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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 343622238
Report Date: 06/30/2026
Date Signed: 09/17/2026 10:47:41 AM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
This is an official report of an unannounced visit/investigation of a complaint received in our office on
06/25/2026 and conducted by Evaluator Loraine Perez
PUBLIC
COMPLAINT CONTROL NUMBER: 03-CC-20260625083807
FACILITY NAME:VOROBYEV, TATYANAFACILITY NUMBER:
343622238
ADMINISTRATOR:VOROBYEV, TATYANAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(916) 239-5794
CITY:ANTELOPESTATE: CAZIP CODE:
95843
CAPACITY:14CENSUS: 13DATE:
06/30/2026
UNANNOUNCEDTIME BEGAN:
03:25 PM
MET WITH:Tatyana VorobyevTIME COMPLETED:
06:30 PM
ALLEGATION(S):
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Licensee did not ensure that proper ratios were maintained.
Licensee allowed children to access the off-limit areas.
Licensee did not maintain children’s records at the facility.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Loraine Perez met with Licensee TATYANA VOROBYEV, for the purpose of conducting an unannounced initial complaint investigation inspection pertaining to the above allegations. The purpose of today's inspection was explained to Licensee.
During today's inspection, LPA conducted interviews, observed care, and obtained relevant documentation.
Based on LPA observation, and record review, the facility did not notify the Department of changes to off-limits areas. In seven of 13 children's files reviewed LIC624 was missing. At the time of arrival LPA observed Licensee was providing care to 13 children without an assistant. Citations are recorded on the following LIC9099D.
The preponderance of evidence standard has been met, therefore the above allegations are SUBSTANTIATED.
Report continues on LIC9099C
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Amanda Blesi
LICENSING EVALUATOR NAME: Loraine Perez
LICENSING EVALUATOR SIGNATURE:

DATE: 06/30/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/30/2026
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 5
Control Number 03-CC-20260625083807
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME: VOROBYEV, TATYANA
FACILITY NUMBER: 343622238
VISIT DATE: 06/30/2026
NARRATIVE
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The Facility Representative was informed that this report dated 06/30/2026 documents two Type A citation and must be posted for parental review for 30 consecutive days. The facility must also provide a copy of this licensing report 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 each child's file for verification.

Exit interview was conducted and a copy of this report was given to the Facility Representative,TATYANA VOROBYEV. Notice of site was given and must remain posted for parental review for 30 days. Appeal rights were provided.
SUPERVISORS NAME: Amanda Blesi
LICENSING EVALUATOR NAME: Loraine Perez
LICENSING EVALUATOR SIGNATURE:

DATE: 06/30/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/30/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 5
Control Number 03-CC-20260625083807
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

FACILITY NAME: VOROBYEV, TATYANA
FACILITY NUMBER: 343622238
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/30/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
07/01/2026
Section Cited
CCR
102416.5(d)(2)
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For a Large Family Child Care Home, the maximum number of children for whom care may be provided at any one time when there is an assistant provider in the home, ...: More than twelve and up to fourteen children only if the criteria in Section 1597.465 of the Health and Safety Code are met.
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Licensee stated she shall have a 14 year old assistant when adult assistant is not present, also Licensee husband shall be an assistant when needed. LPA shall return for a plan of correction inspection.
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This requirement was not met at evidenced by:
Upon LPA arrival Licensee was alone providing care for 13 children without an assistant. This posses an immediate risk to the health and safety of persons in care.
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Type A
07/01/2026
Section Cited
CCR
102416.3(a)(6)
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Prior to making alterations or additions to a family child care home..., the licensee shall notify the Department ... , ...: Any change from an area of the family child care home previously identified as "off limits" to an area where care and supervision will be provided to children in care.
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Licensee stated she shall not use off-limit areas with children in care. LPA shall perform a return plan of correction visit.
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This requirement was not met at evidenced by:
Licensee allowed a child to nap in an off-limit area prior to notify the Department. This posses an immediate risk to the health and safety of 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: Amanda Blesi
LICENSING EVALUATOR NAME: Loraine Perez
LICENSING EVALUATOR SIGNATURE:

DATE: 06/30/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/30/2026
LIC9099 (FAS) - (06/04)
Page: 3 of 5
Control Number 03-CC-20260625083807
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

FACILITY NAME: VOROBYEV, TATYANA
FACILITY NUMBER: 343622238
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/30/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
07/30/2026
Section Cited
CCR
102417(g)(7)
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An emergency information card shall be maintained..., the parent's authorization for the licensee or registrant to consent to emergency medical care.

This requirment was not met as evidenced by:
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Licensee stated she shall notify parents tomorrow and request they sign and return the LIC624. LPA shall return for a plan of correction inspection and record review.
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Based on record review, Licensee did not maintain a signed LIC624 consent to emergency medical treatment from 7 out of 13 childrens files reviewed. This posses a potential risk to the health and safety of 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: Amanda Blesi
LICENSING EVALUATOR NAME: Loraine Perez
LICENSING EVALUATOR SIGNATURE:

DATE: 06/30/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/30/2026
LIC9099 (FAS) - (06/04)
Page: 4 of 5