483009150-9-10-2021-01-CC-LLEI-C6UU8M-20210914152145

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 483009150
Report Date: 09/10/2021
Date Signed: 09/10/2021 01:12:49 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 101 GOLF COURSE DR. STE. A-230
ROHNERT PARK, CA 94928

This is an official report of an unannounced visit/investigation of a complaint received in our office on
05/21/2021 and conducted by Evaluator Elpidia Hernandez Torres

PUBLIC

COMPLAINT CONTROL NUMBER: 01-CC-20210521103338

FACILITY NAME:	LEE, EKESHA FCCH		FACILITY NUMBER:	483009150
ADMINISTRATOR:	LEE, EKESHA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(510) 921-7889
CITY:	SUISUN CITY	STATE: CA	ZIP CODE:	94585
CAPACITY:	14	CENSUS: 4	DATE:	09/10/2021
		UNANNOUNCED	TIME BEGAN:	12:25 PM
MET WITH:	Ekesha Lee		TIME COMPLETED:	01:30 PM

ALLEGATION(S):

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Day care child sustained multiple unexplained injuries while in care

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA), Elpidia Hernandez Torres, conducted a subsequent complaint investigation inspection on 09/10/2021 at 12:30PM to deliver the finding regarding the above allegation. LPA previously met with Licensee, Ekesha Lee, on 05/26/2021, via a tele-inspection due to the COVID-19 pandemic, to discuss the purpose of the complaint inspection and obtained facility records. This complaint received on 05/21/2021 was investigated by Investigator, Sonia Boyal, from the Department’s Investigation Branch (IB). The complaint alleged that on 11/18/2020, a day care child (C1) sustained multiple unexplained injuries while in care. The injuries were described as left leg pain, swelling to the left knee, swelling to the left third finger, and bruising in the abdomen.

The Licensee (LS) was interviewed on 07/21/2021 and denied witnessing any injuries on C1. LS further claimed that although C1 was fussy, crying, and complaining of pain to either the leg, arm, or foot, no unusual incidents occurred on the day in question that could have resulted in the injuries. No other staff worked at the facility that day.
Continued 9099-C

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Leslie Lepori	TELEPHONE: (707) 588-5060
LICENSING EVALUATOR NAME: Elpidia Hernandez Torres	TELEPHONE: (707) 771-5568
LICENSING EVALUATOR SIGNATURE:	DATE: 09/10/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/10/2021

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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Control Number 01-CC-20210521103338

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 101 GOLF COURSE DR. STE. A-230
ROHNERT PARK, CA 94928

FACILITY NAME: LEE, EKESHA FCCH	FACILITY NUMBER: 483009150
	VISIT DATE: 09/10/2021

NARRATIVE

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During the course of the investigation, interviews were conducted with eight parents, seven children, medical staff and law enforcement on 05/24/21, 05/27/21, 06/10/21, 07/09/21, 07/12/21, 07/21/21, 07/22/21, and 07/26/21. Medical records and law enforcement reports were reviewed. Parent and children’s statements did not report any health and safety concerns at the facility. Children did not report any unusual incidents on the day the injuries allegedly occurred. The medical records indicated that there were no fractures or dislocations and that the cause of the symptoms was unclear.

Based on the investigation and medical records, there was no definitive evidence to determine the cause of the injuries and where the injuries occurred. Although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violation occurred, therefore the allegation is deemed unsubstantiated. This report was discussed and reviewed with LS. Notice of Site Visit shall be posted for 30 days. Appeal Rights were provided.

SUPERVISOR'S NAME: Leslie Lepori	TELEPHONE: (707) 588-5060
LICENSING EVALUATOR NAME: Elpidia Hernandez Torres	TELEPHONE: (707) 771-5568
LICENSING EVALUATOR SIGNATURE:	DATE: 09/10/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/10/2021

LIC9099 (FAS) - (06/04)

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