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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197419145
Report Date: 06/28/2022
Date Signed: 07/07/2022 11:33:06 AM

Document Has Been Signed on 07/07/2022 11:33 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
CCLD Regional Office, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME:KUDRINA & KUDRINA FAMILY CHILD CAREFACILITY NUMBER:
197419145
ADMINISTRATOR:KUDRINA, ZINAYIDA & SVITLAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(818) 577-3599
CITY:TARZANASTATE: CAZIP CODE:
91356
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 6DATE:
06/28/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
11:53 AM
MET WITH:Zinayida KudrinaTIME COMPLETED:
03:00 PM
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On 6/28/2022 Program Analyst (LPA), Judy Laureano conducted an unannounced Annual Required Inspection and was met by Zinayida Kudrina. Licensee language of preference is Russian. Co-licensee, Svitlana Kudrina arrived during the middle of the inspection.

Days and hours of operation are 8:00 a.m. to 6:00 p.m., Monday through Friday. Facility provides care and supervision to children ages 2 to 5 years old.

LPA toured the home inside and outside and a census was taken, 6 children were present during the inspection.

Current facility sketch reviewed, and Licensee confirmed that bedroom 1, living room dining room/eating and back yard are used for the day care. Families access the day care room through the side entrance of the home. LPA observed a side wooden door with a ring camera doorbell. Upon entering the facility, you are led to the back yard. Licensee confirmed that dining room area/eating area is used for the day care and children nap in bedroom 3. The living room is used for the day care room. The bathroom that children use is located next to bedroom 3.

The following areas are currently OFF LIMITS: main entrance of the home, bedroom 2/office room and master bedroom with a bathroom and Kitchen area. LPA observed a safety gate outside the kitchen area and a sliding door at the other side of the kitchen. LPA observed a detached garage, designated as OFF LIMITS, garage is gated and children do not have access to the area.

There is no swimming pool or other bodies of water on the premises. There are no firearms or ammunition on the premises. No poisons were observed during the inspection.
SUPERVISORS NAME: Claudia Escobedo
LICENSING EVALUATOR NAME: Judy Laureano
LICENSING EVALUATOR SIGNATURE: DATE: 06/28/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/28/2022
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: KUDRINA & KUDRINA FAMILY CHILD CARE
FACILITY NUMBER: 197419145
VISIT DATE: 06/28/2022
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Detergents, cleaning compounds, medication and other hazardous items are made inaccessible and stored under the kitchen cabinet. Safety gate was observed outside the kitchen making the area inaccessible.

There is a working fire extinguisher, smoke detector, carbon monoxide detector and adequate heating and ventilation for safety and comfort. Fire pull station was observed in the hallway outside bedroom 2/office. LPA did not observe any stairs in the home. Safe toys and play equipment are observed. The home has working telephone service and LPA confirmed the phone number is 818-577-8572.

Facility does not take in any infant. Licensee confirmed that facility does only enrolls children ages 2 to 5 years of age.

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.

LPA reviewed a sample of children’s files and observed files were complete. Licensee’s Mandated Reporter Training was not available for review. Licensee agrees to complete online training and submit proof of completion by 7/11/2022. Licensee’s pediatric CPR/First Aid expires on 2/2023. LPA reviewed the LIC311D with licensee and provided a sample packet of all necessary forms.

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.

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.
SUPERVISORS NAME: Claudia Escobedo
LICENSING EVALUATOR NAME: Judy Laureano
LICENSING EVALUATOR SIGNATURE:

DATE: 06/28/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/28/2022
LIC809 (FAS) - (06/04)
Page: 2 of 6
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: KUDRINA & KUDRINA FAMILY CHILD CARE
FACILITY NUMBER: 197419145
VISIT DATE: 06/28/2022
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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.

A notice of site visit was given and must remain posted for 30 days.
Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

Exit interview conducted and report was reviewed with the licensee Zinayida Kudrina.
SUPERVISORS NAME: Claudia Escobedo
LICENSING EVALUATOR NAME: Judy Laureano
LICENSING EVALUATOR SIGNATURE:

DATE: 06/28/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/28/2022
LIC809 (FAS) - (06/04)
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