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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 503911280
Report Date: 04/17/2024
Date Signed: 04/17/2024 12:25:27 PM

Document Has Been Signed on 04/17/2024 12:25 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
FRESNO CC RO, 1310 E. SHAW AVE,
FRESNO, CA 93710
FACILITY NAME:GLUKHOVSKIY, KIMBERLY FAMILY CHILD CAREFACILITY NUMBER:
503911280
ADMINISTRATOR/
DIRECTOR:		GLUKHOVSKIY, KIMBERLYFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(209) 681-4470
CITY:MODESTOSTATE: CAZIP CODE:
95355
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: DATE:
04/17/2024
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:00 AM
MET WITH:Kimberly GlukhovskiyTIME VISIT/
INSPECTION COMPLETED:
01:00 PM
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On 04/17/2024, an unannounced Case Management inspection was conducted today by Licensing Program Analyst (LPA), Valerie Mireles. LPA met with Licensee, Kimberly Glukhovskiy. The purpose of today's inspection was to update the licensees facility sketch to make bedroom #1 inaccessible.

The Licensee submitted an updated facility sketch to Community Care Licensing, on 04/04/2024, and will be making bedroom #1 inaccessible moving forward. Licensee is making the bedroom inaccessible to the day care children by placing a door knob spinner to the handle of the bedroom.

Per Title 22, Division 12, Chapter 3, of the California Code of Regulations, no deficiency is being cited during today's visit. This report shall be made available to the public upon request.
SUPERVISORS NAME: Cynthia Brannon
LICENSING EVALUATOR NAME: Valerie Mireles
LICENSING EVALUATOR SIGNATURE: DATE: 04/17/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/17/2024
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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