483009951-8-15-2023-01-CC-LLEI-CUR2T4-20230815174007

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 483009951
Report Date: 08/15/2023
Date Signed: 08/15/2023 03:17:00 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, 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
05/16/2023 and conducted by Evaluator Melchisedeck Augustin

PUBLIC

COMPLAINT CONTROL NUMBER: 01-CC-20230516164025

FACILITY NAME:	POWELL, DENISHIA FCCH		FACILITY NUMBER:	483009951
ADMINISTRATOR:	POWELL, DENISHIA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(707) 563-0903
CITY:	VALLEJO	STATE: CA	ZIP CODE:	94591
CAPACITY:	14	CENSUS: 10	DATE:	08/15/2023
		UNANNOUNCED	TIME BEGAN:	02:10 PM
MET WITH:	Denishia Powell - Licensee		TIME COMPLETED:	02:45 PM

ALLEGATION(S):

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Child in care sustained unexplained injuries

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA), Melchisedeck Augustin made a subsequent complaint-investigation visit and met with Licensee, Denishia Powell (LS) for the purpose of delivering finding for the above allegation. LPA previously met with LS on 05/24/23 and 08/09/23 to initiate the investigation by discussing the purpose of the visit, conducting interviews with LS and staff and children, making observations; and requested a facility roster of the children currently in care. It is alleged that a child in care sustained unexplained injuries. The reported a child (C6) sustained visible bruises on both wrist and arms due to lack of or absence of supervision.

LPA interviewed LS, two staff (S2-S3), four children (C1-C4), four parents (P1-P4), and two adults (A1-A2) from 05/24/23 through 08/14/23. LS statement denied claims about C6 sustaining bruises or any injuries while in care at the facility. LS stated C6 was wearing a sweater with long sleeve which covered the arms and LS affirmed she did not see any bruise(s). According to LS, the child(ren) were not left without staff supervision, no other child caused injury to C6, and LS did not notice any indication of injury as C6 did not cry of pain. (Continue to LIC 809-C)

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Leslie Lepori
LICENSING EVALUATOR NAME: Melchisedeck Augustin
LICENSING EVALUATOR SIGNATURE:	DATE: 08/15/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/15/2023

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-20230516164025

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: POWELL, DENISHIA FCCH	FACILITY NUMBER: 483009951
	VISIT DATE: 08/15/2023

NARRATIVE

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LS further stated facility staff did not report to her any incident involving injury to any child(ren), and if a child had been involved in an incident which resulted in injury; LS would have notified the child’s parent.

Multiple statements provided by staff (S2 & S3) did not report any concerns and did not corroborate claims about C6 sustaining bruises at the facility. S2 did not see any child arrive to care with a new bruise and never saw staff act rude, hit, or children left without staff supervision. S3 reported she was not present during the time C6 attended care. Staff confirmed the facility’s discipline policy consisted of staff asking a child(ren) to sit down on a chair for three to five minutes and staff talking with the child until that child calmed down. P2-P4 reported their child did not sustain unexplained injuries at the facility and confirmed they always saw an adult staff present during pickup time, but P1 reported on at least three different occasions during pickup time, P1 saw C4, who was not an adult, left alone to supervise the children. Statements provided by witnesses (C1, C2 & C4) reported they had not seen staff yelled, screamed, acted mean, or hit any child(ren) in care. Although there was some indication that C6 sustained injuries, it could not be determined how and where, and the injuries could not be attributed to a lack of or absence of 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. Exit interview conducted and report was reviewed with the Licensee, Denishia Powell. 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. The were no violation of the California Code of Regulations, Title 22; Division 12; observed at this time. Appeal Rights were provided.

SUPERVISORS NAME: Leslie Lepori
LICENSING EVALUATOR NAME: Melchisedeck Augustin
LICENSING EVALUATOR SIGNATURE:	DATE: 08/15/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/15/2023

LIC9099 (FAS) - (06/04)

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