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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 304314183
Report Date: 08/05/2026
Date Signed: 08/05/2026 12:32:49 PM

Document Has Been Signed on 08/05/2026 12:32 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:LOPATINA, ALEVTINAFACILITY NUMBER:
304314183
ADMINISTRATOR/
DIRECTOR:		LOPATINA, ALEVTINAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(949) 469-1935
CITY:IRVINESTATE: CAZIP CODE:
92620
CAPACITY: 14TOTAL ENROLLED CHILDREN: 11CENSUS: 9DATE:
08/05/2026
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:32 AM
MET WITH:Licensee Alevtina Lopatina TIME VISIT/
INSPECTION COMPLETED:
01:00 PM
NARRATIVE
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Licensing Program Analyst (LPA) Thompson conducted an unannounced annual random inspection on today's date. Upon walking up to the front entrance door at approximately 9:32 AM, LPA could here children in care. LPA knocked and rang the door bell on three separate occasions then called the licensee at 9:37 AM and left a voicemail. At approximately 9:38 AM the front door opened and LPA met with assistant/staff #1 (S1) Julissa Quevedo. LPA asked S1 for licensee Alevtina Lopatina and was told the licensee was not home. LPA then entered the family child care home after LPA introduced himself and provided the reason for the visit. Upon entering the home, LPA observed two assistants/staff caring for nine children. The facility operating hours are Monday through Friday, 8:30 a.m. to 5:30 p.m. Licensee Alevtina Lopatina arrived at approximately 10:05 AM.

During the inspection, LPA verified that the facility was operating within its licensed capacity and maintaining the required child-to-provider ratio. A review of the Facility Personnel Report Summary confirmed that all individuals requiring caregiver background clearances have obtained the required criminal record and Child Abuse Central Index (CACI) clearances or approved exemptions.

The child care area consist of two downstairs bedrooms, one bathroom, living room, kitchen, dinning room, den, and back yard as the day care areas. The children walk through the hallway to access the bathroom. LPA toured the entire home since there was an approximate delay of six minutes from the time LPA knocked on the front entrance door then entered the home.

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Nguyen K Tran
Dean Thompson
DATE: 08/05/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/05/2026
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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California Health & Human Services Agency
California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:
  • Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.
  • Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)
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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE COUNTY CC RO, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
FACILITY NAME: LOPATINA, ALEVTINA
FACILITY NUMBER: 304314183
VISIT DATE: 08/05/2026
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While touring the home, at 9:40 AM, LPA observed an accessible knife in an unlocked drawer inside the kitchen where children had access to. When LPA observed the knife, food was not being prepared and children were not eating. LPA observed S1 place the knife out of reach from children in care. At 9:44 AM, LPA observed the stairs leading to the second floor had a gate but the gate was not latched/locked. Where children are less than five years old are in care, stairs shall be fenced or barricaded.

At approximately 9:48 AM, While touring the second floor of the home, LPA observed Semen (Simon) Lopatin inside the master bedroom closet. Simon stated he sometimes help provide care for children at Alevtina Lopatina family child care home but not on a daily basis. 102370 Criminal Record Clearance (d) All individuals subject to a criminal record review pursuant to Health and Safety Code Section 1596.871 shall prior to working, residing, or volunteering in a licensed facility: (2) Request a transfer of a criminal record clearance as specified in Section 102370(j).

LPA provided Guardian Information and website info: https://www.cdss.ca.gov/inforesources/cdss-programs/community-care-licensing/caregiver-background-check/guardian

Licensee was reminded that all adults 18 and over living or working in the home, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a licensed Family Child Care Home. A civil penalty of $100.00 minimum/day for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.

The home is equipped with a functioning carbon monoxide detector, smoke detector, and a fire extinguisher that meets statutory and State Fire Marshal requirements. The most recent emergency drill was documented on October 15, 2025. LPA reminded licensee to conduct and document emergency drills at least once every six months. Cleaning supplies, detergents, medications, and other hazardous items were stored inaccessible to children. The licensee stated there are no firearms on the premises.

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NAME OF LICENSING PROGRAM MANAGER: Nguyen K Tran
NAME OF LICENSING PROGRAM ANALYST: Dean Thompson
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 08/05/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/05/2026
LIC809 (FAS) - (06/04)
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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE COUNTY CC RO, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
FACILITY NAME: LOPATINA, ALEVTINA
FACILITY NUMBER: 304314183
VISIT DATE: 08/05/2026
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The home contains age-appropriate toys and materials for the children in care. The LPA verified that the facility has a working telephone (cellular service). The licensee stated that the backyard is used for outdoor activities. The backyard was inspected and found to be in compliance with licensing requirements. No bodies of water were observed on the property.

The licensee maintains a current roster of children in care. Children's records for those present during the inspection were reviewed and found to be complete and in compliance. Records included Emergency Information (LIC 700), immunization records, Affidavit Regarding Liability Insurance (LIC 282), Consent for Emergency Medical Treatment (LIC 627), Notification of Parents' Rights (LIC 995A), and found to be in compliance. Infant Safe Sleep documentation was not reviewed due to licensee not having any infants enrolled. Licensee was reminded the department considers infants to be 0 to 24 months of age and safe sleep documentation should be available for review.

Staff #2 (S2) has a current American Red Cross approved Pediatric CPR/First Aid certification and is valid through December 28, 2026. Licensee Pediatric CPR/First Aid certification expired February 14, 2025. Documentation verifying compliance with immunization requirements for pertussis and measles was reviewed and found to be current in accordance with Health and Safety Code section 1597.622.

The licensee's Mandated Reporter Training certification is valid through February 12, 2026, in accordance with Health and Safety Code section 1596.8662, which requires licensed child care providers and employees to complete training every two years.

