<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 343625666
Report Date: 08/05/2024
Date Signed: 08/05/2024 10:45:04 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
07/17/2024 and conducted by Evaluator Michelle Perez
PUBLIC
COMPLAINT CONTROL NUMBER: 03-CC-20240717091815
FACILITY NAME:KASHIRSKII, ANDREIFACILITY NUMBER:
343625666
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY:8CENSUS: 3DATE:
08/05/2024
UNANNOUNCEDTIME BEGAN:
08:45 AM
MET WITH:Andre KashirskiiTIME COMPLETED:
11:00 AM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
License-
Licensee's temporary absences exceeded more than 20 percent of the hours during which the facility provides care per day
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On August 5, 2024, at approximately 08:45 AM Licensing Program Analayst (LPA), Michelle Perez, met with licensee, Andrei Kasherskii and spouse Margarita Kashirskaia for the purpose of delivering findings for the above allegation. Upon arrival, LPA observed 03 children in care.

It was alleged, that the licensee is not present for 80 percent of their operating hours on a daily basis. Throughout the investigation, LPA conducted interviews with prior families and made observations to determine if the licensee was absent more than 20 percent of the day. LPA determined that the licensee was not present for 80 percent of their operating hours and and was rarely seen in the facility. LPA found that licensee would leave an assistant to provide full time care for the children enrolled.

Cont on 9099C
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Keven Peters
LICENSING EVALUATOR NAME: Michelle Perez
LICENSING EVALUATOR SIGNATURE:

DATE: 08/02/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/02/2024
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 03-CC-20240717091815
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: KASHIRSKII, ANDREI
FACILITY NUMBER: 343625666
VISIT DATE: 08/05/2024
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
Based on the LPAs interviews and observations, the preponderance of evidence standard has been met, therefore the above allegation is found to be substantiated. California Code of Regulations (CCR) Title 22, 102417(a) are being cited on the attached 9099D
SUPERVISORS NAME: Keven Peters
LICENSING EVALUATOR NAME: Michelle Perez
LICENSING EVALUATOR SIGNATURE:

DATE: 08/02/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/02/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 03-CC-20240717091815
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: KASHIRSKII, ANDREI
FACILITY NUMBER: 343625666
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/05/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
08/16/2024
Section Cited
CCR
102417(a)
1
2
3
4
5
6
7
Licensee not present 80% of operating hours.
The licensee shall be present in the home and shall ensure that children in care are supervised at all times. When circumstances require the licensee to be temporarily absent from the home, the licensee shall arrange for a substitute adult to care for and supervise the children during his/her absence.
1
2
3
4
5
6
7
Licensee is to provide a letter to LPA outlining that it is understood licensee(s) must be present for 80% of operating hours.

LPA will be returning to conduct an unannounced visit to verify licensee is present during operating hours
8
9
10
11
12
13
14
Temporary absences shall not exceed 20 percent of the hours that the facility is providing care per day.
This was not evidenced by: LPA conducting interviews with prior families which confirmed licensee was not regularly present for 80% of operating hours.
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: Keven Peters
LICENSING EVALUATOR NAME: Michelle Perez
LICENSING EVALUATOR SIGNATURE:

DATE: 08/02/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/02/2024
LIC9099 (FAS) - (06/04)
Page: 3 of 3