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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 414004840
Report Date: 06/24/2025
Date Signed: 06/24/2025 12:23:13 PM

Document Has Been Signed on 06/24/2025 12:23 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 CC RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME:OSTROVSKA, OKSANAFACILITY NUMBER:
414004840
ADMINISTRATOR/
DIRECTOR:		OSTROVSKA,OFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(925) 967-6856
CITY:REDWOOD CITYSTATE: CAZIP CODE:
94065
CAPACITY: 14TOTAL ENROLLED CHILDREN: 10CENSUS: 10DATE:
06/24/2025
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:50 AM
MET WITH:Oksana OstrovskaTIME VISIT/
INSPECTION COMPLETED:
12:30 PM
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On June 24, 2025 at approximately 8:50am, Licensing Program Analyst (LPA) Catrina Quimbo conducted an unannounced, annual inspection. LPA met with licensee, Oksana Ostrovska, and explained the purpose of the visit.

Present during LPA's visit included 10 preschool age children and teaching assistant. Licensee is a large license and is operating within capacity limits. Licensee lives in the home with their spouse and adult child. All adults living and present in the home during LPA's visit have fingerprint clearance on file and are associated to licensee's facility number.

Hours of operation are Monday through Friday 8:00am to 6:00pm. Licensee operates their home as a Russian immersion program.

The home is a single level home. The DAY CARE AREAS are the living room, kitchen, dining area, hallway bathroom, bedroom #3 (activity room), bedroom #4 (napping room), and backyard. The OFF LIMIT AREAS bedroom #1, bedroom #2, bathroom #2 (in napping room) and garage. LPA observed off limit areas to be made inaccessible with child safety door handles.

With licensee, LPA inspected day care areas for health and safety hazards. LPA observed home to be clean and organized. Electrical outlets are made inaccessible with child safety covers. Day care areas are equipped with a variety of toys, materials and equipment that are age appropriate and clean. Per licensee, toys and materials are sanitized daily or every week.

Flooring in day care areas include soft padding and rugs that are clean, free of stains. Per licensee, floors are swept, mopped and vacuumed daily or weekly. There is a fireplace in the living room that is appropriately barricaded, made inaccessible to children.
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NAME OF LICENSING PROGRAM MANAGER: Marie Rodriguez
NAME OF LICENSING PROGRAM ANALYST: Catrina Quimbo
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 06/24/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/24/2025
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: OSTROVSKA, OKSANA
FACILITY NUMBER: 414004840
VISIT DATE: 06/24/2025
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LPA observed cabinets in kitchen to be made inaccessible with child safety locks. LPA observed knives in kitchen to also be made inaccessible in home's high shelves. LPA did not observe any accessible poisons or cleaning solutions.

Licensee provides a food service that includes breakfast, morning snack, lunch and afternoon snack. Reusable dishes are utilized for children that are sanitized daily in home's dishwasher.

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 was observed to be in working condition and equipped with age appropriate toileting equipment. Licensee provides diapers to diapering children, if needed. LPA observed diapers and wipes to be appropriately stored. LPA also observed dirty diapers to be appropriately thrown away in a garbage bin with a tight fitting lid.

Children sleep on mini beds in the nap room. Per licensee, every child has an assigned bed. Licensee provides sheets and blankets that are laundered weekly or as needed. Licensee does not provide care to 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 fully fenced and enclosed. Backyard includes a variety of toys and equipment that are in good condition. There is an outdoor play structure that is secure and has grass underneath. Flooring in backyard also includes artificial turf that is in good condition. LPA did not observe any pools, spas or bodies of water on site. There is also sufficient shade, if needed.
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NAME OF LICENSING PROGRAM MANAGER: Marie Rodriguez
NAME OF LICENSING PROGRAM ANALYST: Catrina Quimbo
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 06/24/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/24/2025
LIC809 (FAS) - (06/04)
Page: 3 of 4
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: OSTROVSKA, OKSANA
FACILITY NUMBER: 414004840
VISIT DATE: 06/24/2025
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Home is equipped with a fully charged fire extinguisher, fully stalked first aid kit and multiple smoke and carbon monoxide detectors. Carbon monoxide detector was tested during LPA's visit, which was observed to be working.

Licensing documentation is properly posted and made available for review. A childcare roster was also made available for LPA's review. Emergency disaster drills are conducted and are appropriately documented. Last disaster drill was conducted 01/06/2025. Next disaster drill is scheduled for 07/06/2025. Per licensee, there are no weapons or firearms in the home.

LPA reviewed facility records that included all enrolled children's records, licensee's record and teaching assistant's record. Children's records are complete. Licensee has a current CPR/First Aid certification that will expire 03/2027. LPA observed both licensee and assistant present have required immunizations available for review. Both licensee and assistant present also have a current Mandated Reporter certification that was made available for LPA's review.

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, Oksana Ostrovska, 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, Oksana Ostrovska.
NAME OF LICENSING PROGRAM MANAGER: Marie Rodriguez
NAME OF LICENSING PROGRAM ANALYST: Catrina Quimbo
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 06/24/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/24/2025
LIC809 (FAS) - (06/04)
Page: 4 of 4