343622055-7-19-2022-03-CC-KPES-CGPRZQ-20220726132820

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 343622055
Report Date: 07/19/2022
Date Signed: 07/19/2022 12:27:29 PM

Unsubstantiated

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
05/24/2022 and conducted by Evaluator Lea Habtom

PUBLIC

COMPLAINT CONTROL NUMBER: 03-CC-20220524154439

FACILITY NAME:	BOYKO, NATALIA & BARANOVA, TAMARA		FACILITY NUMBER:	343622055
ADMINISTRATOR:	BOKYO, N. & BARANOVA, T.		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(916) 470-6898
CITY:	FAIR OAKS	STATE: CA	ZIP CODE:	95628
CAPACITY:	14	CENSUS: 13	DATE:	07/19/2022
		UNANNOUNCED	TIME BEGAN:	11:15 AM
MET WITH:	Natalia Boyko		TIME COMPLETED:	12:40 PM

ALLEGATION(S):

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Day care children sustained injuries while in care.
Day care staff did not provide adequate supervision to day care children.
Day care provider did not report that day care child was ill while in care.

INVESTIGATION FINDINGS:

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On July 19, 2022 Licensing Program Analysts Lea Habtom and Jeremey McClain met with licensee Natalia Boyko for the purpose of an unannouced visit to deliver the findings for the above allegations. During today’s visit there was a census of 13 children being supervised by 3 staff.

Day care children sustained injuries while in care.

During the investigation, LPA Habtom toured the facility, conducted observation and interviewed those pertinent to the investigation. It was alleged that a day care child sustained injuries while in care. Based on parent, children and staff interviews LPA Habtom was unable to gather corroborating information to determine if a lack of supervision resulted in a child being injured therefore the allegation is determined to be UNSUBSTANTIATED. Although it may or may have not happened, there is not a preponderance of evidence to prove that the alleged violations occured.

Report continued on 9099-C

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Keven Peters	TELEPHONE: (916) 263-5728
LICENSING EVALUATOR NAME: Lea Habtom	TELEPHONE: (916) 208-2538
LICENSING EVALUATOR SIGNATURE:	DATE: 07/19/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/19/2022

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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Control Number 03-CC-20220524154439

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833

FACILITY NAME: BOYKO, NATALIA & BARANOVA, TAMARA	FACILITY NUMBER: 343622055
	VISIT DATE: 07/19/2022

NARRATIVE

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Day care staff did not provide adequate supervision to day care children.

During the investigation, LPA Habtom toured the facility, conducted observation and interviewed those pertinent to the investigation. It was alleged that day care staff did not provide adequate supervision to day care children. Based on parent, children and staff interviews LPA Habtom was unable to gather corroborating information to determine that staff do not provide adequate supervision to children in care therefore the allegation is determined to be UNSUBSTANTIATED. Although it may or may have not happened, there is not a preponderance of evidence to prove that the alleged violations occurred.

Day care provider did not report that day care child was ill while in care.

During the investigation, LPA Habtom toured the facility, conducted observation and interviewed those pertinent to the investigation. It was alleged that day care provider did not report that a day care child was ill while in care. Based on interviews, LPA Habtom was unable to gather information to determine that a child was sick while in care and that the parents were not notified therefore based on the limited information the allegation is determined to be UNSUBSTANTIATED. Although it may or may have not happened, there is not a preponderance of evidence to prove that the alleged violations occurred.

SUPERVISOR'S NAME: Keven Peters	TELEPHONE: (916) 263-5728
LICENSING EVALUATOR NAME: Lea Habtom	TELEPHONE: (916) 208-2538
LICENSING EVALUATOR SIGNATURE:	DATE: 07/19/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/19/2022

LIC9099 (FAS) - (06/04)

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