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

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 483010615
Report Date: 09/06/2024
Date Signed: 09/06/2024 02:24:50 PM

Document Has Been Signed on 09/06/2024 02:24 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
SANTA ROSA RO, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405
FACILITY NAME:SKRNJUG, VERONIKA FCCHFACILITY NUMBER:
483010615
ADMINISTRATOR/
DIRECTOR:		FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: DATE:
09/06/2024
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:42 PM
MET WITH:Veronika SkrnjugTIME VISIT/
INSPECTION COMPLETED:
02:40 PM
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 09/6/2024, at 12:42 PM, Licensing Program Analyst (LPA), Selena Mariani made a Licensee Initiated Case Management visit to the facility and met with Licensee, Veronika Skrnjug, to verify updated facility sketch and review facility and children files. Prior to visit, on 09/04/2024, Licensee notified LPA on the facility’s updates and provided an updated facility sketch.

During the visit, LPA observed three child being supervised by Licensee and Assistant. The home was toured inside and out. LPA observed two bedrooms and bathroom upstairs to be included as on-limits. LPA observed gates on both side of the stairs, making it inaccessible to children without adult supervision.

The facility has been approved of the changes made to the home.

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

Exit interview conducted and report was reviewed with the Licensee, Veronika Skrnjug.

SUPERVISORS NAME: Alexis Hollon
LICENSING EVALUATOR NAME: Selena Mariani
LICENSING EVALUATOR SIGNATURE: DATE: 09/06/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/06/2024
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