483007592-6-26-2024-01-CC-LLEI-D6P48M-20240628185258

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 483007592
Report Date: 06/26/2024
Date Signed: 06/26/2024 11:29:42 AM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405

This is an official report of an unannounced visit/investigation of a complaint received in our office on
04/02/2024 and conducted by Evaluator Melchisedeck Augustin

PUBLIC

COMPLAINT CONTROL NUMBER: 01-CC-20240402140022

FACILITY NAME:	VAEZINIA, VICTORIA FAMILY CHILD CARE HOME		FACILITY NUMBER:	483007592
ADMINISTRATOR:	VAEZINIA, VICTORIA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(707) 452-8888
CITY:	VACAVILLE	STATE: CA	ZIP CODE:	95687
CAPACITY:	14	CENSUS: 11	DATE:	06/26/2024
		UNANNOUNCED	TIME BEGAN:	10:35 AM
MET WITH:	Victoria Vaezinia - Licensee		TIME COMPLETED:	11:45 AM

ALLEGATION(S):

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Provider caused injury to daycare child.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA), Melchisedeck Augustin made an unannounced Complaint-Investigation visit and met with Licensee (LS), Victoria Vaezinia, for the purpose of delivering finding for the above allegation. LPA previously met with LS on 04/05/24 to initiate the investigation by discussing the purpose of the visit, conducting an interview with LS, staff, and children; and requested a facility roster of the children in care. It is alleged that the provider caused injury to a daycare child. The report noted a child (C1) sustained a knot on the left eye.

LPA interviewed LS and two staff (S1-S2), two children (C3-C4), two adults (A1-A2), and five parents (P1-P5), starting on 04/04/24 through 06/10/24. Some children were not verbal, too young to interview, or did not qualify to be interviewed. LS acknowledged C1’s left swollen eye but denied C1’s condition was a result of staff conduct or lack/absence of supervision. According to LS, she did not see any existing injuries when C1 was dropped off, and she noticed a blue colored birth mark on the left side of the face after staff pointed it out, but LS did not know exactly how C1 sustained the alleged injuries but assumed C1 was bitten by an insect.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Leslie Lepori	TELEPHONE: (707) 588-5060
LICENSING EVALUATOR NAME: Melchisedeck Augustin	TELEPHONE: (707) 494-4918
LICENSING EVALUATOR SIGNATURE:	DATE: 06/26/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/26/2024

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 01-CC-20240402140022

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405

FACILITY NAME: VAEZINIA, VICTORIA FAMILY CHILD CARE HOME	FACILITY NUMBER: 483007592
	VISIT DATE: 06/26/2024

NARRATIVE

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S1 & S2 reported they were present on the day C1 allegedly sustained the injury, but staff stated they did not witness any incident involving injury to C1. Staff noticed C1’s eye was swollen after nap during a diaper changing session, no other child(ren) injured C1; and the swelling was not a result of staff conduct and/or inadequate supervision. During nap time, children were physically checked 3-7 minutes; and the facility’s discipline policy consisted of staff talking with child(ren) to resolve conflicts.

C3 & C4 did not report any concerns, and the children confirmed they did not see any child(ren) fall or hurt themselves, they never saw any staff/adult(s) hit, pinch or cause injury to any child(ren); children were never left unattended; staff talked to and utilized time out as tools to address children’s challenging behavior(s); and the children felt safe at the facility. P1-P5 did not have any knowledge or information relevant to the allegation. Parents divulged they never witnessed staff cause harm to any child(ren) and described staff’s character as kind and expressed that their child enjoyed going to the facility. A1 reported LS notified her that C1 had a knot on the eye, but prior to C1 arriving at the facility, C1 did not have a knot on the left eye, and when asked how C1 sustained the injury; LS allegedly kept changing her story and did not explain how C1 sustained the swollen eye. Another adult (A2) whose child was no longer enrolled at the facility, reported her child allegedly disclosed a staff pinched him multiple times for not taking a nap, but that statement was not corroborated.

On 04/15/24, the Department obtained a police report (PD) which did not provide evidence to support the claims about LS causing injury to C1, and the report suggested that the swelling was caused by a bug or allergic reaction. Based on the investigation, it could not be determined how and where C1 sustained the swollen eye, and there were no conclusive evidence to confirm C1’s swollen left eye occurred as a result of staff conduct and/or inadequate supervision. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is unsubstantiated. A notice of site visit was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100. There were no violation(s) of California Code of Regulations, Title 22, Division 12 cited at this time. Appeal Rights were provided.

SUPERVISOR'S NAME: Leslie Lepori	TELEPHONE: (707) 588-5060
LICENSING EVALUATOR NAME: Melchisedeck Augustin	TELEPHONE: (707) 494-4918
LICENSING EVALUATOR SIGNATURE:	DATE: 06/26/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/26/2024

LIC9099 (FAS) - (06/04)

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