The LPA discussed supervision requirements with the licensee. The licensee understands that children must be supervised at all times and may never be left unattended in parked vehicles. The licensee also understands that if temporarily absent from the facility, care and supervision must be provided by a qualified substitute who has the required criminal background clearances, Child Abuse Central Index clearance or exemption, immunization documentation, current Pediatric CPR/First Aid certification, and Mandated Reporter Training.

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NAME OF LICENSING PROGRAM MANAGER: Nguyen K Tran
NAME OF LICENSING PROGRAM ANALYST: Dean Thompson
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 08/05/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/05/2026
LIC809 (FAS) - (06/04)
Page: 4 of 7
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE COUNTY CC RO, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
FACILITY NAME: LOPATINA, ALEVTINA
FACILITY NUMBER: 304314183
VISIT DATE: 08/05/2026
NARRATIVE
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LPA discussed the safe sleep regulations with licensee and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-andresources/safe-sleep as an additional resource. LPA also informed licensee of the importance of checking for and removing any recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment. Licensee stated she does not have infants enrolled.


In the areas that were evaluated, Physical Plant - Type A: 102417(g)(3), Physical Plant - Type A: 102417(g)(4), Physical Plant - Type B: 102417(g)(9)(A), and Criminal Record Clearance - Type B: 102370(d)(2) deficiencies were observed of the California Code of Regulations, Title 22, Division 12 at the time of the visit. See LIC 809D pages for deficiencies.

LPA Thompson informed licensee Alevtina Lopatina that this report dated 8/5/2026, document(s) two Type A citation(s) which shall be posted for 30 consecutive days as there is/are immediate risk(s) to the health, safety, or personal rights of children in care.

Also, LPA Thompson informed the licensee Alevtina Lopatina to provide a copy of this licensing report dated 8/5/2026, that documents any Type A citation(s) to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification.

During the exit interview, the Licensee Alevtina Lopatina, confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.

A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with the licensee Alevtina Lopatina.
NAME OF LICENSING PROGRAM MANAGER: Nguyen K Tran
NAME OF LICENSING PROGRAM ANALYST: Dean Thompson
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 08/05/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/05/2026
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 08/05/2026 12:32 PM - It Cannot Be Edited


Created By: Dean Thompson On 08/05/2026 at 11:12 AM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME: LOPATINA, ALEVTINA
FACILITY NUMBER: 304314183

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/05/2026

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type A
Section Cited
CCR
102417(g)(3)
Operation of A Family Child Care Home
(g) The home shall be free from defects or conditions which might endanger a child. Safety precautions shall include but not limited to: (3) Where children are less than five years old are in care, stairs shall be fenced or barricaded.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, the licensee did not comply with the section cited above. At 9:44 AM, LPA observed the stairs leading to the second floor had a gate but the gate was not latched/locked which poses an immediate health, safety or personal rights risk to persons in care.
POC Due Date: 08/05/2026
Plan of Correction
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LPA observed S1 close and latch the gate during the visit.
Type A
Section Cited
CCR
102417(g)(4)
Operation of A Family Child Care Home
(g) The home shall be free from defects or conditions which might endanger a child. Safety precautions shall include but not limited to: (4) Poisons, detergents, cleaning compounds, medicines, firearms and other items which could pose a danger if readily available to children shall be stored where they are inaccessible to children.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, the licensee did not comply with the section cited above. While touring the home, at 9:40 AM, LPA observed an accessible knife in an unlocked drawer inside the kitchen where children have access to which poses an immediate health, safety or personal rights risk to persons in care.
POC Due Date: 08/05/2026
Plan of Correction
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LPA observed the assistant place the knife out of reach from children in care.
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
Nguyen K Tran
NAME OF LICENSING PROGRAM MANAGER:
Dean Thompson
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 08/05/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/05/2026


LIC809 (FAS) - (06/04)
Page: 6 of 7
Document Has Been Signed on 08/05/2026 12:32 PM - It Cannot Be Edited


Created By: Dean Thompson On 08/05/2026 at 11:12 AM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME: LOPATINA, ALEVTINA
FACILITY NUMBER: 304314183

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/05/2026

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102417(g)(9)(A)
Operation of A Family Child Care Home
(g) The home shall be free from defects or conditions which might endanger a child. Safety precautions shall include but not limited to: (9) Each family child care home shall have a written disaster plan of action prepared on a form approved by the Department. All children, age and ability permitting, and the provider, the assistant provider, and other members of the household, shall be instructed in their duties under the disaster plan. As their age and ability permit, newly enrolled children shall be informed promptly of their duties as required in the plan. (A) Each family child care home shall conduct fire drills and disaster drills at least once every six months.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, interview, and record review, the licensee did not comply with the section cited above. The most recent emergency drill was documented on October 15, 2025, which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 08/05/2026
Plan of Correction
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Licensee documented an emergency drill during the visit.
Type B
Section Cited
CCR
102370(d)(2)
102370 Criminal Record Clearance (d) All individuals subject to a criminal record review pursuant to Health and Safety Code Section 1596.871 shall prior to working, residing, or volunteering in a licensed facility: (2) Request a transfer of a criminal record clearance as specified in Section 102370(j).

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, interview, and record review, the licensee did not comply with the section cited above. At approximately 9:48 AM, While touring the second floor of the home, LPA observed Simon Lopatin inside the master bedroom closet. Semen (Simon) Lopatin was not associated to the licensed day care which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 08/05/2026
Plan of Correction
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LPA observed licensee associate Semen (Simon) Lopatin to the licensed facility during the visit.
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
Nguyen K Tran
NAME OF LICENSING PROGRAM MANAGER:
Dean Thompson
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 08/05/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/05/2026


LIC809 (FAS) - (06/04)
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