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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 304313419
Report Date: 12/13/2022
Date Signed: 12/13/2022 11:22:35 AM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
This is an official report of an unannounced visit/investigation of a complaint received in our office on
09/16/2022 and conducted by Evaluator Pat Rivas
PUBLIC
COMPLAINT CONTROL NUMBER: 06-CC-20220916154604
FACILITY NAME:PRISYAZHNYUK, YULIAFACILITY NUMBER:
304313419
ADMINISTRATOR:PRISYAZHNYUK, YULIAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(949) 870-2160
CITY:IRVINESTATE: CAZIP CODE:
92620
CAPACITY:14CENSUS: 4DATE:
12/13/2022
UNANNOUNCEDTIME BEGAN:
09:14 AM
MET WITH:Yulia Prisyazhnyuk, LicenseeTIME COMPLETED:
09:43 AM
ALLEGATION(S):
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Licensee does not reside in home
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) P Rivas conducted an unannounced complaint visit to render findings for the above complaint. Upon entrance LPA met staff Flor Pfeifer and Staff #2(S2). LPA took census and noted 3 children in area with Ms. Pfiefer and one child in area with S2. Ms. Pfeifer advised that licensee had left on an errand approximately 10 minutes before.(approx 9:00am) The areas were separated by a curtain that blocks view from each area. Licensee arrived at 9:23am.

A review of the Facility Personnel Report Summary on 12/13/2022 indicates all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions

The Regional Office received a complaint on 09/16/22 alleging that licensee does not reside in home. The investigation consisted of LPA observations, interviews with licensee, parents, staff and witnesses.
cont. 9099c
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Rina Lopez
LICENSING EVALUATOR NAME: Pat Rivas
LICENSING EVALUATOR SIGNATURE:

DATE: 12/13/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/13/2022
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
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Control Number 06-CC-20220916154604
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION 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: 12/13/2022
NARRATIVE
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The licensee stated she lives here and leaves after work hours for the weekend to a another property thatshe owns. States her hours of operation are Monday to Friday from 8:30am to 5:00pm. Licensee states
she is here at all hours of operation but may leave on errands throughout the week. Interview with staff indicated that licensee lives here for the most part. Interview with 2 out of 5 parents indicated there were no concerns with care and they believed licensee lived in facility. 3 out of 5 parents did not return LPA's call. LPA interviewed two witnesses who indicated they believe licensee lives In the facility. Review of record shows licensee's name is on lease.

Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation(s) did or did not occur, therefore the allegation is unsubstantiated.

An exit interview was conducted with Licensee Ms. Prisyazhnyuk Appeal Rights were explained. The Director was provided a copy of appeal rights (LIC 9058) 01/16) 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. First level appeals should be sent to the Regional Manager to the address listed.

The Notice of Site Visit was given and discussed it must be posted as required by H & S Code Sec. 1596.817. Notice of Site Visit must be posted for 30 consecutive days. Failure to post will result in civil penalties of $100.00.
SUPERVISORS NAME: Rina Lopez
LICENSING EVALUATOR NAME: Pat Rivas
LICENSING EVALUATOR SIGNATURE:

DATE: 12/13/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/13/2022
LIC9099 (FAS) - (06/04)
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