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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 343623019
Report Date: 02/17/2023
Date Signed: 02/17/2023 12:53:41 PM

Document Has Been Signed on 02/17/2023 12:53 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, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833
FACILITY NAME:BOYKO, GALINAFACILITY NUMBER:
343623019
ADMINISTRATOR:BOYKO, GALINAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(916) 207-0335
CITY:FAIR OAKSSTATE: CAZIP CODE:
95628
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 12DATE:
02/17/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
11:45 AM
MET WITH:Galina BoykoTIME COMPLETED:
01:00 PM
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On February 17, 2023 Licensing Program Analyst (LPAs) Lea Habtom and Amanda Blesi arrived at the home of Galina Boyko for a case management visit. The purpose of today's inspection is to address ratio adherence based on last inspection on February 8, 2023. At the time of arrival, a census was taken of 3 infants and 9 preschool children being supervised by 2 staff. Licensee was not present at the time of LPA's arrival. During the inspection licensee arrived around 12:00 pm. LPA L. Habtom confirmed that all staff have fingerprint clearance and associations. Deficiencies cited on February 8, 2023 were cleared during today's inspection and cleared letters were provided to licensee. LPA L. Habtom reviewed the report with the licensee Galina Boyko. No Title 22 regulations were cited during today's inspection. A notice of site visit was provided and appeal rights.
SUPERVISORS NAME: Keven Peters
LICENSING EVALUATOR NAME: Lea Habtom
LICENSING EVALUATOR SIGNATURE: DATE: 02/17/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/17/2023
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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