<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 304313419
Report Date: 02/08/2022
Date Signed: 02/08/2022 04:31:47 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
FACILITY NAME:PRISYAZHNYUK, YULIAFACILITY NUMBER:
304313419
ADMINISTRATOR:PRISYAZHNYUK, YULIAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(949) 870-2160
CITY:IRVINESTATE: CAZIP CODE:
92620
CAPACITY:14CENSUS: 11DATE:
02/08/2022
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
03:15 PM
MET WITH:Yulia PrisyazhnyukTIME COMPLETED:
05:00 PM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
Licensing Program Analyst (LPA) Alanna Gontarek conducted an announced case management-other inspection to the facility address above. LPA met with Yulia Prisyazhnyuk who provided a tour of the facility indoors and outdoors. There were 11 children present and 2 staff upon arrival.

During tour of facility, at 9:00 a.m., LPA observed two men sleeping in bed in separate rooms. LPA asked who the men were and the Licensee disclosed: Jonathan Winters and Ozcelik Mehmet. Licensee stated that Ozcelik Mehmet was her husband's friend, and has not completed a LiveScan/Fingerprint Clearance Request, and has been residing in the home since December of 2021. Licensee also disclosed that the other man, Jonathan Winters, the Licensee's brother, has not received a criminal record clearance exemption, and has been residing in the home since September 2021. This violates Title 22 Division 12 Chapter 1 Article 3: 102370(d)(1) Criminal Record Clearance.

Both individuals did not receive a criminal record clearance or exemption prior to presence in the home. A civil penalty of $100.00/day/per person, for a maximum of 5 days, for both individuals, will be assessed today in the amount of $1000.00.

LPA provided Licensee with a copy of the LiveScan. LPA advised to have Ozcelik complete the LiveScan immediately. LPA advised Licensee that both individuals may not continue residing in the home as of today, 2/8/22, until both individuals receive fingerprint clearances. Declaration was obtained.

Licensee was reminded that all adults 18 and over living or working in the home, 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/per person up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

Based on LPA's observations, record review and interviews conducted, the following violation was observed in accordance with California Code of Regulations, Title 22, Division 12, Chapter 1, Article 3: Section 102370 Criminal Record Clearance 102370 (d)(1), and is being cited on attached LIC 809D page.

SUPERVISOR'S NAME: Patricia MaganaTELEPHONE: (714) 703-2821
LICENSING EVALUATOR NAME: Alanna GontarekTELEPHONE: (714) 703-2800
LICENSING EVALUATOR SIGNATURE:

DATE: 02/08/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/08/2022
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC809 (FAS) - (06/04)
Page: 1 of 3
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
FACILITY NAME: PRISYAZHNYUK, YULIA
FACILITY NUMBER: 304313419
VISIT DATE: 02/08/2022
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
Page 2:

LPA Alanna Gontarek informed licensee Yulia Prisyazhnyuk that this report dated (2/8/2022) documents 1 Type A citation. Type A citations shall be posted for 30 consecutive days as there is immediate risk to the health, safety, or personal rights of children in care. Also, LPA Alanna Gontarek informed the licensee to provide a copy of this licensing report dated (2/8/2022) that documents any Type A citation to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification.

Exit interview conducted and report was reviewed with the Licensee, Yulia Prisyazhnyuk. Appeal Rights and deficiencies were discussed. The Licensee was provided a copy of their appeal rights (LIC 9058) and their signature on this form acknowledges receipt of these rights. All appeals must be in writing and received by the Regional Office within 15 business days.

A notice of site visit was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

-End of Report-

SUPERVISOR'S NAME: Patricia MaganaTELEPHONE: (714) 703-2821
LICENSING EVALUATOR NAME: Alanna GontarekTELEPHONE: (714) 703-2800
LICENSING EVALUATOR SIGNATURE:

DATE: 02/08/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/08/2022
LIC809 (FAS) - (06/04)
Page: 3 of 3
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME: PRISYAZHNYUK, YULIA
FACILITY NUMBER: 304313419
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/08/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
02/09/2022
Section Cited

1
2
3
4
5
6
7
"Criminal Record Clearance:
(d) All individuals subject to a criminal record review pursuant to Health and Safety Code Section 1596.871 shall prior to working, residing, or volunteering in a licensed facility:(1) Obtain a California clearance or a criminal record exemption ... Department." This requirement is not met as evidenced by:
8
9
10
11
12
13
14
During tour of facility, at 9:00 a.m., LPA observed 2 men sleeping in separate rooms. Licensee disclosed that Ozcelik Mehmet has not completed a LiveScan/Fingerprint Clearance Request, and has been residing in the home since12/21. Jonathan Winters has not received a criminal record clearance exemption, and has been residing in the home since 9/21.
This poses an immediate health and safety risk, or personal rights of children in care.
8
9
10
11
12
13
14
the due date of 2/9/22. LPA obtained a declaration. LPA assessed a civil penalty of $1000.00 for uncleared adults living in the home.

1
2
3
4
5
6
7

1
2
3
4
5
6
7
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME: Patricia MaganaTELEPHONE: (714) 703-2821
LICENSING EVALUATOR NAME: Alanna GontarekTELEPHONE: (714) 703-2800
LICENSING EVALUATOR SIGNATURE:
DATE: 02/08/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/08/2022
LIC809 (FAS) - (06/04)
Page: 2 of 3