304313419-5-5-2022-06-CC-AGOK-CE5M3G-20220505091503

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 304313419
Report Date: 05/04/2022
Date Signed: 05/05/2022 09:15:11 AM

Document Has Been Signed on 05/05/2022 09:15 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
CCLD Regional Office, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME:	PRISYAZHNYUK, YULIA		FACILITY NUMBER:	304313419
ADMINISTRATOR:	PRISYAZHNYUK, YULIA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(949) 870-2160
CITY:	IRVINE	STATE: CA	ZIP CODE:	92620
CAPACITY:	14	CENSUS: 9	DATE:	05/04/2022
TYPE OF VISIT:	Case Management - Other	UNANNOUNCED	TIME BEGAN:	03:45 PM
MET WITH:	Vladislav Sluchenkov, Licensee's spouse/assistant		TIME COMPLETED:	06:00 PM

NARRATIVE

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Licensing Program Analyst (LPA) Alanna Gontarek conducted an announced case management- other inspection to the facility address above. LPA met with Vladislav Sluchenkov, licensee's husband/assistant who provided a tour of the facility indoors. There were 9 children present and 2 staff , Vladislav Sluchenkov- licensee's husband and Olga Smiyan.
During tour of facility, at 2:57 p.m., LPA observed Olga Smiyan sitting on the floor of the infant nap area by sliding glass door, providing care and supervision, rocking one infant. LPA asked Vlad if Olga was fingerprinted and Vlad stated, "No, she has no papers. She is a refugee from Ukraine and has no passport or driver's license so she cannot get fingerprinted." LPA asked what Olga does at the day care and Vlad stated she is a volunteer and is at facility from 12:30 p.m. and stays until 4:00 p.m. to help with nap time and cleaning. LPA asked if Olga lived at the facility, and Vlad stated, "No, she only comes at 12:30 p.m. to help with nap time and cleaning." LPA asked how long Olga has been at facility helping out, and Vlad said, "About 2 weeks." Vlad disclosed that Olga is a sister of one of the children's authorized representatives, and wanted to help the child's authorized representative, and stated parents are aware of Olga's presence at the facility. Licensee arrived at 3:17 p.m. with one minor child and stated she was picking her children up from school. LPA stated minor child she arrived with was her son. During interview conducted with Licensee, Licensee disclosed she has had "a lot of turn over" with employees, and Olga helps with the daycare, stating Olga watches children during nap and helps with cleaning and sanitizing the daycare from 1:30 p.m. to 3:30 p.m. daily, since 4/25/22. This violates Title 22 Division 12 Chapter 1 Article 3: 102370(d)(1) Criminal Record Clearance.

Olga Smiyan did not receive a criminal record clearance or exemption prior to initial presence in the home. A civil penalty of $100.00/day, for a maximum of 5 days, for Olga Smiyan, will be assessed today in the amount of $500.00.

LPA provided Licensee with a copy of the LiveScan. LPA advised to have Olga Smiyan complete the LiveScan immediately. LPA advised Licensee that Olga may not continue working with the children at the daycare as of today, 5/4/22 until fingerprint clearance for Olga Smiyan is received. 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

SUPERVISOR'S NAME: Patricia Magana	TELEPHONE: (714) 703-2821
LICENSING EVALUATOR NAME: Alanna Gontarek	TELEPHONE: (714) 703-2800
LICENSING EVALUATOR SIGNATURE:	DATE: 05/04/2022

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/04/2022

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
CCLD Regional Office, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME: PRISYAZHNYUK, YULIA	FACILITY NUMBER: 304313419
	VISIT DATE: 05/04/2022

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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.

LPA Alanna Gontarek informed licensee Yulia Prisyazhnyuk that this report dated (5/4/22) 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 (5/4/2022) 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.

Based on LPA's observations, Licensing Information System (LIS)- Facility Personnel Report 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. Civil Penalty is being assessed today in the amount of $500.00.

Exit interview conducted with Licensee, Yulia Prisyazhnyuk. A copy of this report and the Appeal Rights (LIC 9058 FAS 01/16) were given and explained. Licensee’s signature on this form acknowledges receipt of these rights. A Confidential Names list (LIC811) was provided during this visit. The Notice of Site Visit (LIC 9213) – must remain posted for 30 days during the hours of operation after each site inspection by a licensing representative. Failure to maintain posting as required will result in a civil penalty of $100.00.

(End of Report)

SUPERVISOR'S NAME: Patricia Magana	TELEPHONE: (714) 703-2821
LICENSING EVALUATOR NAME: Alanna Gontarek	TELEPHONE: (714) 703-2800
LICENSING EVALUATOR SIGNATURE:	DATE: 05/04/2022

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/04/2022

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 05/05/2022 09:15 AM - It Cannot Be Edited

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: 05/04/2022

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type A 05/05/2022 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 2:57 p.m., LPA observed Olga Smiyan sitting, providing care and supervision, rocking, one infant. on the floor of the infant nap area. LPA asked Vlad if Olga was fingerprinted and Vlad stated, "No." Vlad stated Olga comes at 12:30 p.m. and stays until 4:00 p.m. to help with nap time and cleaning. This poses an immediate health, safety, and personal rights risk to the children in care.	8 9 10 11 12 13 14	form to licensee. LPA obtained a declaration from licensee. LPA assessed a civil penalty of $500.00 for uncleared adult being present in the home without fingerprint clearance.
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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 Magana	TELEPHONE: (714) 703-2821
LICENSING EVALUATOR NAME: Alanna Gontarek	TELEPHONE: (714) 703-2800
LICENSING EVALUATOR SIGNATURE:	DATE: 05/04/2022

I acknowledge receipt of this form and understand my appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/04/2022

LIC809 (FAS) - (06/04)

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