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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 414002194
Report Date: 10/24/2024
Date Signed: 10/24/2024 10:39:34 AM

Document Has Been Signed on 10/24/2024 10:39 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
SAN BRUNO CC RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME:TSYURA, IRINAFACILITY NUMBER:
414002194
ADMINISTRATOR/
DIRECTOR:		TSYURA, IRINAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(415) 722-5458
CITY:DALY CITYSTATE: CAZIP CODE:
94015
CAPACITY: 14TOTAL ENROLLED CHILDREN: 12CENSUS: 10DATE:
10/24/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:25 AM
MET WITH:Irina TsyuraTIME VISIT/
INSPECTION COMPLETED:
11:00 AM
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On October 24, 2024 at approximately 8:25am, Licensing Program Analyst (LPA) Catrina Quimbo conducted an unannounced, annual inspection. LPA met with licensee's assistant, A1, and explained the purpose of the visit. Upon LPA's arrival, licensee was not present. Per A1, licensee temporarily left to complete an errand. Present upon LPA's arrival included 4 preschool children, A1 and A2. LPA observed A1 and A2 to have a current CPR/First Aid certification.

Hours of operation are Monday through Friday 7:30am to 6:00pm. The main entrance to the day care is through the side gate of the home. At approximately 8:40am, licensee, Irina Tsyura, returned to facility. LPA continued inspection with licensee. Present during LPA's visit included licensee, A1, A2 and 10 preschool children. Facility is operating within capacity limits and ratio during LPA's visit.

Licensee lives in the multi-level home with A1, A2 and A1's mom. All adults living and/or working in the home have fingerprint clearance on file. LPA inspected day care areas for health and safety hazards. The DAY CARE AREAS are the living room (play room), dining room (classroom), lobby area, bathroom #1 (located in the lobby area on ground floor) and backyard. The OFF LIMIT AREAS are the kitchen (pass by only), garage and entire third level of home. Off limit areas are made inaccessible with child safety gates and/or locked doors.

LPA observed living room to have a variety of toys and equipment that are good condition. There is sufficient furniture for children's use that are age appropriate. LPA observed home to have a variety of materials and activities for children that are clean. Home is in good repair with proper temperature and ventilation. Flooring in day care areas includes carpets and rugs that are free of stains. LPA did not observe any accessible electrical outlets or cleaning solutions in day care areas. There is sufficient storage for children's belongings located in the lobby, labeled with children's names and pictures.

LPA observed home is equipped with multiple, fully charged fire extinguishers and a fully stocked first aid kit. LPA observed home to be equipped with a fire alarm system, smoke detectors and carbon monoxide detector. LPA tested carbon monoxide detector during visit, which was observed to be working.
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SUPERVISORS NAME: Marie Rodriguez
LICENSING EVALUATOR NAME: Catrina Quimbo
LICENSING EVALUATOR SIGNATURE: DATE: 10/24/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/24/2024
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 3
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN BRUNO CC RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME: TSYURA, IRINA
FACILITY NUMBER: 414002194
VISIT DATE: 10/24/2024
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Bathroom was observed to be clean and in working condition. LPA observed bathroom to have age appropriate toileting equipment and materials that are in good condition. Children have their own individual hand towels that are properly labeled with their individual names.

Children sleep in the living room on floor mats. LPA observed mats to be appropriately stored in closet. Licensee provides sheets and blankets that are laundered daily. Per licensee, mats are stripped of sheets and sanitized daily. No infants are currently enrolled in program. Licensee stated they are aware of sleeping logs for napping infants.

LPA discussed the safe sleep regulations with licensee and discussed the Child Care Licensing Safe Sleep webpage athttps://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-andresources/safe-sleep as an additional resource. LPA also informed 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.

Backyard is entirely enclosed and fenced. There are a variety of outdoor toys and equipment that are in good condition. Per A1, backyard is cleaned daily. Flooring in backyard includes rubber padding. LPA did not observe any pools, spas or bodies of water on site.

Licensee provides a food service for children that includes breakfast, lunch, dinner and two snacks. LPA observed kitchen cabinets and drawers to have child safety locks installed. Reusable utensils are used for children that are sanitized daily. LPA observed knives to be in kitchen's high shelves and in a child safety locked drawer. Garbage bin has a tight fitting lid.

Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02-CCP. 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: https://www.ada.gov/resources/child-care-centers/.

LPA reviewed five random children's files. Children's files are complete with emergency contact information and immunization cards. Licensee maintains a childcare roster that made available for LPA's review. Disaster drills are conducted and properly documented. Last disaster drill was conducted 06/20/2024.
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SUPERVISORS NAME: Marie Rodriguez
LICENSING EVALUATOR NAME: Catrina Quimbo
LICENSING EVALUATOR SIGNATURE:

DATE: 10/24/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/24/2024
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 CC RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME: TSYURA, IRINA
FACILITY NUMBER: 414002194
VISIT DATE: 10/24/2024
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LPA observed licensing documents to be properly posted and available for review. Licensee's CPR/First Aid certification is current and will expire 02/2025. Licensee's Mandated Reporter certification is also current and will expire 04/2025. Both A1 and A2 have current CPR/First Aid certifications and Mandated Reporter certifications. Per licensee, there are no weapons or firearms in the home. Per licensee, there are no pets in the home.

To improve the quality and value of the new inspection process, a survey may 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 CARE tools, please send email inquiries 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/inspection-process.

Licensee was reminded that all adults 18 and over living or working in the home, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, 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 for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.

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

During the exit interview, the licensee, Irina Tsyura, confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.

No deficiencies were issued today during LPA's visit.

A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with the licensee, Irina Tsyura. .
SUPERVISORS NAME: Marie Rodriguez
LICENSING EVALUATOR NAME: Catrina Quimbo
LICENSING EVALUATOR SIGNATURE:

DATE: 10/24/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/24/2024
LIC809 (FAS) - (06/04)
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