343622802-2-6-2026-03-CC-ABLI-DSFSL9-20260323135754

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 343622802
Report Date: 02/06/2026
Date Signed: 02/06/2026 03:55:52 PM

Unsubstantiated

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
02/05/2026 and conducted by Evaluator Julia Maryanova

PUBLIC

COMPLAINT CONTROL NUMBER: 03-CC-20260205141618

FACILITY NAME:	SHTEZEL, TAMARA & PRIBYTOVA, IRINA		FACILITY NUMBER:	343622802
ADMINISTRATOR:	SHTEZEL, T & PRIBYTIVA, I		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(916) 256-9029
CITY:	ORANGEVALE	STATE: CA	ZIP CODE:	95662
CAPACITY:	14	CENSUS: 12	DATE:	02/06/2026
		UNANNOUNCED	TIME BEGAN:	02:15 PM
MET WITH:	Irina Shtezel		TIME COMPLETED:	04:15 PM

ALLEGATION(S):

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Licensee falsified record

INVESTIGATION FINDINGS:

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On Friday, February 6, 2026, Licensing Program Analysts (LPAs) Julia Maryanova and Tanya Washington met with Licensee, Irina Pribytova to conduct an unannounced initial complaint investigation and deliver findings pertaining to the above allegation. The purpose of today's inspection was explained. LPAs observed 12 child care children being supervised by 3 staff. Flora Bilik arrived at the facility apprx. 2:20pm.

RP claims that Licensee Pribytova did not take Mandated Reporter Training dated 09/09/2025. Licensee claims that she took the training herself and followed up with a second course in her language on January 21, 2026. During the investigation, LPA conducted staff interviews and document reviews which did not corroborate the allegations of Licensee falsified records.

Although the allegation may be true or may have happened, there is not a preponderance of evidence to prove the allegation; therefore, the allegation is unsubstantiated. Exit interview was conducted and report was reviewed with Facility Representative, Flora Bilik. Appeal rights were provided. Notice of site visit was given and must remain posted for 30 days.

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Amanda Blesi
LICENSING EVALUATOR NAME: Julia Maryanova
LICENSING EVALUATOR SIGNATURE:	DATE: 02/06/2026

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/06/2026

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

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
02/05/2026 and conducted by Evaluator Julia Maryanova

PUBLIC

COMPLAINT CONTROL NUMBER: 03-CC-20260205141618

FACILITY NAME:	SHTEZEL, TAMARA & PRIBYTOVA, IRINA		FACILITY NUMBER:	343622802
ADMINISTRATOR:	SHTEZEL, T & PRIBYTIVA, I		FACILITY TYPE:	810
ADDRESS:	6407 TRAJAN DRIVE		TELEPHONE:	(916) 256-9029
CITY:	ORANGEVALE	STATE: CA	ZIP CODE:	95662
CAPACITY:	14	CENSUS: 12	DATE:	02/06/2026
		UNANNOUNCED	TIME BEGAN:	02:15 PM
MET WITH:	Irina Shtezel		TIME COMPLETED:	04:15 PM

ALLEGATION(S):

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Licensee does not live in the facility.

INVESTIGATION FINDINGS:

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On Friday, February 6, 2026, Licensing Program Analysts (LPAs) Julia Maryanova and Tanya Washington met with Licensee, Irina Pribytova to conduct an unannounced initial complaint investigation and deliver findings pertaining to the above allegation. The purpose of today's inspection was explained. LPAs observed 12 child care children being supervised by 3 staff.

During investigation, LPAs conducted interviews, obtained records and made observations. During observations and staff interviews, LPAs learned that Licensee Shtezel has moved out from the faciliy as of November 2025. LPAs did not observe Licensee Pribytova's personal belongings. Based on observation the preponderance of evidence standard has been met and above allegations are substantiated.

Deficiencies are noted on subsequent page of this report LIC9099-D. An exit interview was conducted and a notice of site visit provided. Notice of site visit shall remain posted for 30 days.

Substantiated

Estimated Days of Completion:

SUPERVISORS NAME: Amanda Blesi
LICENSING EVALUATOR NAME: Julia Maryanova
LICENSING EVALUATOR SIGNATURE:	DATE: 02/06/2026

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/06/2026

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

Page: 2 of 3

Control Number 03-CC-20260205141618

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: SHTEZEL, TAMARA & PRIBYTOVA, IRINA	FACILITY NUMBER: 343622802
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 02/06/2026

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type A 02/09/2026 Section Cited CCR 102352(h)(1)	1 2 3 4 5 6 7	Definitions As defined by Government Code Section 244: "Home" means the licensee's residence as defined by Government Code Section 244. This requirement is not met as evidenced by:	1 2 3 4 5 6 7	This license must be forfeited as the original Licensee Shtezel moved out as of November, 2025. If the facility wishes to continue to operate the facility must submit a new application by end of day 02/09/2026.
	8 9 10 11 12 13 14	During observations and staff interviews, LPAs learned that Licensee Shtezel has moved out from the facility as of November 2025. LPAs did not observe Licensee Pribytova's personal belongings. This is an immidiate health and safety risk to children in care.	8 9 10 11 12 13 14
	1 2 3 4 5 6 7		1 2 3 4 5 6 7
	1 2 3 4 5 6 7		1 2 3 4 5 6 7

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

SUPERVISORS NAME: Amanda Blesi
LICENSING EVALUATOR NAME: Julia Maryanova
LICENSING EVALUATOR SIGNATURE:	DATE: 02/06/2026

I acknowledge receipt of this form and understand my appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/06/2026

LIC9099 (FAS) - (06/04)

Page: 1 of 1

Control Number 03-CC-20260205141618

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: SHTEZEL, TAMARA & PRIBYTOVA, IRINA	FACILITY NUMBER: 343622802
	VISIT DATE: 02/06/2026

NARRATIVE

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Title 22 deficiencies are cited on the subsequent page of this report. For TYPE A DEFICIENCIES ONLY upon receipt, licensee shall post LIC 809-D with Type A deficiencies for 30 days and provide copies of this licensing report to parents/ guardians of children who are currently enrolled as well as parents/ guardians of children newly enrolled at the facility during the next 12 months. Parents/guardians must acknowledge receipt of this report and citation by signing a LIC 9224, “ACKNOWLEDGEMENT OF RECEIPT OF LICENSING REPORTS”. LIC 9224 and Appeal Rights and a copy of this report was left at the facility.

An exit interview was conducted with facility representative Flora Bilik. A Notice of Site Visit was posted.

SUPERVISORS NAME: Amanda Blesi
LICENSING EVALUATOR NAME: Julia Maryanova
LICENSING EVALUATOR SIGNATURE:	DATE: 02/06/2026

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/06/2026

LIC9099 (FAS) - (06/04)

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