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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 073409093
Report Date: 09/04/2025
Date Signed: 09/04/2025 01:26:00 PM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
OAKLAND CC RO, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612
This is an official report of an unannounced visit/investigation of a complaint received in our office on
08/14/2025 and conducted by Evaluator Ashley Hollinger
PUBLIC
COMPLAINT CONTROL NUMBER: 02-CC-20250814191247
FACILITY NAME:KOMAROVA, GALINAFACILITY NUMBER:
073409093
ADMINISTRATOR:KOMAROVA, GALINAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(415) 568-0191
CITY:ANTIOCHSTATE: CAZIP CODE:
94531
CAPACITY:14CENSUS: 8DATE:
09/04/2025
UNANNOUNCEDTIME BEGAN:
09:10 AM
MET WITH:Galina KomarovaTIME COMPLETED:
10:30 AM
ALLEGATION(S):
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NEGLECT/LACK OF SUPERVISION
INVESTIGATION FINDINGS:
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On 09/04/2025, Licensing Program Analysts (LPAs) Ashley Hollinger and Dana Santiago conducted an Unannounced Subsequent Complaint Investigation at Galina Komarova’s Family Child Care Home. LPAs met with Licensee, Galina Komarova, and explained the purpose of the investigation. During today’s inspection LPAs observed six (6) preschoolers, one (1) toddler, and one (1) infant in care.

The findings for the above allegation was delivered during the inspection to which the Complainant alleges that their child sustained an injury due to lack of supervision during the Licensee’s care. During the investigation, LPAs inspected the facility and found age-appropriate toys in the facility, reviewed records, collected evidence including medical examination notes stating that the child’s injury was likely sustained from falling from a sitting height while in daycare on 08/08/2025, and conducted interviews with the Complainants who stated that their infant child was picked up around 4:34 PM and contacted the Licensee via text message at 5:32 PM on 08/08/2025 with a photograph of injury that shows bruising and redness on the eye and a scratch on the left side of the infant child’s nose.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Monica Mathur
LICENSING EVALUATOR NAME: Ashley Hollinger
LICENSING EVALUATOR SIGNATURE:

DATE: 09/04/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/04/2025
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 3
Control Number 02-CC-20250814191247
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
OAKLAND CC RO, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612
FACILITY NAME: KOMAROVA, GALINA
FACILITY NUMBER: 073409093
VISIT DATE: 09/04/2025
NARRATIVE
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PAGE 2

LPAs also interviewed the Licensee and Licensee’s assistant who stated that they actively supervise children in care but did not observe the infant child falling on 08/08/2025.

LPAs discussed and highlighted with the Licensee and their assistant the importance of reporting requirements and how to report when the office is closed. LPAs also discussed the importance of active supervision of children in care especially active supervision of infants.

Based on observations, interviews with the Complainant and staff, which were conducted and record review(s), the preponderance of evidence standard has been met, therefore the above allegation(s) is found to be SUBSTANTIATED. California Code of Regulations Title 22, Division 12 and Chapter 1 are being cited on the attached LIC 9099D.
Exit interview was conducted with Licensee, Galina Komarova and appeal rights were provided.

A NOTICE OF SITE VISIT WAS ISSUED AND MUST BE POSTED FOR 30 CONSECUTIVE DAYS.
SUPERVISORS NAME: Monica Mathur
LICENSING EVALUATOR NAME: Ashley Hollinger
LICENSING EVALUATOR SIGNATURE:

DATE: 09/04/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/04/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 02-CC-20250814191247
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
OAKLAND CC RO, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612

FACILITY NAME: KOMAROVA, GALINA
FACILITY NUMBER: 073409093
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/04/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
09/18/2025
Section Cited
CCR
102417(a)
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102417(a) Operation of a Family Child Care Home

(a) The licensee shall be present in the home and shall ensure that children in care are supervised at all times......
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The Licensee will submit a plan of how they will ensure adequate supervision and future compliance with the above regulation. The Licensee will submit proof to the Department by 09/18/2025.
Failure to correct will result in a $100 per day civil penalty until corrected.
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This requirement has not been met as evidenced by:

Based on interviews and observations, the Licensee did not comply with the section cited above when providing supervision to day care children, which poses a potential risk to the health and safety of children in care.
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Repeat violations are $250 per violation and $100 per day until corrected.
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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.
SUPERVISORS NAME: Monica Mathur
LICENSING EVALUATOR NAME: Ashley Hollinger
LICENSING EVALUATOR SIGNATURE:

DATE: 09/04/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/04/2025
LIC9099 (FAS) - (06/04)
Page: 3 of 3