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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 304313619
Report Date: 02/25/2022
Date Signed: 02/25/2022 03:13:37 PM


Document Has Been Signed on 02/25/2022 03:13 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, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868



FACILITY NAME:LOPATIN, SIMONFACILITY NUMBER:
304313619
ADMINISTRATOR:LOPATIN, SIMONFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(617) 331-8588
CITY:IRVINESTATE: CAZIP CODE:
92618
CAPACITY:14CENSUS: 10DATE:
02/25/2022
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
02:35 PM
MET WITH:Maria OnofreTIME COMPLETED:
03:45 PM
NARRATIVE
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Licensing Program Analyst (LPA) Mahnaz (Nancy) Malek conducted a case management inspection of this facility. The Covid-19 Emergency Response questionnaire was reviewed and answered. LPA met with Academic Supervisor, Maria Onofre. The licensee, Simon Lopatin was not present. LPA observed a total of 10 children of whom one was under 2 years old and 9 were over 2 years of age. LPA observed 4 staff present excluding Maria Onofre.

On the day of LPA's inspection of 2-22-2022 LPA observed 14 children of whom 2 were under 2 years of age. The rest of the children were between 2 to 4 years of age. LPA observed 4 staff on that day supervising children.
A review of staff records on this date indicated all facility staff or other individuals who required caregiver background checks have received criminal record and child abuse index clearances or exemptions.

On today's inspection, LPA discussed the staffing child and ratio with Maria Onofre. In order for the facility to have a total of 14 children with an assistant, following shall apply: Maximum capacity when there is an assistant present, 12 children with no more than 4 infants. When reached to 14 children, no more than 3 infants, one child in kindergarten or elementary school and one child at least age 6.
This deficiency is cited on the next attached form (LIC 809 D) under staffing ratio and capacity. Section 102416.5(2)(a)
The Notice of Site Visit was posted. Facility representative was informed that the Notice of Site Visit must be posted for 30 consecutive days. Failure to post will result in civil penalties of $100. The director was provided a copy of their appeal right (LIC 9058 01/2016) and their signature on this form acknowledges receipt of these rights. The facility was provided information about the E-Learning Modules available at https://ccld.childcarevideos.org
This report ends here.
SUPERVISOR'S NAME: Rina LopezTELEPHONE: (714) 703-2808
LICENSING EVALUATOR NAME: Mahnaz MalekTELEPHONE: (714) 292-9851
LICENSING EVALUATOR SIGNATURE:
DATE: 02/25/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/25/2022
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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Document Has Been Signed on 02/25/2022 03:13 PM - 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: LOPATIN, SIMON
FACILITY NUMBER: 304313619

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/25/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
03/01/2022
Section Cited

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A large family day care home may provide care for more than 12 children and up to and including 14 children, if all of the following conditions are met: At least one child is enrolled in and attending kindergarten or elementary school and a second child is at least six years of age. This requirement was not met as evidenced by LPA's observation
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 and reviewing birth dates of children on 2-22-2022 that there were 14 children present with 4 staff including 2 children under 2 years old and 12 children ages 2 to 4 years old. The facility failed to meet the requirement to include two school age children in the group of 14 children, This is a potential hazard to the health and safety
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present when at least one child is enrolled and attending kindergarten or elementary school and a second child is at least six years of age not present.
Maria Onofre will send an statement that she is aware of Family Childcare Home Regulations regarding staffing ratio and capacity.

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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: Rina LopezTELEPHONE: (714) 703-2808
LICENSING EVALUATOR NAME: Mahnaz MalekTELEPHONE: (714) 292-9851
LICENSING EVALUATOR SIGNATURE:
DATE: 02/25/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/25/2022
LIC809 (FAS) - (06/04)
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