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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 343622802
Report Date: 11/27/2023
Date Signed: 11/27/2023 10:20:28 AM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
This is an official report of an unannounced visit/investigation of a complaint received in our office on
11/21/2023 and conducted by Evaluator Jeremey McClain
PUBLIC
COMPLAINT CONTROL NUMBER: 03-CC-20231121154606
FACILITY NAME:SHTEZEL, TAMARAFACILITY NUMBER:
343622802
ADMINISTRATOR:SHTEZEL TAMARAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(916) 256-9029
CITY:ORANGEVALESTATE: CAZIP CODE:
95662
CAPACITY:14CENSUS: 6DATE:
11/27/2023
UNANNOUNCEDTIME BEGAN:
08:00 AM
MET WITH:Tamara ShtezelTIME COMPLETED:
10:30 AM
ALLEGATION(S):
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Daycare child was hit by staff
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Jeremey McClain met with licensee Tamara Shtezel for the purpose of a complaint investigation. Six children were present during today’s inspection. Assistants Flora Bilik, Olena Hovta and Maryia Krikunova were present during today’s inspection.
It was alleged that a staff hit a child in care. During today inspection, LPA conducted an interview with licensee and her assistant Flora Bilik. During interviews it was revealed that former Staff 1 hit Child 1 on the back of their head and screamed at the child while they were in care. The child did not suffer any injuries. Staff 1 was fired on 11/22/2023.
The preponderance of evidence standard has been met; therefore, the allegation is determined to be SUBSTANTIATED.
Title 22 deficiencies are cited on the subsequent page of this report. If not corrected, these violations pose an immediate risk to the health and safety of children in care. Licensee acknowledges, that upon receipt TYPE A DEFICIENCIES, a LIC 9099-D with Type A deficiencies shall be posted for 30 days. Licensee also acknowledges that they must provide copies of this licensing report to parents/guardians of children in care and to parents/guardians of children newly enrolled at the facility during the next 12 months.
LPA provided an LIC 9224, which must be signed by parents/guardians and kept with the children's files. Appeal Rights were provided. An exit interview was conducted, and a Notice of Site Visit posted.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Keven Peters
LICENSING EVALUATOR NAME: Jeremey McClain
LICENSING EVALUATOR SIGNATURE:

DATE: 11/27/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/27/2023
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 03-CC-20231121154606
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

FACILITY NAME: SHTEZEL, TAMARA
FACILITY NUMBER: 343622802
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/27/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
11/27/2023
Section Cited
CCR
101223(a)(3)
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Personal Rights. (a) The licensee shall ensure that each child is accorded the following personal rights:(3) To be free from corporal or unusual punishment, infliction of pain, humiliation, intimidation, ridicule, coercion, threat, mental abuse or other actions of a punitive nature...
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Staff 1 was fired from the facility. Child 1's parent were informed of the incident. LPA advised that a training be conducted with current staff regarding proper staff relations with children.
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This requirement was not met as evidenced by interviews with the licensee an her assistant. They stated that on 11/16/2023, former Staff 1 hit Child 1 on the back of their head and screamed at the child while they were in care. This posed an immediate risk to the health and safety of 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.
SUPERVISORS NAME: Keven Peters
LICENSING EVALUATOR NAME: Jeremey McClain
LICENSING EVALUATOR SIGNATURE:

DATE: 11/27/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/27/2023
LIC9099 (FAS) - (06/04)
Page: 3 of 3