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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 013418512
Report Date: 01/14/2025
Date Signed: 01/14/2025 10:21:45 AM

Document Has Been Signed on 01/14/2025 10:21 AM - 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:YAROSHEVSKAYA, ANNAFACILITY NUMBER:
013418512
ADMINISTRATOR/
DIRECTOR:		YAROSHEVSKAYA, ANNAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(925) 828-3071
CITY:DUBLINSTATE: CAZIP CODE:
94568
CAPACITY: 12TOTAL ENROLLED CHILDREN: 12CENSUS: 6DATE:
01/14/2025
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:05 AM
MET WITH:Licensee, Anna YaroshevskayaTIME VISIT/
INSPECTION COMPLETED:
10:30 AM
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Licensing Program Analyst (LPA) Jyoti Saini met with Licensee Anna Yarosherskaya for an unannounced Annual Random Inspection. LPA disclosed the purpose of the inspection and was granted entry into the facility by the Licensee. Present during this inspection was Licensee, her mother supervising one (1) infant and five(5) preschoolers. The Licensee is within the capacity limits of a Large License. The Licensee lives at home with her husband and mother. The house is two story with four bedrooms and two and a half bathrooms, a family room, a living room, a kitchen, a dining room, a garage, and a back yard. The hours of operation are 7:00 AM- 6:00 PM, Monday -Friday.
ON-LIMIT AREAS: family room( main daycare area) and a half bathroom( next to garage door) in the backyard. OFF-LIMIT AREAS are the second floor, kitchen, dining room, living room, and garage. All the off-limit areas are made inaccessible to children by locked doors, safety gates, and visual supervision.
The home has a working telephone, a smoke and carbon monoxide detector, and a fire extinguisher that meets the minimum requirements. LPA did not observe any bodies of water. The Licensee confirmed that no firearms were stored in the facility. There are child-size tables and chairs for snacks and activities. The Licensee provides cots, and children bring their blankets and sheets. Per Licensee, The blankets and sheets are washed weekly by the Parents. A child safety gate is located at the bottom of the stairs to prevent access to the stairs and upper levels for children in care. The backyard is a designated outdoor area equipped with a play house, tricycle, ride-on push cars, and slide. The Licensee's CPR and first aid expires on 05/24/2026. The Licensee provides daily snacks and meals. LPA reviewed children's files. All the files are complete and up to date. The Licensee was reminded about the infant's sleep checks. All required postings are properly posted.
SUPERVISORS NAME: Wynn Norona
LICENSING EVALUATOR NAME: Jyoti Saini
LICENSING EVALUATOR SIGNATURE: DATE: 01/14/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/14/2025
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
OAKLAND SOUTH EAST, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME: YAROSHEVSKAYA, ANNA
FACILITY NUMBER: 013418512
VISIT DATE: 01/14/2025
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During Inspection, 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.

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-and-resources/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.



Licensee was reminded about Mandated Reporter training available on CCLD website. Training must be completed every 2 years. Training can be taken online at www.mandatedreporterca.com

To improve the quality and value of the new inspection process, a survey will 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 tools, please send them by email 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.

No deficiency cited today.

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

Exit interview conducted and report was reviewed with the licensee, Anna Yaroshevskaya.

SUPERVISORS NAME: Wynn Norona
LICENSING EVALUATOR NAME: Jyoti Saini
LICENSING EVALUATOR SIGNATURE:

DATE: 01/14/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/14/2025
LIC809 (FAS) - (06/04)
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