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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 566215253
Report Date: 09/21/2021
Date Signed: 09/21/2021 11:11:12 AM



STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117
This is an official report of an unannounced visit/investigation of a complaint received in our office on
06/28/2021 and conducted by Evaluator Austin Rios
PUBLIC
COMPLAINT CONTROL NUMBER: 17-CC-20210628165408
FACILITY NAME:VENTURA CHILDREN'S LEARNING CENTERFACILITY NUMBER:
566215253
ADMINISTRATOR:VIKTORIIA SHEVKUNOVAFACILITY TYPE:
830
ADDRESS:1110 PETIT AVE.TELEPHONE:
(805) 672-0300
CITY:VENTURASTATE: CAZIP CODE:
93004
CAPACITY:22CENSUS: 34DATE:
09/21/2021
UNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Viktoria ShevkunovaTIME COMPLETED:
11:25 AM
ALLEGATION(S):
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Personal Rights-Staff did not report child's injury to parent
INVESTIGATION FINDINGS:
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On September 21, 2021 at 9:00 AM, Licensing Program Analyst (LPA) Austin Rios conducted an unannounced inspection to conclude a complaint investigation. LPA met with Director Viktoira Shevkunova and explained the nature and the purpose of the inspection. Director provided LPA a tour of the home inside and out. There were 34 children in care at the time of the inspection. The department obtained an allegation that staff did not report child's injury to parent.

Interviews were conducted with Complainant, Parents of children in care, staff and obtained documenation regarding the incident of Child#1. On 6/14/2021 C#1 was bit by another child at the facility. Staff witnessed the incident happen, assessed the child, as well as applied ice, however, staff did not report to parent because staff didn't think it would leave a mark. Parent learned of the bite later that day after observing the mark on C#1 body. Facility notified parent the next day as well as had parent sign an incident report.
Substantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Ana TolentinoTELEPHONE: (805) 562-0437
LICENSING EVALUATOR NAME: Austin RiosTELEPHONE: (805) 635-4725
LICENSING EVALUATOR SIGNATURE:

DATE: 09/21/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/21/2021
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 1 of 5
Control Number 17-CC-20210628165408
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117
FACILITY NAME: VENTURA CHILDREN'S LEARNING CENTER
FACILITY NUMBER: 566215253
VISIT DATE: 09/21/2021
NARRATIVE
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This agency has investigated the complaint alleging, “Staff did not report child's injury to parent”, and based on interviews conducted and documentation obtained, the preponderance of evidence standard has been met, therefore the allegation is found to be SUBSTANTIATED.

Exit interview was conducted with director. The Notice of Site Visit (LIC9213) was posted. The notice shall be posted for 30 consecutive days. Failure to maintain posting as required will result in a $100.00 civil penalty.


Web site address to obtain forms, review quarterly updates, review Title 22 & Health & Safety Codes is: https://www.cdss.ca.gov/inforesources/child-care-licensing
SUPERVISOR'S NAME: Ana TolentinoTELEPHONE: (805) 562-0437
LICENSING EVALUATOR NAME: Austin RiosTELEPHONE: (805) 635-4725
LICENSING EVALUATOR SIGNATURE:

DATE: 09/21/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/21/2021
LIC9099 (FAS) - (06/04)
Page: 2 of 5
Control Number 17-CC-20210628165408
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117

FACILITY NAME: VENTURA CHILDREN'S LEARNING CENTER
FACILITY NUMBER: 566215253
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/21/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
09/21/2021
Section Cited
CCR
101218.1(B)
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101218.1 Admission Procedures and Parental and Authorized Representative's Rights (B) Provides the child's parent...with information about the child care center...procedures to be followed should the child become ill or injured while at the child care center...
This requirement is not met as evidenced by
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Facility willl provide a written statement of how the facility will ensure that staff report any child's injury to parents by 9/30/2021 and submit to LPA via email austin.rios@dss.ca.gov or text to (805) 635-4725
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After LPA interviews and record review it was determined staff did not report child's injury to parent
This poses a potential risk to the health and safety of the children in care
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME: Ana TolentinoTELEPHONE: (805) 562-0437
LICENSING EVALUATOR NAME: Austin RiosTELEPHONE: (805) 635-4725
LICENSING EVALUATOR SIGNATURE:

DATE: 09/21/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/21/2021
LIC9099 (FAS) - (06/04)
Page: 3 of 5
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117
This is an official report of an unannounced visit/investigation of a complaint received in our office on
06/28/2021 and conducted by Evaluator Austin Rios
PUBLIC
COMPLAINT CONTROL NUMBER: 17-CC-20210628165408

FACILITY NAME:VENTURA CHILDREN'S LEARNING CENTERFACILITY NUMBER:
566215253
ADMINISTRATOR:VIKTORIIA SHEVKUNOVAFACILITY TYPE:
830
ADDRESS:1110 PETIT AVE.TELEPHONE:
(805) 672-0300
CITY:VENTURASTATE: CAZIP CODE:
93004
CAPACITY:22CENSUS: 34DATE:
09/21/2021
UNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Viktoria ShevkunovaTIME COMPLETED:
11:25 AM
ALLEGATION(S):
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Lack of Supervision-Staff did not properly supervise day care child
Personal Rights-Child sustained an injury while in care
INVESTIGATION FINDINGS:
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On September 21, at 9:00 AM Licensing Program Analyst (LPA) Austin Rios conducted an unannounced inspection to conclude a complaint investigation. LPA met with Director Viktoira Shevkunova and explained the nature and the purpose of the inspection. Director provided LPA a tour of the facility inside and out. There were 34 children in care at the time of the inspection. The department obtained allegations that staff did not properly supervise daycare child and child sustained an injury while in care.

Interviews were conducted with Complainant, Parents of children in care, staff ,and LPA obtained documenation of previous incident reports. LPA reviewed all prior incident reports on file with parent signatures. C#1 did receive an injury while in care however, staff witnessed the incidents happen, properly assessed the child, and did incident reports in a timely manner. Although the above 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 above allegation is Unsubstantiated.
Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Ana TolentinoTELEPHONE: (805) 562-0437
LICENSING EVALUATOR NAME: Austin RiosTELEPHONE: (805) 635-4725
LICENSING EVALUATOR SIGNATURE:

DATE: 09/21/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/21/2021
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 5 of 5