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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 304314674
Report Date: 09/10/2026
Date Signed: 09/10/2026 05:23:32 PM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE COUNTY CC RO, 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
09/04/2026 and conducted by Evaluator Susan Deschampe
COMPLAINT CONTROL NUMBER: 06-CC-20260904162148
FACILITY NAME:SALII, INNAFACILITY NUMBER:
304314674
ADMINISTRATOR:SALII, INNAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(747) 306-3680
CITY:NEWPORT BEACHSTATE: CAZIP CODE:
92660
CAPACITY:12CENSUS: 10DATE:
09/10/2026
UNANNOUNCEDTIME BEGAN:
02:00 PM
MET WITH:Facility Representative, Anastasiia KurochkinaTIME COMPLETED:
05:45 PM
ALLEGATION(S):
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Facility operating over capacity.
INVESTIGATION FINDINGS:
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Russian Translation provided by Translator ID# 38838235.

On 09/10/2026, Licensing Program Analyst (LPA) Deschampe conducted an unannounced 10 Day Complaint investigation. LPA arrived at the facility at 2:00PM for surveillance and entered the large Family Child Care Home (FCCH) at 2:30PM. The current census was 1 infant and 9 preschool-aged children with 1 staff.

A review of the Facility Personnel Report Summary on this date, 09/10/2026 indicates facility staff who require caregiver background checks have received criminal record and child abuse index clearances or exemptions.

LPA entered the FCCH and observed 1 infant and 9 preschool-aged children with 1 staff. Staff stated licensee and the husband are at an appointment. Staff called the licensee's husband who told LPA they will not return in time to meet with LPA. Through record review, LPA confirmed the ages of children present (pictures taken). At approximately 3:00PM, one (1) two-year old (2) child left with their parent/authorized representative.
Substantiated
Estimated Days of Completion: 84
SUPERVISORS NAME: Thuy Ho
LICENSING EVALUATOR NAME: Susan Deschampe
LICENSING EVALUATOR SIGNATURE:

DATE: 09/10/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/10/2026
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 1 of 3
Control Number 06-CC-20260904162148
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION 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: SALII, INNA
FACILITY NUMBER: 304314674
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/10/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
09/14/2026
Section Cited
CCR
102416.5(e)
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Section 102416.5(e) If no assistant provider is present at a Large FCCH, then the licensee shall comply with the capacity requirements for a Small FCCH...

This requirement is not met as evidence by:
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Licensee to comply with licensed capacity.
Licensee to give licensing report to parents/authorized representatives.
Licensee to have parents/authorized representative sign the LIC9224 within 24 hours.
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Based on LPA observation, record review, staff interview. 1 staff present w/10 children ages 1-4 years. Licensee & husband did not return while LPA was present. This poses an immediate Health, Safety, or Personal Rights risk to persons in care.
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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.
SUPERVISOR'S NAME: Thuy Ho
LICENSING EVALUATOR NAME: Susan Deschampe
LICENSING EVALUATOR SIGNATURE:

DATE: 09/10/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/10/2026
LIC9099 (FAS) - (06/04)
Page: 3 of 3
Control Number 06-CC-20260904162148
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION 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: SALII, INNA
FACILITY NUMBER: 304314674
VISIT DATE: 09/10/2026
NARRATIVE
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Page 2 (Complaint Investigation)

Based on LPA’s interviews, observations, and record review, the preponderance of evidence standard has been met, therefore the allegation that the facility is operating over capacity is found to be SUBSTANTIATED. California Code of Regulations (CCR) Title 22 Division 12 Section 102416.5(e) Staffing Ratio and Capacity is being cited. Please refer to LIC 9099D for documentation of deficiency. Copy of CCR 102416.5 Staffing Ratio and Capacity document given to facility representative.

Facility representative was informed of the following: 1. Provide a copy of this report to the parents/authorized representatives currently enrolled by the next business day or immediately upon return.
2. A copy of this report shall also be provided to the parents/authorized representatives of any newly enrolled children for the next 12 months (1 year). 3. Obtain signature and date from the child's parents/authorized representatives on the Acknowledgement of Receipt of Licensing Reports (LIC9224). 4. Keep a record immediately upon receipt of the completed and signed LIC9224 acknowledging receipt of this report in the child's file.

Exit interview conducted and report was reviewed with the facility representative, Anastasiia Kurochkina. The Notice of Site Visit was posted during the visit. The facility representative was reminded that the Notice of Site Visit must remain posted for 30 consecutive days. The Notice of Site Visit must be posted on, or immediately adjacent to, the interior side of the main door of the facility. However, due to LPA observations and staff interview of children's pick-up/drop-off, the required postings need to be posted on the front door for parents/authorized representatives to see.

Appeal Rights were discussed and provided. The facility representative’s signature acknowledges receipt of these rights. The licensee may submit an appeal in writing to the Regional Manager within 15 business days from the date of receiving the penalty assessment or notice of deficiency. First level appeals must be sent to the Regional Manager at the address listed above. End of report
SUPERVISORS NAME: Thuy Ho
LICENSING EVALUATOR NAME: Susan Deschampe
LICENSING EVALUATOR SIGNATURE:

DATE: 09/10/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/10/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 3