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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 304314145
Report Date: 06/27/2025
Date Signed: 07/29/2025 09:32:26 AM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE COUNTY CC RO, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
This is an official report of an unannounced visit/investigation of a complaint received in our office on
05/02/2025 and conducted by Evaluator Soo Jin Jung
PUBLIC
COMPLAINT CONTROL NUMBER: 06-CC-20250502105936
FACILITY NAME:BURDINA, SABINAFACILITY NUMBER:
304314145
ADMINISTRATOR:BURDINA, SABINAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(415) 370-8883
CITY:LAKE FORESTSTATE: CAZIP CODE:
92630
CAPACITY:14CENSUS: 8DATE:
06/27/2025
UNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Licensee, Sabina BurdinaTIME COMPLETED:
11:00 AM
ALLEGATION(S):
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LIcensee allowed daycare child to attend daycare without any paperwork.
INVESTIGATION FINDINGS:
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*This is an amended version of the original report written on 6/27/2025.*
On 6/27/2025, Licensing Program Analyst (LPA) Jung, conducted an unannounced visit to the facility to deliver findings for a complaint that was received at the Orange County Regional Child Care Licensing Office. LPA met with licensee, Sabina Burdina, and explained the reason for the visit. LPA was led on a tour of the facility and observed a total of eight (8) children with the licensee and one (1) assistant.
A review of the Facility Personnel Report Summary on this date indicates all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions. During today’s inspection the facility was operating within its licensed capacity and within compliance of staffing ratios.
On 5/2/2025, the Orange County Regional Child Care Licensing Office received a complaint with one allegation listed above: Reporting Party (RP) alleged that (1) licensee allowed daycare child to attend daycare without any paperwork.
(Go to Page 2)
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Nguyen K Tran
LICENSING EVALUATOR NAME: Soo Jin Jung
LICENSING EVALUATOR SIGNATURE:

DATE: 06/27/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/27/2025
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 06-CC-20250502105936
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE COUNTY CC RO, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
FACILITY NAME: BURDINA, SABINA
FACILITY NUMBER: 304314145
VISIT DATE: 06/27/2025
NARRATIVE
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(Page 2)
On 5/7/2025, LPA made an unannounced visit to the facility. During the visit, LPA conducted file reviews and interviewed the licensee and one (1) assistant. Children present could not be qualified for interviews. Licensee provided LPA with facility roster, parent handbook, children’s records, and additional documents pertinent to the investigation.

During licensee’s interview, they admitted that they did not obtain enrollment documents for one child prior to the child’s first day of enrollment. While they usually process enrollment documents prior to all children starting, they had one child recently attend the daycare without following this usual process. They stated the documents were collected on the second day of enrollment instead.

LPA was able to conduct two (2) parent interviews. Parents interviewed did not divulge any information to support the allegations stated above. Parents interviewed praised the licensee for their customer service and quality of program.

The Orange County Regional Child Care Licensing Office has investigated the complaint alleging licensee allowed daycare child to attend daycare without any paperwork. Based on information gathered from LPA’s interviews and record reviews, the preponderance of evidence standard has been met, therefore the allegation is substantiated. California Code of Regulations, Title 22, Division 12 & Chapter 1, Section 102421(a) Child’s Records cited; see LIC 9099D.

A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with the licensee, Sabina Burdina.

End of report.
SUPERVISORS NAME: Nguyen K Tran
LICENSING EVALUATOR NAME: Soo Jin Jung
LICENSING EVALUATOR SIGNATURE:

DATE: 06/27/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/27/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 06-CC-20250502105936
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE COUNTY CC RO, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME: BURDINA, SABINA
FACILITY NUMBER: 304314145
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/27/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
06/27/2025
Section Cited
CCR
101421(a)
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101421(a) Child's Records: The licensee shall maintain, in each child's record, the signed and dated notice form required in Section 102419(d). This requirement was not met as evidenced by:
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Licensee obtained C4's records and showed them to LPA during visit. LPA verified that C4's records were complete. Deficiency has been cleared.
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Based on interview and record review, the licensee did not comply with the section cited above in that, licensee did not maintain records for Child 4 (C4), which poses a potential 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.
SUPERVISORS NAME: Nguyen K Tran
LICENSING EVALUATOR NAME: Soo Jin Jung
LICENSING EVALUATOR SIGNATURE:

DATE: 06/27/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/27/2025
LIC9099 (FAS) - (06/04)
Page: 3 of 3