414004633-12-12-2025-05-CC-CQUO-DPAQJB-20251212111229

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 414004633
Report Date: 12/12/2025
Date Signed: 12/12/2025 11:12:38 AM

Document Has Been Signed on 12/12/2025 11:12 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:	GRODNITSKY, LYUBOV		FACILITY NUMBER:	414004633
ADMINISTRATOR/ DIRECTOR:	GRODNITSKY, LYUBOV		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(408) 425-8815
CITY:	BELMONT	STATE: CA	ZIP CODE:	94002
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 8	CENSUS: 7	DATE:	12/12/2025
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	08:48 AM
MET WITH:	Lyubov "Luba" Grodnitsky		TIME VISIT/ INSPECTION COMPLETED:	11:30 AM

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	On December 12, 2025 at approximately 8:48am, Licensing Program Analyst (LPA) Quimbo conducted an unannounced, annual inspection. LPA met with licensee, Lyubov "Luba" Grodnitsky, and explained the purpose of the visit. Licensee lives in the multi-level home with their spouse and minor child. Present during LPA's visit included licensee, licensee's spouse and 7 preschool children. Licensee is operating within capacity limits and ratio during today's visit. Licensee also has an additional assistant who is not present during today's visit. Adults living and working in the home have fingerprint clearance on file. Hours of operation are Monday through Friday 8:30am to 5:30pm. Main entrance to the family child care is through the side gate. Licensee operates their home as a Russian immersion program. Operations of family child care home are on the ground level of the home only. The DAY CARE AREAS are the main play room, bedroom #1 (napping room), bathroom#1 and left portion of backyard. The OFF LIMIT AREAS are the garage, right portion of the backyard, entire second level of home and entire third level of home. There are stairs in the home that lead to the second level of the home that are made inaccessible with a child safety gate. With licensee, LPA inspected day care areas for health and safety hazards. LPA observed day care areas to be clean and organized. Shelves in the main play room have a variety of children's toys and materials that are in good condition. Per licensee, toys and materials are sanitized daily or monthly. Tables and chairs for children's use are age appropriate and are in good condition. There is a large rug in the main playroom that was observed to be clean, free of stains. Per licensee, rug is vacuumed daily and floor is also mopped daily. There is a fireplace in the main play room that is made inaccessible, appropriately barricaded by furniture. LPA observed electrical outlets in day care areas to be made inaccessible with child safety covers. There are cabinets and closets in day care areas that are also made inaccessible with child safety locks. (Continue Report on Page 2...)

NAME OF LICENSING PROGRAM MANAGER: Marie Rodriguez
NAME OF LICENSING PROGRAM ANALYST: Catrina Quimbo
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 12/12/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/12/2025

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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California Health & Human Services Agency

California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:

Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.

Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)

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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: GRODNITSKY, LYUBOV	FACILITY NUMBER: 414004633
	VISIT DATE: 12/12/2025

NARRATIVE

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Licensee provides a food service that includes breakfast, lunch and two snacks. Licensee utilizes both disposable and reusable plates and utensils. Per licensee, reusable plates and utensils are washed daily in home's dishwasher. Children also bring their individual water bottles to the home that were observed to be labeled. Per licensee, no currently enrolled children have allergies. LPA observed licensee maintains an Incidental Medical Services (IMS) plan in the home that was made available for review during LPA's visit.

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/

Bathroom for children's use is in between the nap room and main play room. LPA observed bathroom to be equipped with age appropriate toileting equipment. LPA also observed bathroom to be in working condition. Per licensee, there are a couple of children who are currently in diapers. Licensee provides diapers and wipes that were observed to be stored appropriately. LPA observed home to be equipped with a garbage bin with a tight fitting lid. LPA also observed cleaning solutions and poisons to be stored behind child safety locked cabinets.

Children sleep in the napping room on children's beds. Licensee provides sheets and blankets for children that are laundered bi-weekly. LPA observed beds to be placed appropriately and sheets to be stored on beds. LPA did not observe any cribs on site.

LPA discussed the safe sleep regulations with licensee and discussed the Child Care Licensing Safe Sleep webpage at https://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 and removing any 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 fully enclosed and fenced. Left side of the backyard is for day care use while right side of backyard is off limits to children. LPA observed off limit portion is made inaccessible with a fence. Outdoor area includes a variety of outdoor toys and equipment that are in good condition. There are storage containers in backyard that were observed to have children's toys and materials. LPA observed a large umbrella in backyard for shade, if needed. LPA did not observe pools, spas or bodies of water on site.
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NAME OF LICENSING PROGRAM MANAGER: Marie Rodriguez
NAME OF LICENSING PROGRAM ANALYST: Catrina Quimbo
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 12/12/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/12/2025

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: GRODNITSKY, LYUBOV	FACILITY NUMBER: 414004633
	VISIT DATE: 12/12/2025

NARRATIVE

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Home is equipped with a fully charged fire extinguisher, multiple first aid supplies and a smoke and carbon monoxide detector. LPA tested carbon monoxide detector during today's visit, which was observed to be in working condition.

LPA reviewed licensing documentation during today's visit. Licensing documentation is posted, made available for public review. Licensee conducts and documents emergency disaster drills. Last documented disaster drill was conducted 10/8/2025. Licensee maintains a childcare roster that was made available for review. Liability insurance is also maintained and was made available for LPA's review. There are two pets (dog and cat) in the home. Licensee maintains pets' vaccines that were also made available for LPA's review. Per licensee, there are no weapons or firearms in the home.

LPA reviewed children's records and staffs' records, which are complete. Children's records include immunization records, physician reports and emergency contact information. Staffs' records include CPR and First Aid certifications, Mandated Reporter certifications and required immunizations. Licensee's CPR and First Aid certification will expire 6/2027. Licensee's Mandated Reporter certificate is also current and will expire 3/2027.

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 Lyubov Grodnitsky, confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.

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

No deficiencies were issued during today'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, Lyubov Grodnitsky.

NAME OF LICENSING PROGRAM MANAGER: Marie Rodriguez
NAME OF LICENSING PROGRAM ANALYST: Catrina Quimbo
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 12/12/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/12/2025

LIC809 (FAS) - (06/04)

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