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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197493890
Report Date: 01/07/2022
Date Signed: 01/07/2022 02:55:14 PM

Document Has Been Signed on 01/07/2022 02:55 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, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME:KRYSHCHENKO FAMILY CHILD CAREFACILITY NUMBER:
197493890
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 6DATE:
01/07/2022
TYPE OF VISIT:Case Management - OtherANNOUNCEDTIME BEGAN:
10:30 AM
MET WITH:Iryna KryshchenkoTIME COMPLETED:
01:30 PM
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On January 7, 2022, Licensing Program Analyst (LPA), V. Wheatley conducted an announced Case Management inspection for the purpose of an increase in capacity. The licensee is requesting to increase from a small license to a large license. LPA met with licensee Iryna Kryshchenko and her husband Sean Meehan at 10:30am. The licensee's assistant Staff #1 was also present. LPA toured the inside and and outside of the home and observed six children on the premises playing outside in the backyard. The parents enter through the side of the home. LPA observed Covid-19 signs posted and hand sanitizer. Days and hours of operation are Monday through Friday, 8am to 6pm. Previous inspection conducted on Oct. 21, 2021.

Current facility sketch reviewed and confirmed that one large bedroom (den) are used for providing care accessible to children and a small area near the kitchen. All other rooms are off-limits and made inaccessible by use of locks. Detergents, cleaning compounds, medication and other hazardous items are made inaccessible. Although LPA observed a child proof gate at the entrance of the kitchen, the licensee was still informed to keep knives and sharp objects inaccessible. LPA observed a working fire extinguisher, smoke detector, and carbon monoxide detector. LPA observed adequate heating and air condition for safety and comfort. Safe toys and play equipment are observed. The home has working telephone service and LPA confirmed the phone number. The fire department conducted an inspection and approved the large license.

LPA discussed Safe Sleep Regulations with licensee although there are no infants present. Cribs and play yards will be kept free from all loose articles and objects while infants are sleeping, and there are no objects hanging above or attached to the crib or play yard. Infants are not swaddled while in care. Provider physically checks on sleeping infants every fifteen minutes and documents any signs of distress which includes but is not limited to flushed skin color, increase in body temperature, restlessness and labored breathing. Infants can be visually observed through an open door if sleeping in a separate room. Individual Infant Sleeping Plan is completed and in file for each infant up to 12 months of age. Infants up to 12 months of age are placed on their backs for sleeping.
SUPERVISORS NAME: Maureen Neal
LICENSING EVALUATOR NAME: Veronica Wheatley
LICENSING EVALUATOR SIGNATURE: DATE: 01/07/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/07/2022
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, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: KRYSHCHENKO FAMILY CHILD CARE
FACILITY NUMBER: 197493890
VISIT DATE: 01/07/2022
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Licensee ensures that children in care are supervised at all times and is aware children shall not be left in parked vehicles. Car seats are used for transportation purposes only and are not used for sleeping children. The outdoor play area in the backyard is fenced and there are no hazards to children present. Capacity as specified on the license is being maintained.

There is no swimming pool or other bodies of water on the premises. LPA did observe a bird bath which is empty. LPA informed the licensee and her husband that all bodies of water must be inaccessible. They both agreed to keep it empty. Per license, there are no firearms or ammunition on the premises. There are no pets on the premises.

All adults who reside or work in the home have a criminal record clearance or exemption. There are no excluded individuals present at this home. Incidental Medical Services (IMS) are not currently being provided. Licensee is aware that an IMS plan is required to be submitted to the licensing office if they provide any of these services. Information regarding Americans with Disability Act (ADA) can be obtained by contacting US Department of Justice toll free ADA Information line at (800) 514-0301(voice), (800) 514-0383 (TDD) and website link https://www.ada.gov/childqanda.htm.

LPA discussed the Community Care Licensing website www.ccld.ca.gov which will provide access to Provider Information Notices (PINs), Quarterly Updates, COVID-19 Information and Resources, Mandated Reporter Training, Safe Sleep in Child Care, Lead Poisoning Facts, Forms and Regulations.

Per Title 22, Division 12, Chapter 3, of the California Code of Regulations, no deficiencies are cited. A license for 14 (large) will be granted.

This report shall be made available to the public upon request. LIC 9213 Notice of Site Visit is provided and required to be posted for 30 days.

Exit interview.

A copy of this report will be emailed to the licensee and will be acknowledge via Read Receipt.
SUPERVISORS NAME: Maureen Neal
LICENSING EVALUATOR NAME: Veronica Wheatley
LICENSING EVALUATOR SIGNATURE:

DATE: 01/07/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/07/2022
LIC809 (FAS) - (06/04)
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