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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 073409219
Report Date: 04/19/2023
Date Signed: 04/19/2023 03:58:11 PM

Document Has Been Signed on 04/19/2023 03:58 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, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612
FACILITY NAME:STEFANETS, NATALIIAFACILITY NUMBER:
073409219
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 10CENSUS: 6DATE:
04/19/2023
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
03:20 PM
MET WITH:Nataliia StefanetsTIME COMPLETED:
04:20 PM
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On 4/19/23 at 3:20 PM Licensing Program Analyst (LPA) Michelle Sutton conducted an unannounced Case Management inspection for a change of capacity at Nataliia Stefanets Family Childcare Home. LPA met with Nataliia and explained the purpose of today's inspection. LPA was granted the inspection authority to enter the Home. The family childcare home days and hours are Monday to Friday 7:30 AM to 6:00 PM. Present in the home at time of inspection were licensee, assistant and 6 preschool children. Licensee is in compliance for the maximum licensed capacity and ratio for a Small Family Child Care Home.

Licensee 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 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.

INDOOR SPACE: LPA toured the indoor space of the home. The home consist of 4 bedroom, 3 bathrooms, living room, dinning room, laundry room, kitchen and garage.


IN-USE AREAS: downstairs bathroom, play room to the right of the entry way, downstairs bedroom, and backyard.
OFF-LIMIT AREAS: entire second level, kitchen, living room, dining area, laundry room, and garage. These areas are inaccessible by visual supervision and safety gates.
OUTDOOR SPACE: LPA toured the outdoor area (backyard). The right side of the yard is where the facility operates. LPA observed there are no pools, hot tubs or other bodies of water.
SUPERVISORS NAME: Sherelle Johnson
LICENSING EVALUATOR NAME: Michelle Sutton
LICENSING EVALUATOR SIGNATURE: DATE: 04/19/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/19/2023
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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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, SUITE 1102
OAKLAND, CA 94612
FACILITY NAME: STEFANETS, NATALIIA
FACILITY NUMBER: 073409219
VISIT DATE: 04/19/2023
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LPA observed: fully charged 2A10BC fire extinguisher, working smoke and carbon monoxide detectors throughout the home. Medicines, cleaning products, sharp objects are stored inaccessible to children. LPA reminded licensee that baby walkers, bouncers, jumpers and similar items are not allowed in family childcare homes. Licensee states that there no pets, no arms and ammunition stored in the home.

Children files and Facility files were reviewed. Facility contained licensee's proof of ownership, Children's Roster, Licensee’s mandated reporter training, pediatric CPR and first aid, immunization against influenza, pertussis, measles and opt out statement for current flu season. Fire department granted fire clearance.

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

A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with the licensee Nataliia Stefanets. LPA has approved facility license for a Large family childcare home.
SUPERVISORS NAME: Sherelle Johnson
LICENSING EVALUATOR NAME: Michelle Sutton
LICENSING EVALUATOR SIGNATURE:

DATE: 04/19/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/19/2023
LIC809 (FAS) - (06/04)
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