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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 343624984
Report Date: 05/31/2023
Date Signed: 05/31/2023 10:07:52 AM

Document Has Been Signed on 05/31/2023 10:07 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
RIVER CITY (SACTO)CC, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME:BOYKO, GALINAFACILITY NUMBER:
343624984
ADMINISTRATOR:BOYKO, GALINAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(916) 317-5391
CITY:ANTELOPESTATE: CAZIP CODE:
95843
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 0DATE:
05/31/2023
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Galina BoykoTIME COMPLETED:
10:30 AM
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On May 31, 2023 at 9:00 AM, Licensing Program Analysts (LPAs) Tanya Washington and Eddie Barragan met with Applicant Galina Boyko for the purpose of a pre-licensing inspection. There were no other adults or children in the home during the inspection. All individuals subject to criminal background review have obtained a criminal record clearance. Applicant plans to operate Monday- Friday from 5:00 AM to 1:00 AM. Applicant understands that she may not care for the same child over the 24 hour period. The inspection was conducted in Russian. Applicant has obtained permission from the landlord to be able to provide care to fourteen children, signed form LIC9149 is on file. Applicant was granted a fire clearance by Sacramento Metropolitan Fire Department on 05/24/2023. Applicant has sufficient experience to operate as a large provider at this location. Applicant stated that she plans to hire assistants and is aware of ratio and capacity regulations.

A health and safety inspection was conducted inside and out. This facility is a single story home which contains four bedrooms, 3 bathrooms, 2 play rooms, dining room, living room, kitchen, laundry room and garage. The off-limit areas will consist of the left wing which has four bedrooms and two bathrooms. Additionally the facility will have the laundry room and garage off limits. Applicant currently only plans to use the enclosed porch area for children's outdoor play. The yard is currently not fully enclosed and the ground portion of the backyard will remain off limits until further maintenance is complete. Applicant understands that she is required to contact the Regional Office when she changes areas from off limits to on limits or vise versa. Applicant indicated that 100% supervision will be provided to children while they play out in the backyard. Off-limits areas will remain inaccessible to children by closed doors and/or supervision. Toxic and hazardous items are inaccessible to children. Functioning smoke, carbon monoxide detectors and fire extinguisher were observed in the home. Applicant has completed the required Preventative Health and Safety training on 10/15/2022, current pediatric CPR and first aid certification is valid until 04/2025. Applicant stated that there are no weapons in the home. There are two fireplaces in the home, one is located in the play room and the other is located in the living room, both fire places are barricaded and will not be used while daycare is in operation. Supervision was discussed and applicant understands that children must also be 100% supervised around bodies of water and public parks. Immediate Civil Penalty regulation and deficiencies were reviewed.

REPORT CONTINUES ON NEXT PAGE LIC809C.
SUPERVISORS NAME: Amanda Blesi
LICENSING EVALUATOR NAME: Tanya Washington
LICENSING EVALUATOR SIGNATURE: DATE: 05/31/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/31/2023
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVER CITY (SACTO)CC, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME: BOYKO, GALINA
FACILITY NUMBER: 343624984
VISIT DATE: 05/31/2023
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Applicant was reminded that all adults 18 and over living in the home, persons who provide care and supervision to children, and staff who have contact with children, 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 reviewed with applicant the LIC 311D, Forms/Records To Keep In Your Family Child Care Homes, children’s forms/records, facility forms/records, and information to be posted.

LPA consulted applicant regarding the following topics; new upcoming regulations, Type A vs. Type B deficiencies, complaints, LPA’s right to interview children without parental consent, civil penalties, incidental medical services, placement of detergents, placement of poisons, placement of medicines, announced vs. unannounced inspections, posting requirements, unusual incident reports, licensing file management, fire drills, 80% supervision, 100% supervision, fingerprint clearances, advertising, mandated reporting and best practices.

LPA consulted the applicant regarding personal rights. Applicant understands that corporal, physical and/or unusual forms of punishment is never allowed toward day care children or their own children during day care hours.
LPA provided the Community Care Licensing website www.ccld.ca.gov, so the applicant can obtain updated licensing information, new regulations and access forms. LPA advised applicant of their responsibility to stay current regarding new regulations.

LPA advised applicant to sign up for the quarterly updates provided by the Childcare Advocates Program. LPA provided the link https://www.cdss.ca.gov/inforesources/Community-Care-Licensing/subscribe for the applicant to sign up for the updates.
http://www.ada.gov/childqanda.htm

REPORT CONTINUES ON NEXT PAGE LIC809C.
SUPERVISORS NAME: Amanda Blesi
LICENSING EVALUATOR NAME: Tanya Washington
LICENSING EVALUATOR SIGNATURE:

DATE: 05/31/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/31/2023
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
RIVER CITY (SACTO)CC, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME: BOYKO, GALINA
FACILITY NUMBER: 343624984
VISIT DATE: 05/31/2023
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LPA discussed the safe sleep regulations with applicant 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 applicant 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.

This facility plans to provide Incidental Medical Services (IMS). For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. When any IMS is provided, a Plan for Providing IMS must be submitted to the Department. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice)/(800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at:

Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other important information communication platform.
To receive important license-related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-care-licensing/subscribe and select the Child Care option to receive email communication.

EFFECTIVE TODAY, 05/31/2023 THE FACILITY IS LICENSED TO SERVE A MAX. CAP OF 12 (WHEN THERE IS AN ASSISTANT PRESENT): WITH NO MORE THAN 4 INFANTS.
OR MAX CAP 14 - NO MORE THAN 3 INFANTS. 1 CHILD IN KINDERGARTEN OR ELEMENTARY SCHOOL AND 1 CHILD AT LEAST AGE 6.
SUPERVISORS NAME: Amanda Blesi
LICENSING EVALUATOR NAME: Tanya Washington
LICENSING EVALUATOR SIGNATURE:

DATE: 05/31/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/31/2023
LIC809 (FAS) - (06/04)
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