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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197409312
Report Date: 12/05/2024
Date Signed: 01/21/2025 03:40:48 PM

Document Has Been Signed on 01/21/2025 03:40 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
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME:ZHURAVKA FAMILY CHILD CAREFACILITY NUMBER:
197409312
ADMINISTRATOR/
DIRECTOR:		ZHURAVKA, ELENAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(818) 728-8109
CITY:ENCINOSTATE: CAZIP CODE:
91436
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 4DATE:
12/05/2024
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:30 AM
MET WITH:Licensee Elena ZhuravakaTIME VISIT/
INSPECTION COMPLETED:
10:30 AM
NARRATIVE
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On 12/05/2024 at 8:30am,  Licensing Program Analyst (LPA) Amelia Morales conducted an unannounced Case Management visit to this facility. Upon arrival, LPA met with Licensee Elena Zhuravka who guided LPA on a tour of the facility. There were 4 children present during the visit, and 2 staff members.

LPA explained the purpose of the visit which was to obtain signatures and deliver amended report. on 11/22/2024, a type A Citation was issued for 2 staff that did not have fingerprint clearance. A Civil Penalty was assessed for 1000 at that time. Licensee informed LPA that on the Civil Penalty one of the Individuals last name was incorrect.

During today's visit LPA Morales, provided the Licensee a new LIC421BG that reflects the adjustment of the Civil Penalty that has been reduced to 200 dollars as well as the corrected last name.

Notice of Site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with Licensee Elena Zhuravka.

SUPERVISORS NAME: Betty Bell
LICENSING EVALUATOR NAME: Amelia Morales
LICENSING EVALUATOR SIGNATURE: DATE: 12/05/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/05/2024
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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Document Has Been Signed on 01/21/2025 03:40 PM - It Cannot Be Edited


Created By: Amelia Morales On 12/05/2024 at 08:59 AM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME: ZHURAVKA FAMILY CHILD CARE
FACILITY NUMBER: 197409312

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/05/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
12/05/2024
Section Cited
CCR
102370(d)(1)

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(d) All individuals subject to a criminal record review pursuant to Health and Safety Code Section 1596.871 shall prior to working, residing or volunteering in a licensed facility: (1) Obtain a California clearance or a criminal record exemption as required by the Department or

This requirement is not met as evidenced by:
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This citation was issued on 11/22/22 and has already been cleared.

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Based on observation, interview and record review, the licensee did not comply with the section cited above in that staff 3 & 5 do not have criminal record clearance, which poses an immediate health, safety or personal rights risk to persons in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Betty Bell
LICENSING EVALUATOR NAME:Amelia Morales
LICENSING EVALUATOR SIGNATURE:
DATE: 12/05/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/05/2024


LIC809 (FAS) - (06/04)
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