283008881-5-26-2021-01-CC-LLEI-C3L4CB-20210601185852

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 283008881
Report Date: 05/26/2021
Date Signed: 05/26/2021 01:46:03 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office,
, CA

This is an official report of an unannounced visit/investigation of a complaint received in our office on
01/20/2021 and conducted by Evaluator Kevin O'Connell

COMPLAINT CONTROL NUMBER: 01-CC-20210120161001

FACILITY NAME:	WISNIEWSKI, JACQUELINE FCCH		FACILITY NUMBER:	283008881
ADMINISTRATOR:	WISNIEWSKI, JACQUELINE		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(415) 306-2491
CITY:	NAPA	STATE: CA	ZIP CODE:	94558
CAPACITY:	14	CENSUS: 10	DATE:	05/26/2021
		UNANNOUNCED	TIME BEGAN:	11:15 AM
MET WITH:	Licensee, Jacqueline Wisniewski		TIME COMPLETED:	11:45 AM

ALLEGATION(S):

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Children in care were left unsupervised.
Staff spoke inappropriately to children in care .
Children in care were punished for crying.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA), Kevin O’Connell, conducted a subsequent complaint investigation inspection on 5/26/2021 at 11:15am for the purpose to deliver the findings regarding the above allegations.
LPA met with Licensee, Jacqueline Wisniewski, (L), via a tele-inspection due to the COVID-19 pandemic. (FaceTime)
It was alleged that children in care were left unsupervised, specifically left alone in a sleeping room while crying, staff spoke inappropriately to children in care, children in care were punished for crying, specifically left alone in their cubbies until they stop.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Leslie Lepori	TELEPHONE: (707) 588-5060
LICENSING EVALUATOR NAME: Kevin O'Connell	TELEPHONE: (707) 588-5026
LICENSING EVALUATOR SIGNATURE:	DATE: 05/26/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/26/2021

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 01-CC-20210120161001

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office,
, CA

FACILITY NAME: WISNIEWSKI, JACQUELINE FCCH	FACILITY NUMBER: 283008881
	VISIT DATE: 05/26/2021

NARRATIVE

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The Licensee denied the allegations at 1:30pm on 1/29/21 stating that children are not left unsupervised and there are three staff there to care for the children, Children are not spoken to inappropriately and if a child is not listening she takes them to their cubby area in the kitchen, spoken to about what happened and then returned back to where they were. Children are not punished for crying, when a child is crying, they are taken to their cubby area in the kitchen, spoken to, calmed down, apologize if necessary and returned to playing with the other children.

The investigation consisted of interviews and documentation review.
Staff interviewed 1/29/21 & 5/19/21, S1-S3, could not corroborate the allegations.
Parents interviewed 5/19/21 through 5/25/21, P1 through P7, could not corroborate the allegations. Children interviewed could not corroborate the allegations.

As such, there is not enough evidence to corroborate the above allegations. Based on the available information obtained, during the course of the investigation, although the allegations may have happened or is valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the Department’s findings are that the above allegations are unsubstantiated. This report was reviewed and discussed with the Licensee.
Appeal Rights will be emailed.

SUPERVISOR'S NAME: Leslie Lepori	TELEPHONE: (707) 588-5060
LICENSING EVALUATOR NAME: Kevin O'Connell	TELEPHONE: (707) 588-5026
LICENSING EVALUATOR SIGNATURE:	DATE: 05/26/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/26/2021

LIC9099 (FAS) - (06/04)

Page: 2 of 5

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office,
, CA

This is an official report of an unannounced visit/investigation of a complaint received in our office on
01/20/2021 and conducted by Evaluator Kevin O'Connell

COMPLAINT CONTROL NUMBER: 01-CC-20210120161001

FACILITY NAME:	WISNIEWSKI, JACQUELINE FCCH		FACILITY NUMBER:	283008881
ADMINISTRATOR:	WISNIEWSKI, JACQUELINE		FACILITY TYPE:	810
ADDRESS:	3790 OXFORD STREET		TELEPHONE:	(415) 306-2491
CITY:	NAPA	STATE: CA	ZIP CODE:	94558
CAPACITY:	14	CENSUS: 10	DATE:	05/26/2021
		UNANNOUNCED	TIME BEGAN:	11:15 AM
MET WITH:	Licensee, Jacqueline Wisniewski		TIME COMPLETED:	11:45 AM

