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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 304371444
Report Date: 05/16/2023
Date Signed: 05/16/2023 05:00:06 PM

Document Has Been Signed on 05/16/2023 05:00 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 CO CHILD CARE, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
FACILITY NAME:MERRY HIVEFACILITY NUMBER:
304371444
ADMINISTRATOR:MELNIK, SVETLANAFACILITY TYPE:
850
ADDRESS:23802 AVENIDA DE LA CARLOTATELEPHONE:
(714) 872-3008
CITY:LAGUNA HILLSSTATE: CAZIP CODE:
92653
CAPACITY: 30TOTAL ENROLLED CHILDREN: 27CENSUS: 24DATE:
05/16/2023
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
01:55 PM
MET WITH:Svetlana MelnikTIME COMPLETED:
05:20 PM
NARRATIVE
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Licensing Program Analyst (LPA) Dean Thompson conducted an unannounced case management incident inspection in response to a self-report Unusual Incident dated 5/8/2023. Upon arrival, LPA met with Director Svetlana Melnik. LPA observed 12 preschool age children inside room #102 with Natalia Kreslina and 12 preschool age children inside room # 104 with staff #2 (S2). All children present were napping on cots.

While touring the facility at 2:02 pm, LPA observed Natalia Kreslina caring for 12 children during nap time inside classroom # 102. LPA asked Natalia Kreslina how long she has been employed at Merry Hive Preschool. Natalia stated she has been working at the facility since September 2022 as an assistant. LPA asked Director Svetlana Melnik how long Natalia Kreslina has been working at the center. Director stated Natalia started in September 2022. LPA observed Natalia Kreslina was not associated to Merry Hive Preschool and file records indicated a transfer request was never submitted. Natalia Kreslina file was missing LIC 9182 Criminal Background Clearance Transfer Request form. 101170 Criminal Record Clearance(e) 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 101170(f). Merry Hive Preschool was issued a citation for the same regulation on 8/23/2022.

On 5/8/2023 a self reported Unusual Incident Report (UIR) was filed with the licensing office. The facility reported a child #1 (C1) leaving the facility and being found on the parking lot by an adult from a laundry service agency that was delivering linen to the church. C1 was given to the church security guard then brought back to the preschool.

During today’s visit, LPA obtained an updated copy of the children’s roster, reviewed video footage, reviewed C1 file, interviewed director, and staff.

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SUPERVISORS NAME: Judy Hanson
LICENSING EVALUATOR NAME: Dean Thompson
LICENSING EVALUATOR SIGNATURE: DATE: 05/16/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/16/2023
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE CO CHILD CARE, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
FACILITY NAME: MERRY HIVE
FACILITY NUMBER: 304371444
VISIT DATE: 05/16/2023
NARRATIVE
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In the areas that were evaluated, one (1) type A 101170(e)(2) Criminal Record Clearance deficiency was observed of the California Code of Regulations, Title 22, Division 12 at the time of the visit. Please see LIC 809D.

LPA Thompson informed Director Svetlana Melnik that this report dated 5/16/2023 document(s) one 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 Director Svetlana Melnik to provide a copy of this licensing report dated 5/16/2023 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.

Due to insufficient information available at this time, the reported incident needs further investigation.




Exit interview conducted and report was reviewed with the Director Svetlana Melnik. A notice of site visit was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

Appeal Rights and deficiencies were discussed. Director was provided a copy of their appeal rights (LIC 9058) 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.
SUPERVISORS NAME: Judy Hanson
LICENSING EVALUATOR NAME: Dean Thompson
LICENSING EVALUATOR SIGNATURE:

DATE: 05/16/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/16/2023
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 05/16/2023 05:00 PM - It Cannot Be Edited


Created By: Dean Thompson On 05/16/2023 at 03:45 PM
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: MERRY HIVE
FACILITY NUMBER: 304371444

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/16/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
05/16/2023
Section Cited
CCR
101170(e)(2)

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101170 Criminal Record Clearance (e) 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 101170(f) or

This requirement is not met as evidenced by:
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Director stated she will submit LIC 9182 Criminal Background Clearance Transfer for Natalia Kreslina no later than 5/17/2023.
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While touring the facility at 2:02 pm, LPA observed Natalia Kreslina caring for 12 children during nap time inside classroom # 102. LPA asked Natalia Kreslina how long she has been employed at Merry Hive Preschool. Natalia stated she has been working at the facility since September 2022 as an assistant. file records indicated a transfer request was never made which 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:Judy Hanson
LICENSING EVALUATOR NAME:Dean Thompson
LICENSING EVALUATOR SIGNATURE:
DATE: 05/16/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/16/2023


LIC809 (FAS) - (06/04)
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