435700342-10-22-2021-52-CC-RHAR-C82N8Y-20211022101506

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 435700342
Report Date: 10/22/2021
Date Signed: 10/22/2021 10:15:18 AM

Document Has Been Signed on 10/22/2021 10:15 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, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612

FACILITY NAME:	SOROKINA, MARIYA		FACILITY NUMBER:	435700342
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY: 8	TOTAL ENROLLED CHILDREN: 8	CENSUS: 0	DATE:	10/22/2021
TYPE OF VISIT:	Prelicensing	ANNOUNCED	TIME BEGAN:	08:08 AM
MET WITH:	Mariya Sorokina		TIME COMPLETED:	10:20 AM

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On October 22, 2021 at approximately 8:10am Licensing Program Analyst (LPA) Russ Haderer met with applicant Mariya Sokokina for the purpose of conducting an announced pre-licensing inspection. Living in the home is the applicant, her fingerprint cleared and TB tested husband and their three sons (4, 6 and 9 years old). Present in the home for today’s inspection was the applicant. The hours of operation will be Monday-Friday, 9:00 AM to 5:00PM.

The facility is a 4 bedroom, 2 bathroom home rented by the applicant and contains a living room, dining room, family room (day care classroom) kitchen, four bedrooms (1 is converted to an office), an attached 1-car garage, a front, side and back yard. The home is neat and clean with heating and ventilation for safety and comfort. The home has a screened fireplace in the living room blocked by a small bookshelf. Per applicant, there are no firearms in the home. Per the applicant, the ISOLATION AREA will be in the on-limits office/bedroom away from the other children in care.

On-limit-areas include: Living room, dining room, family room (day care classroom), south side bedroom/(office), both bathrooms in the home and the backyard area on the west side of the yard containing a concrete patio. Applicant was reminded that other than wipes or things used for the children in the on limits bathrooms, they need to be empty of most all items (or locked up) such as cleaning products. There are no accessible hazardous cleaning chemicals or other liquids in the on-limits area.

Off-limit-areas include: Three bedrooms on the north side the attached 1-car garage and the sides and front yard area. The off-limit areas will be inaccessible by closed and/or locked doors, and/or by child supervision.

Applicant will be running a Montessori style classroom for children aged 5 to 10 and has ample age-appropriate toys and learning materials.

SUPERVISORS NAME: Chandra Charles
LICENSING EVALUATOR NAME: Russell Haderer
LICENSING EVALUATOR SIGNATURE:	DATE: 10/22/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/22/2021

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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612

FACILITY NAME: SOROKINA, MARIYA	FACILITY NUMBER: 435700342
	VISIT DATE: 10/22/2021

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A copy of the current lease agreement was reviewed. Ratios were discussed and a copy left for applicant as a reminder. LPA did not observe any bodies of water hazardous materials, or toxins accessible to children on the premises during the inspection.

The home has 2 fully charged 3A40BC fire extinguishers, working smoke detector and a carbon monoxide detector (tested and functioning), and a working telephone. The applicant’s Health and Safety training was completed 7/25/2021 (including the nutrition and Lead Poisoning Prevention requirements), CPR and First Aid certificate is current and expires 7/23/2023. Mandated Reporter has been completed and expires 7/20/2023. The applicant and husband is in compliance with all immunization laws which pertains to day care providers.

LPA reminded applicant of the following; Mandated Reporter training is to be renewed every two years, CPR/First Aid is also renewed every two years. Baby bouncers & drop-down cribs are not allowed at the day-care facility. LPA discussed Unusual Incidents Reports.

Applicant was reminded that all adults 18 and over living or working in the home, including employees and volunteers, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence of children in a licensed Family Child Care Home. A civil penalty of $100.00 minimum/day up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. 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: http://www.ada.gov/childqanda.htm

SUPERVISORS NAME: Chandra Charles
LICENSING EVALUATOR NAME: Russell Haderer
LICENSING EVALUATOR SIGNATURE:	DATE: 10/22/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/22/2021

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
CCLD Regional Office, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612

FACILITY NAME: SOROKINA, MARIYA	FACILITY NUMBER: 435700342
	VISIT DATE: 10/22/2021

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

Materials for operating safely during the Covid Pandemic were reviewed.

For licensing updates email childcareadvocatesprogram@dss.ca.gov and advised to be added to the email list

This home is recommended for Licensure as of today, October 22, 2021.

Exit interview conducted and report was reviewed with the applicant Mariya Sorokina.

SUPERVISORS NAME: Chandra Charles
LICENSING EVALUATOR NAME: Russell Haderer
LICENSING EVALUATOR SIGNATURE:	DATE: 10/22/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/22/2021

LIC809 (FAS) - (06/04)

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