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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197494680
Report Date: 07/22/2024
Date Signed: 07/22/2024 02:20:16 PM

Document Has Been Signed on 07/22/2024 02:20 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:SKRYPNYK SHEVCHUK FAMILY CHILD CAREFACILITY NUMBER:
197494680
ADMINISTRATOR/
DIRECTOR:		ANTON SKRYPNKFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(818) 946-4979
CITY:CANOGA PARKSTATE: CAZIP CODE:
91303
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 12DATE:
07/22/2024
TYPE OF VISIT:POCUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:35 PM
MET WITH: Larsa Shevchuk, LicenseeTIME VISIT/
INSPECTION COMPLETED:
02:45 PM
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On 7/22/24, at 1:35PM, Licensing Program Analyst (LPA) Tatiana Bickham conducted an unannounced Plan of Correction (POC) Visit. Upon arrival, LPA disclosed the purpose of the inspection and met with assistant Licensee Larsa Shevchuk. Licensee guided the LPA on a tour of the facility. There were 12 day care day care children and 2 staff present during today’s inspection..

During the Required - 3 Year inspection conducted on 6/26/24, the following deficiencies were issued;
-Type B: 102417(g)(4) - Bleach and cleaning supplies need to be locked or on top shelf
-Type B: 102417(g) - stove knobs do not have safety knobs and all cabinets accessible to children do not have locks.
-Type B: 102423(a)(2) - Children sleeping garage, Licensee stated RO said children could sleep in the garage as long as it is safe and there are smoke/carbon detectors in the room. Licensee stated RO LPA said to send a updated copy of the facility sketch. No smoke detector in the room.
-Type B: HSC 1596.8662(b)(1)- No one has current mandated reporter training.

Corrections:

-102417(g)(4)- Licensee moved clean solutions to top shelf, making them inaccessible to children in care.

-102417(g) - Licensee put safety locks on all cabinets in the kitchen and added safety knobs to the doors and stove.
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SUPERVISORS NAME: Raul Navarro
LICENSING EVALUATOR NAME: Tatiana Bickham
LICENSING EVALUATOR SIGNATURE: DATE: 07/22/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/22/2024
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: SKRYPNYK SHEVCHUK FAMILY CHILD CARE
FACILITY NUMBER: 197494680
VISIT DATE: 07/22/2024
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-102423(a)(2)- Children are now sleeping in bedroom #2 and the office, the garage is now the learning room and activity center for the children.

-1596.8662(b)(1)- All staff and Licensee's have completed the Mandated Reporter Training, certificates expire in July 2026.

The Notice of Site Visit was provided and must remain posted for 30 days during the hours of operation after each site visit by a licensing representative. Failure to maintain posting as required will result in a civil penalty of $100.00.

Exit interview was conducted with Larsa Shevchuk, Licensee and Appeals Rights provided.

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SUPERVISORS NAME: Raul Navarro
LICENSING EVALUATOR NAME: Tatiana Bickham
LICENSING EVALUATOR SIGNATURE:

DATE: 07/22/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/22/2024
LIC809 (FAS) - (06/04)
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