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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 343623232
Report Date: 02/08/2023
Date Signed: 02/08/2023 12:31:56 PM

Document Has Been Signed on 02/08/2023 12:31 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
CCLD Regional Office, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833
FACILITY NAME:PARKER, PRASKOVIIAFACILITY NUMBER:
343623232
ADMINISTRATOR:PARKER, PRASKOVIIAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(219) 945-7777
CITY:FAIR OAKSSTATE: CAZIP CODE:
95628
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 14DATE:
02/08/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
11:05 AM
MET WITH:Praskoviaa ParkerTIME COMPLETED:
12:40 PM
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On Febraury 8, 2023 Licensing Program Analyst (LPA) Lea Habtom arrived at the location for a case management inspection. LPA L. Habtom met with staff member Zhanna Khidiryan as licensee was not present at the time of arrival. During the inspection, the licensee arrived. The census for today was 14 preschool children, 10 outside being supervised by 1 staff and 4 inside being supervised by 1 staff. The purpose for today's inspection is to amend the annual inspection report conducted on September 29, 2022 for the citation issued for an unfingerprinted adult. All staff have fingerprint clearances and associations to the facility.

During the annual inspection on September 29, 2022, licensee stated an adult in the home who was left alone supervising the children was a volunteer. LPA L. Habtom issued a Type A citation for an unfingerprinted adult however later LPA L. Habtom discovered that the adult had fingerprints association to the facility. LPA L. Habtom notified the licensee that the citation would be removed as well as the penalty not assessed as previously done on September 29, 2022.

There was no Title 22 regulations cited during today's inspection. This report was reviewed with licensee Praskoviaa Parker. A notice of site visit provided and appeal rights.
SUPERVISORS NAME: Keven Peters
LICENSING EVALUATOR NAME: Lea Habtom
LICENSING EVALUATOR SIGNATURE: DATE: 02/08/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/08/2023
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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