435700342-11-6-2023-52-CC-JPLA-CXBRHT-20231106120253

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 435700342
Report Date: 11/06/2023
Date Signed: 11/06/2023 12:03:01 PM

Document Has Been Signed on 11/06/2023 12:03 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
OAKLAND SOUTH EAST, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612

FACILITY NAME:	SOROKINA, MARIYA		FACILITY NUMBER:	435700342
ADMINISTRATOR:	SOROKINA, MARIYA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(217) 390-2667
CITY:	PALO ALTO	STATE: CA	ZIP CODE:	94306
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 14	CENSUS: 11	DATE:	11/06/2023
TYPE OF VISIT:	Required - 3 Year	UNANNOUNCED	TIME BEGAN:	09:30 AM
MET WITH:	Mariya Sorokina		TIME COMPLETED:	12:15 PM

NARRATIVE

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On November 6, 2023 at 9:30am, Licensing Program Analyst (LPA) Julia Placencia arrived at the facility unannounced to conduct a Required-3 Year Inspection. LPA met with licensee Mariya Sorokina. Also residing in the home is the licensee’s husband Ivan Ufimtsev and three sons (11,8 and 6 years old). The facility is a one story single family home. Hours of operation for child care are Monday through Friday, 8:30am to 3:30pm. Per licensee, children are home-schooled and attend her Montessori based program 2, 3 or 5 times per week. The following was observed during today’s inspection:

Capacity/Staffing: The facility operates as a Family Child Care Home (large), which may have a maximum capacity of twelve (12) to fourteen (14) children. At time of inspection, there were eleven (11) school age children including the licensee's 6 year old son. Helper Nadya Smolsky arrived after LPA's arrival.

ON Limit areas (accessible to children in care): Family Room and Living Room are Activity/Class Rooms, Kitchen, Office, Two Bathrooms (one next to office and the other in hallway), Backyard. LPA observed the facility to be clean and in good repair, with heating and ventilation for safety and comfort. There are ample age appropriate activities that are observed to be safe and in good condition. The fireplace is blocked with a children's bookcase. The backyard has a fence surrounding the perimeter of the yard. There are no pools, hot tubs or other bodies of water. LPA did not observe any dangerous conditions, nor any hazardous or toxic items accessible to children in the ON Limit areas of the facility today.

OFF Limit areas (not accessible to children in care): Three Bedrooms, Master Bathroom, Garage. OFF Limit areas are inaccessible by closed and/or locked doors and visual supervision. Licensee is advised to contact Licensing so that an inspection can be completed prior to changing an OFF Limit area to ON Limit.

***Continued on LIC 809C...

SUPERVISORS NAME: Jason Jang
LICENSING EVALUATOR NAME: Julia Placencia
LICENSING EVALUATOR SIGNATURE:	DATE: 11/06/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/06/2023

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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Document Has Been Signed on 11/06/2023 12:03 PM - It Cannot Be Edited

Created By: Julia Placencia On 11/06/2023 at 11:34 AM

Link to Parent Document Below:

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

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

FACILITY NAME: SOROKINA, MARIYA	FACILITY NUMBER: 435700342
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 11/06/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type A

Section Cited

CCR

102416.5(e)

Staffing Ratio and Capacity

(e) If no assistant provider is present at a Large Family Child Care Home, then the licensee shall comply with the capacity requirements for a Small Family Child Care Home as specified in subsections (b) and (c). This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on observation and interview, the licensee did not comply with the section cited above as there were 11 school age children upon LPA's arrival, but no assistant present. This poses an immediate health, safety or personal rights risk to persons in care.
	POC Due Date: 11/07/2023
	Plan of Correction
1 2 3 4	Licensee is advised to ensure a helper is always present, or comply with regulations for a small family child care, and submit a statement ensuring compliance of this regulation. LPA may return to ensure compliance. *** Failure to correct will result in a $100 per day civil penalty until corrected. Repeat violations are $250 per violation and $100 per day until corrected.

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

SUPERVISOR'S NAME:

Jason Jang

LICENSING EVALUATOR NAME:

Julia Placencia

LICENSING EVALUATOR SIGNATURE:

DATE: 11/06/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/06/2023

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
OAKLAND SOUTH EAST, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612

FACILITY NAME: SOROKINA, MARIYA	FACILITY NUMBER: 435700342
	VISIT DATE: 11/06/2023

NARRATIVE

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Emergency Preparedness/Safety: Facility has a fully charged 3A40BC fire extinguisher. Smoke and carbon monoxide detectors were tested and found to be functioning. First aid supplies are available. Facility has phone service. Per licensee, there are no firearms in the home. Emergency Disaster Plan is current (7/19/2021).

Staff Records Review: Licensee and all adults living and/or working in the home have proper criminal background clearances. Licensee has current CPR/First Aid training, which expires on 8/2025. Licensee’s mandated reporter training expires 9/16/2025, and helper Nadiya's expires 10/5/2025. Licensee and helper are in compliance with immunization law.

Children’s Records Review: All required licensing documents were observed. Facility has Liability Insurance. A facility roster is maintained.

Licensing Posting (required): Facility license, Notification of Parents’ Rights, Earthquake Preparedness.

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.

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 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. ***Continued on LIC 809C...

SUPERVISORS NAME: Jason Jang
LICENSING EVALUATOR NAME: Julia Placencia
LICENSING EVALUATOR SIGNATURE:	DATE: 11/06/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/06/2023

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
OAKLAND SOUTH EAST, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612

FACILITY NAME: SOROKINA, MARIYA	FACILITY NUMBER: 435700342
	VISIT DATE: 11/06/2023

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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/.
***Per licensee, currently there are no children taking any kind of medication(s).

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

The following deficiencies were observed during today’s inspection:

Upon arrival at 9:30am, LPA observed there were 11 school age children, but no assistant was present. Assistant Nadiya Smolsky arrived at approximately 10:00am.

See LIC809D for deficiencies cited during today's inspection. Failure to correct will result in a $100 per day civil penalty until corrected. Repeat violations are $250 per violation and $100 per day until corrected.
*** Please see LIC 9102 for Advisory Notes.

The attached type A violation is cited today and must be corrected by the due date. Upon receipt, licensee shall post and provide copies of this licensing report to parents/guardians of children in care at the facility and to parents/guardians of children newly enrolled at the facility during the next 12 months. All parents/guardians must sign an acknowledgement form of proof of receiving this report (LIC 9224). The LIC 9224 must be placed in each child's file to be reviewed by licensing.

A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with licensee Mariya Sorokina.

SUPERVISORS NAME: Jason Jang
LICENSING EVALUATOR NAME: Julia Placencia
LICENSING EVALUATOR SIGNATURE:	DATE: 11/06/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/06/2023

LIC809 (FAS) - (06/04)

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