Licensees and discussed the Child Care Licensing Safe Sleep webpage https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed the Licensee of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

Incidental Medical Services (IMS) policy was discussed. 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: www.ada.gov/childqanda.htm.

The Licensee was reminded about the Provider Information Notices (PINs) on the CCLD website. 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 against influenza, pertussis, and measles or qualifies for an exemption pursuant to Health and Safety code 1596.7995 and 1597.662.
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SUPERVISORS NAME: Garfield Leung
LICENSING EVALUATOR NAME: Brendon Van
LICENSING EVALUATOR SIGNATURE:

DATE: 10/04/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/04/2023
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
SAN BRUNO CHILD CARE, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME: SHKOLNIK, LYUBA & NEMIROVSKAYA, YANINA
FACILITY NUMBER: 384004270
VISIT DATE: 10/04/2023
NARRATIVE
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LPA reviewed AB 1207 with the Licensees. As of January 1, 2018, all staff must complete Mandated Reporter Training every two years. The training can be obtained online at www.mandatedreporterca.com. Effective July 1, 2020, Licensees must have proof of completion of EMSA certified lead poison training if applying for a change of location or capacity change to an existing license.

To improve the quality and value of the new inspection process, a survey will be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or tools, please send them by email to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/process.

Licensee was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain child care by connecting them to childcare providers and Resource and Referral Agencies (R&Rs) throughout California.

During the exit interview, the LICENSEES LYUBA SHKOLNIK AND YANINA NEMIROVSKAYA , confirmed that there are no Registered Sex Offenders living in the facility, and LPA completed the RSO profile in FAS.

During the inspection, LPA requested the Licensees to submit the following updated documents: Incidental Medical services plan; Mandated reporter training certificate, and updated immunization records.

See 809D for Type "A" and “B” deficiencies issued today. The Facility is advised to provide a copy of the Evaluation Report and the Type "A" Deficiency cited to the parents and guardians of children currently enrolled in care and parents of newly enrolled children during the next 12 months. A signed and dated LIC 9224 shall be maintained in all Children's files. This report will be maintained in the facility file and made available for public review three years after the thirty-day posting requirement has been met.
SUPERVISORS NAME: Garfield Leung
LICENSING EVALUATOR NAME: Brendon Van
LICENSING EVALUATOR SIGNATURE:

DATE: 10/04/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/04/2023
LIC809 (FAS) - (06/04)
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