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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 313617391
Report Date: 04/30/2021
Date Signed: 04/30/2021 03:18:16 PM



STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833
This is an official report of an unannounced visit/investigation of a complaint received in our office on
03/26/2021 and conducted by Evaluator Jeremey McClain
PUBLIC
COMPLAINT CONTROL NUMBER: 03-CC-20210326092634
FACILITY NAME:MEDVECKI, VALQUIRIAFACILITY NUMBER:
313617391
ADMINISTRATOR:MEDVECKI, VALQUIRIAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(916) 412-6632
CITY:ROSEVILLESTATE: CAZIP CODE:
95661
CAPACITY:14CENSUS: 11DATE:
04/30/2021
UNANNOUNCEDTIME BEGAN:
09:20 AM
MET WITH:Valquiria MedveckiTIME COMPLETED:
09:45 AM
ALLEGATION(S):
1
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9
Licensee and Staff did not Honor the Personal Rights of a child in care
Lack of Supervision resulted in an injury to a child in care
INVESTIGATION FINDINGS:
1
2
3
4
5
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7
8
9
10
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On April 30th, 2021 Licensing Program Analyst (LPA) Jeremey McClain met with Licensee Valquiria Medvecki via Facetime Video, in order deliver findings regarding the complaint investigation. LPA observed 11 children, Licensee’s assistant Abigail Martinez was present. It was alleged that a child in care was hit by an assistant, that a lack of supervision resulted in an injury to a child, and that the licensee and assistant yelled at a child in care. During the investigation, LPA conducted interviews with staff, children, parents, and a social worker from the County of Sacramento. Licensee also conducted interviews alongside Detective Grove from the Roseville Police Department made observations at the facility/home, and reviewed files. LPA determined that the evidence gathered was conflicting, and therefore could not corroborate the allegations, nor provides grounds to dismiss the allegations. The preponderance of evidence standard has not been met and the allegations are determined to be unsubstantiated.

There were no Title 22 deficiencies as a result of the investigation. LPA reviewed this report with the Licensee and emailed a copy for signature and review. LPA also provided a Notice of Site Visit that must be posted for 30 days.
Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Keven PetersTELEPHONE: (916) 263-5728
LICENSING EVALUATOR NAME: Jeremey McClainTELEPHONE: (916) 216-7801
LICENSING EVALUATOR SIGNATURE:

DATE: 04/30/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/30/2021
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
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