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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 483007592
Report Date: 01/30/2025
Date Signed: 02/03/2025 09:10:14 AM

Document Has Been Signed on 02/03/2025 09:10 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
SANTA ROSA CC RO, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405
FACILITY NAME:VAEZINIA, VICTORIA FAMILY CHILD CARE HOMEFACILITY NUMBER:
483007592
ADMINISTRATOR/
DIRECTOR:		VAEZINIA, VICTORIAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(707) 452-8888
CITY:VACAVILLESTATE: CAZIP CODE:
95687
CAPACITY: 14TOTAL ENROLLED CHILDREN: 16CENSUS: 8DATE:
01/30/2025
TYPE OF VISIT:POCUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:40 AM
MET WITH:Lyubov MailovaTIME VISIT/
INSPECTION COMPLETED:
11:39 AM
NARRATIVE
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Licensing Program Analyst (LPA) Robert Maciel made a Plan of Correction visit for the purpose of following up to verify compliance with capacity requirements. LPA met with facility representative Lyubov Mailova (S3). On 12/12/24, the facility was cited for exceeding the maximum capacity of children in care allowed at one time.

During todays visit, LPA observed 8 children in care supervised by 3 staff (S1, S2, and S3). The facility was operating within the licensed capacity and ratio requirements. At the time of arrival, the Licensee (LS) was not present at the facility. Assistant Lyubov Mailova (S3) stated that LS had left the house at 9:25 AM. S3 stated that the facility hours of operation are from 7 AM to 6 PM. S2 possessed a current Pediatric 1st Aid and CPR certificate which expires in June 2026. LS did not arrive at the home as of 11:37 AM, beyond the allowable 20% of the hours of operation.

Exit interview was conducted and report was read to facility representative, Lyubov Mailova (S3). The following violation(s) of the California Code of Regulations, Title 22; Division 12, was observed during today’s visit. See LIC 809-D. Appeal Rights were provided. A notice of site visit was given and must remain posted for 30 days. Failure to do so will result in an immediate civil penalty of $100.
Erin VirruetaTELEPHONE: (530) -89-4325
Robert MacielTELEPHONE: (707) 588-5026
DATE: 01/30/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/30/2025
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 02/03/2025 09:11 AM - It Cannot Be Edited

Document is an Amendment of Original Document on 02/03/2025 09:10 AM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SANTA ROSA CC RO, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405


FACILITY NAME: VAEZINIA, VICTORIA FAMILY CHILD CARE HOME
FACILITY NUMBER: 483007592

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/30/2025
DEFICIENCIES & PLANS OF CORRECTION (POCs)
Section Cited
CCR
102417(a)
The licensee shall be present in the home and shall ensure that children in care are supervised at all times. When circumstances require the licensee to be temporarily absent from the home, the licensee shall arrange for a substitute adult to care for and supervise the children during his/her absence. Temporary absences shall not exceed 20 percent of the hours that the facility is providing care per day.

This requirement was not met as evidenced by:
Deficient Practice Statement
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POC Due Date: 02/06/2025
Plan of Correction
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LPA Maciel gave Facility representative Lyubov Mailova a copy of the regulation 1024179(a). Lyubov stated that she would give it to Victoria who would write a statement attesting to her understanding of the regulation and submit it to LPA by email at robert.maciel@dss.ca.gov.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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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.
Erin VirruetaTELEPHONE: (530) -89-4325
Robert MacielTELEPHONE: (707) 588-5026

DATE: 01/30/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/30/2025

LIC809 (FAS) - (06/04)
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