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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 304313619
Report Date: 01/09/2025
Date Signed: 01/09/2025 04:38:17 PM

Document Has Been Signed on 01/09/2025 04:38 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
ORANGE COUNTY CC RO, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
FACILITY NAME:LOPATIN, SIMON AND LOPATIN, ALEXEYFACILITY NUMBER:
304313619
ADMINISTRATOR/
DIRECTOR:		LOPATIN, SIMONFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(617) 331-8588
CITY:IRVINESTATE: CAZIP CODE:
92618
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 10DATE:
01/09/2025
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
02:40 PM
MET WITH:Simon LopatinTIME VISIT/
INSPECTION COMPLETED:
03:30 PM
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An unannounced Case Management was conducted on this date 01/09/2025, by Licensing Program Analyst (LPA) Alma Castro to provide the facility a copy of an Amended Complaint Report. LPA met with Licensee, Simon Lopatin, and informed them of the purpose of the visit. The overall observed census was 3 staff members and 10 preschool-age children.

A review of staff criminal clearance records on this date 01/09/2024 indicates that all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions.

During the visit, LPA reviewed the Amended Report with the Licensee, who acknowledged and signed the Amended Report.

An exit interview was completed. The report was reviewed and discussed. The Licensee was informed that the “Notice of Site Visit” must be posted for 30 consecutive days. Failure to post will result in Civil Penalties of $100.00.



End of the Report.
SUPERVISORS NAME: Nguyen K Tran
LICENSING EVALUATOR NAME: Alma Castro
LICENSING EVALUATOR SIGNATURE: DATE: 01/09/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/09/2025
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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