<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 414004766
Report Date: 04/27/2022
Date Signed: 04/27/2022 09:53:45 AM

Document Has Been Signed on 04/27/2022 09:53 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
CCLD Regional Office, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME:BAKIROVA, HANNA & BAKIROV, MYKHAILOFACILITY NUMBER:
414004766
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 5DATE:
04/27/2022
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
08:40 AM
MET WITH:Licensees, Hanna & MykhhailoTIME COMPLETED:
10:00 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 April 27th, 2022 at 8:40am, Licensing Program Analyst (LPA), Kassandra Medrano, met with Licensee's, Hanna and Mykhailo. The purpose of the inspection was explained and was for a Case Management inspection for an increase of capacity. LPA and Licensee's inspected entire home and yard for Health and Safety Hazards. Per licensee fire clearance has been granted, but department has yet to receive the document. Present in the home are the two Licensees, and 5 children. This type of home is a two story. Off limit areas were identified as, the entire upper level, garage, front yard, and kitchen. The child care operates 8am-6pm, Monday through Friday. LPA observed the following: Stairs in the home are properly barricaded if caring for children under five years old. Day-care area is clean, orderly, and equipped with age appropriate toys and equipment for the children. No baby walkers, bouncers, exercausers, etc. allowed to be used during child-care hours. Home has proper lighting and ventilation. Home has a working telephone, a working smoke and carbon monoxide detector, and a fully charged 2A10BC fire extinguisher. Licensee states there are no bodies of water on the property. There is a fireplace in the day-care area, and it is properly barricaded. There are no detergents, or cleaning products accessible to day-care children. Poisons are locked. Licensee states there are no guns or weapons of any kind in the home. The backyard is fenced. Emergency drills are conducted at least once every six months and properly logged. Licensee provides daily snacks and meals, depending on family, parents will provide. Isolation of sick children reviewed/discussed. Capacity options were reviewed. Licensee understands that care cannot be provided for more than the capacity as stated on the license. Requirements for reporting suspected child abuse was discussed, as well as reporting requirements for unusual incidences. All required postings are properly posted (License/Parent’s Rights poster/Emergency Disaster Plan and Earthquake Preparedness Checklist) Capacity limits of a Large License have been reviewed with Licensee. Licensee is reminded that when operating at a Large capacity, there must be a Helper present.

License will be recommended for approval once Regional Office receives:

-Fire Clearance

No deficiencies were issued today under Title 22 Division 12 of the Ca. Code of Regulations.

This report and Notice of Site Visit will be emailed to Licensee. Rights to comment and appeal were discussed with Licensee. This report must be available in the facility for public review. Additional questions, call Office, M-F, 8am-5pm, 650-266-8800 or 1-844-538-8766. Website: www.cdss.ca.gov

SUPERVISORS NAME: Ali Zebila
LICENSING EVALUATOR NAME: Kassandra Medrano
LICENSING EVALUATOR SIGNATURE: DATE: 04/27/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/27/2022
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 1