ALLEGATION(S):

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Staff forced children in care to eat.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA), Kevin O’Connell, conducted a subsequent complaint investigation inspection on 5/26/2021 at 11:15am for the purpose to deliver the findings regarding the above allegation.
LPA met with Licensee, Jacqueline Wisniewski, (L), via a tele-inspection due to the COVID-19 pandemic. (FaceTime)
It was alleged that staff forced children in care to eat.
The Licensee denied the allegations at 1:30pm on 1/29/21 stating that if children say no, they stop eating. They are not forced to eat.

Substantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Leslie Lepori	TELEPHONE: (707) 588-5060
LICENSING EVALUATOR NAME: Kevin O'Connell	TELEPHONE: (707) 588-5026
LICENSING EVALUATOR SIGNATURE:	DATE: 05/26/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/26/2021

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

LIC9099 (FAS) - (06/04)

Page: 3 of 5

Control Number 01-CC-20210120161001

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office,
, CA

FACILITY NAME: WISNIEWSKI, JACQUELINE FCCH	FACILITY NUMBER: 283008881
	VISIT DATE: 05/26/2021

NARRATIVE

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The investigation consisted of interviews and documentation review.
Staff interviewed 1/29/21 & 5/19/21, S1-S3, could not corroborate the allegations.

Parents interviewed 5/19/21 through 5/25/21, P1 through P3 & P5, P6 & P7, could not corroborate the allegations. P4 stated that her child revealed that C1 was forced to eat before being able to play with the other children multiple times.
Through children interviews, this unrelated source, C1 revealed that C1 was forced to eat when C1 did not want to, multiple times, before being able to leave the table to play after lunch with the other children. Other children interviewed could not corroborate the allegation.

Based on evidence obtained, the preponderance of evidence standard has been met, therefore the above allegations are found to be substantiated. The following violations(s) of the California Code of Regulations, Title 22: Division 12, were observed: See LIC9099D. Appeal Rights were provided.

SUPERVISOR'S NAME: Leslie Lepori	TELEPHONE: (707) 588-5060
LICENSING EVALUATOR NAME: Kevin O'Connell	TELEPHONE: (707) 588-5026
LICENSING EVALUATOR SIGNATURE:	DATE: 05/26/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/26/2021

LIC9099 (FAS) - (06/04)

Page: 4 of 5

Control Number 01-CC-20210120161001

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office,
, CA

FACILITY NAME: WISNIEWSKI, JACQUELINE FCCH	FACILITY NUMBER: 283008881
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 05/26/2021

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 06/09/2021 Section Cited CCR 102423(a)(1)	1 2 3 4 5 6 7	Personal Rights (a) Each child receiving services from a family child care home shall have certain rights that shall not	1 2 3 4 5 6 7	POC Licensee states that she will hold a training with her staff addressing this issue and send CCL notification of contents of training by 6/9/2021.
	8 9 10 11 12 13 14	be waived or abridged by the licensee regardless of consent or authorization from the child's authorized representative. These rights include, but are not limited to, the following: (4) To be free from corporal or unusual punishment, infliction of pain, humiliation, intimidation, ridicule, coercion, threat, mental abuse, or other actions of a punitive nature, including, but not limited to: interference with eating, sleeping or toileting; or withholding shelter, clothing, medication or aids to physical functioning. The requirement has not been met as evidenced by: Based on interviews with a parent and a child, a child was forced to eat when said child did not want to, multiple times, before being able to leave the table to play after lunch with the other children. This poses a potential risk to the 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.

SUPERVISOR'S NAME: Leslie Lepori	TELEPHONE: (707) 588-5060
LICENSING EVALUATOR NAME: Kevin O'Connell	TELEPHONE: (707) 588-5026
LICENSING EVALUATOR SIGNATURE:	DATE: 05/26/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/26/2021

LIC9099 (FAS) - (06/04)

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