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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198022068
Report Date: 04/06/2026
Date Signed: 04/06/2026 02:17:08 PM

Document Has Been Signed on 04/06/2026 02:17 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
CCLD Regional Office, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME:TSYRENOVA FAMILY CHILD CAREFACILITY NUMBER:
198022068
ADMINISTRATOR/
DIRECTOR:		TSYRENOVA, VIKTORIIAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(747) 215-4498
CITY:GLENDALESTATE: CAZIP CODE:
91207
CAPACITY: 14TOTAL ENROLLED CHILDREN: 0CENSUS: 0DATE:
04/06/2026
TYPE OF VISIT:PrelicensingANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:00 PM
MET WITH:Victoriia Tsyrenova, ApplicantTIME VISIT/
INSPECTION COMPLETED:
02:35 PM
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On 04/06/26, at 12:00 PM Licensing Program Analyst (LPA) Anomeh Eivazian conducted an announced pre-licensing follow up inspection to the above facility to ensure all corrections from 03/24/26 were corrected. LPA met with Victoriia Tsyrenova, Applicant who guided analyst on a tour of the facility. Per applicant operation hours will be Monday to Friday, 7:00 a.m. to 11:00 p.m.. Applicant states she will care for children 1-12 years old.

Applicant was previously licensed at 411 Lincoln Avenue #25, Glendale, CA 91205 with facility number 198021558. Fire clearance for Large Family Child Care Home was granted on 03/10/26.

The following corrections were observed during this inspection:

There is a in ground pool on the premises which is located in the backyard. The pool area is off-limit and inaccessible to the children. Pool area in the backyard is separated by five feet high (60 inches) iron fencing in one side, the gap from the ground to the bottom of the fence is less that 2 inches and it is covered by mesh , also gates swing away from the pool, self-closing with a self-latching, key lockable devise placed no lower than 60 inches above the ground. The other side of the pool, which leads to the Stocker Street is covered with at least six feet high trees with fencing, the other two sides of the pool which is facing toward the building is fenced by five feet high (60 inches) mesh fencing, with no gap from the ground to the bottom of the enclosure, no gaps or voids that can allow the passage of a sphere with a diameter equal to or greater than four inches. However, the mesh fencing gates swing inside the pool, self-closing with a self-latching, key lockable devise placed no lower than 60 inches above the ground. An outside surface is free of protrusions, cavities, or other physical characteristics that would serve as handhold or footholds that could

REPORT CONTINUES ON NEXT PAGE 1 of 2
NAME OF LICENSING PROGRAM MANAGER: Christina Gabelman
NAME OF LICENSING PROGRAM ANALYST: Anomeh Eivazian
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 04/06/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/06/2026
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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California Health & Human Services Agency
California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:
  • Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.
  • Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)
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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, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: TSYRENOVA FAMILY CHILD CARE
FACILITY NUMBER: 198022068
VISIT DATE: 04/06/2026
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enable a child to climb over. Also, applicant provided documentation that mesh fencing is compliant with American Society for Testing and Materials (ASTM) International Standard F2286. Also, LPA observed an alarm that was placed in the swimming pool, will sound upon detecting an entrance into the water. During this inspection, LPA asked the applicant to test the alarm. The alarm was turned on and was in working condition when applicant put her hand in the pool and LPA heard the alarm went off and heard by LPA. The alarm is compliant with ASTM International Standard F2208. A life ring with a minimum exterior of 17 inches and labeled as approved by the United Stated Coast Guard and a rescue pole with a body hook and a minimum fixed length of 12 feet was observed by LPA visible from the swimming pool and readily available for immediate use.

LPA also informed applicant she shall perform a daily inspection of the drawing prevention safety feature and safety equipment before opening the facility and maintain log of the inspections to be provided to the department upon request.

LPA also observed operable door alarms on the off-limit bedrooms doors which lead to the backyard, facing the pool and on off-limit bedrooms windows facing the pool.

LPA observed fireplace in the living room was screened with a fire resistance screen to prevent access.

LPA observed applicant filled the decorative water fountain in the off-limit area in the backyard with dirt and plants flowers to make it safe for children.

The following corrections need to be corrected prior to obtaining a small family child care license. Corrections are due by 05/06/26:

- Applicant will make sure the pool mesh fencing gate swings away from the pool with a self-latching device.

A large family child care license will be granted upon receipt of proof of corrections for the above. Once licensed, the applicant is required to adhere to the terms and limitations stated on the license.



Exit interview conducted and report was reviewed with the applicant, Victoriia Tsyrenova.

REPORT END 2 of 2
NAME OF LICENSING PROGRAM MANAGER: Christina Gabelman
NAME OF LICENSING PROGRAM ANALYST: Anomeh Eivazian
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 04/06/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/06/2026
LIC809 (FAS) - (06/04)
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