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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434416371
Report Date: 04/21/2022
Date Signed: 04/21/2022 03:43:05 PM

Document Has Been Signed on 04/21/2022 03:43 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
CCLD Regional Office, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME:MANKOVSKAJA, LUDMILAFACILITY NUMBER:
434416371
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 7CENSUS: 6DATE:
04/21/2022
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
12:41 PM
MET WITH:Ludmila "Mila" MankovskajaTIME COMPLETED:
02:05 PM
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Licensing Program Analyst (LPA) Samantha Yip conducted an unannounced Case Management- Licensee Initiated inspection. LPA met with Licensee Ludmila "Mila" Mankovskaja and explained the reason for the inspection. The purpose of this inspection is Licensee added a playground and extended her deck to her home. She is requesting to place the playground and deck to on-limits for the children. An updated LIC 999A: Facility Sketch was sent on 04/18/2022.

During today's inspection, LPA inspected the playground and deck. The playground area is fenced. The gap between the fencing is no more than 4 inches wide and the gap between the ground and the fence is 4.5 inches. The playground is anchored to the ground. Licensee stated that she is going to have the children access the playground from the play area. There are stairs which leads to the playground. The top of the fence has a gate; however, the bottom of the stairs is not barricaded. Children can also access the playground area from the deck There are stairs which leads down to the playground area from the deck. The top of the deck has a gate to barricade it, but the bottom of the stairs is not barricaded. Licensee stated that she will purchase gates and place it on the bottom of both staircase. Licensee will submit proof to Licensing.

LPA also inspected the deck. Licensee will only be using the left side of the deck for children. There is a gate to separate the off-limit area of the deck. Licensee placed netting around the railing. The deck was obtained to safe for children.

LPA discussed with Licensee about children's personal rights during today's inspection. Licensee stated that she will submit CPR/1st Aid to Licensing by 04/22/2022.

LPA informed Licensee that upon barricading stairs, the playground area is safe for the children's use. No deficiencies were cited as a result of this inspection. Exit interview conducted and report was reviewed with the licensee Mila Mankovskaja. A notice of site visit was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.
SUPERVISORS NAME: Joel Segura
LICENSING EVALUATOR NAME: Samantha Yip
LICENSING EVALUATOR SIGNATURE: DATE: 04/21/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/21/2022
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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