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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197495294
Report Date: 09/15/2023
Date Signed: 09/15/2023 11:05:12 AM

Document Has Been Signed on 09/15/2023 11:05 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:KUZINA FAMILY CHILD CAREFACILITY NUMBER:
197495294
ADMINISTRATOR:VIKTORIIA KUZINAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(267) 261-2560
CITY:GARDENASTATE: CAZIP CODE:
90249
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: DATE:
09/15/2023
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Viktoriia KuzinaTIME COMPLETED:
11:00 AM
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On 9/15/2023, Licensing Program Analyst (LPA) V. Wheatley conducted a second announced pre-licensing inspection for the purpose of a new license. The meeting was to ensure that health, safety and personal rights, as required by Title 22 Regulations governing California Family Child Care Homes, will be met by the applicant, Viktoriia Kuzina for a new license. The parents will enter the side of the home and a parent board will be placed there to view documents. The applicant has units and experience to be allowed to have a large day care. The fire department submitted a fire clearance to the Department.

LPA observed the requested corrections today. LPA observed the applicant and her family all moved into the home and the following.

1. A latch on the closet door in the day care room.
2. A child proof covers over all outlets.
3. A Parent board at entrance with all required documents.
4. A portable gate for the area near the garage and entrance into the backyard.

Based on the corrections a license will be granted immediately.

Exit interview. Report provided to applicant.
SUPERVISORS NAME: Maureen Neal
LICENSING EVALUATOR NAME: Veronica Wheatley
LICENSING EVALUATOR SIGNATURE: DATE: 09/15/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/15/2023
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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