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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 197493596
Report Date: 01/26/2021
Date Signed: 01/27/2021 07:37:06 AM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
This is an official report of an unannounced visit/investigation of a complaint received in our office on
11/02/2020 and conducted by Evaluator Margarit Sislyan
COMPLAINT CONTROL NUMBER: 30-CC-20201102121345
FACILITY NAME:STOLYAROVA FAMILY CHILD CAREFACILITY NUMBER:
197493596
ADMINISTRATOR:STOLYAROVA, ALINAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(323) 921-2540
CITY:NORTHRIDGESTATE: CAZIP CODE:
91325
CAPACITY:14CENSUS: DATE:
01/26/2021
UNANNOUNCEDTIME BEGAN:
12:10 PM
MET WITH:Alina StolyarovaTIME COMPLETED:
12:40 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
License - Facility operating out of ratio.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Margarit Sislyan, Licensing Program Analyst (LPA) conducted tele-visit via Face-Time on 1/26/2021 at 12:10 PM to continue the investigation of the above allegation and deliver the investigation findings.
LPA spoke with Alina Stolyarova, Licensee.
LPA observed there were 6 children present at the facility along with licensee and her assistant.
During the investigation LPA interviewed parties relevant to the above allegation. Based on LPA's observation interviews conducted and preponderance of evidence the above allegation is unsubstantiated, means that although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violation occurred.
Licensee has been advised that an email shall be sent with the report attached, which has been reviewed during the Tele-Visit and a read receipt via email shall be considered an acknowledgement that they are in receipt of this form.

Exit interview
Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Mary RuizTELEPHONE:
LICENSING EVALUATOR NAME: Margarit SislyanTELEPHONE:
LICENSING EVALUATOR SIGNATURE:

DATE: 01/26/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/26/2021
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
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