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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 343617934
Report Date: 04/14/2021
Date Signed: 05/11/2021 09:56:13 AM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833
FACILITY NAME:LOBKOV, VERAFACILITY NUMBER:
343617934
ADMINISTRATOR:LOBKOV, VERAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(916) 799-9532
CITY:CITRUS HEIGHTSSTATE: CAZIP CODE:
95621
CAPACITY:14CENSUS: 5DATE:
04/14/2021
TYPE OF VISIT:OfficeANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Vera LobkovTIME COMPLETED:
10:45 AM
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On April 14, 2021, Licensing Program Analyst (LPA) Tanya Washington and Licensing Program Manager (LPM) Roxana Saravia contacted Licensee, Vera Lobkov for a scheduled informal meeting which is being conducted over Facetime due to COVID-19 pandemic.

LPM defined the difference between Non-Compliance and an Informal meeting. LPM advised that the purpose of today's meeting is to help provider gain compliance.

Today's informal meeting was arranged by the Department to discuss a recent Type A citation which was cited on 02/08/2021.

Department received a complaint on 07/15/2020 which alleged that a child sustained bruising to both ears while in care of Licensee Lobkov. Investigation Branch of the department substantiated the allegation and the facility received a citation for a violation of child's personal rights.

Licensee took the following measures to correct this violation: Licensee stated that her family members who reside in the home will assist with supervision of children, she will conduct health checks upon drop off and throughout the day and will examine a child if they display a form of discomfort.

Due to this substantiated finding the Department will conduct additional monitoring of the facility for a period of two years.

During today's meeting, LPM suggested that licensee review the Department web site www.ccld.ca.gov for updated regulations and important information regarding licensing. LPM suggested that Licensee can view information videos at www.ccld.childcarevideos.org.
SUPERVISOR'S NAME: Roxana SaraviaTELEPHONE: (916) 263-5744
LICENSING EVALUATOR NAME: Tanya WashingtonTELEPHONE: 916-879-1209
LICENSING EVALUATOR SIGNATURE:

DATE: 04/14/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/14/2021
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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