485407546-4-19-2023-01-CC-LLEI-CR4NUG-20230421104616

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 485407546
Report Date: 04/19/2023
Date Signed: 04/19/2023 09:11:06 AM

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
01/12/2023 and conducted by Evaluator Melchisedeck Augustin

PUBLIC

COMPLAINT CONTROL NUMBER: 01-CC-20230112154839

FACILITY NAME:	NAEBKHEL, SURYA FAMILY CHILD CARE HOME		FACILITY NUMBER:	485407546
ADMINISTRATOR:	NAEBKHEL, SURYA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(916) 600-8145
CITY:	VACAVILLE	STATE: CA	ZIP CODE:	95687
CAPACITY:	14	CENSUS: 2	DATE:	04/19/2023
		UNANNOUNCED	TIME BEGAN:	08:40 AM
MET WITH:	Surya Naebkhel - Licensee		TIME COMPLETED:	09:00 AM

ALLEGATION(S):

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Child sustained unexplained injuries while in care.
Staff allowed daycare children to engage in inappropriate interactions.
Inadequate diaper care resulted in child sustaining a rash.
Facility did not maintain heating for safety and comfort of children.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA), Melchisedeck Augustin made a subsequent complaint-investigation visit and met with Licensee, Surya Naebkhel (LS) for the purpose of delivering findings for the above allegations. LPA previously met with LS on 01/18/23 to discuss the purpose of the visit, made observations, and to initiate the investigation. It was alleged that a child sustained unexplained injuries while in care; staff allowed daycare children to engage in inappropriate interactions; inadequate diaper care resulted in a child sustaining a rash; and the facility did not maintain heating for safety and comfort of children. The report more specifically noted a child (C2) sustained a red colored bump between the forehead, had a scabbed blister on the inner thigh because of wearing a diaper for too long, another child pulled C1’s hair during a two-week period, and the garage was cold.

LPA, Augustin interviewed LS and one staff (S1), two children (C1 & C3), and three parents (P1-P3) from 01/18/23 through 04/06/23; and obtained a facility roster of the children currently in care. Some children were not verbal, too young to interview, or did not qualify to be interviewed. (Continue to LIC 9099-C)

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Leslie Lepori
LICENSING EVALUATOR NAME: Melchisedeck Augustin
LICENSING EVALUATOR SIGNATURE:	DATE: 04/19/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/19/2023

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-20230112154839

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: NAEBKHEL, SURYA FAMILY CHILD CARE HOME	FACILITY NUMBER: 485407546
	VISIT DATE: 04/19/2023

NARRATIVE

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LS denied all the allegations, stating the children were calm and got along, and staff did not hit or handled any child(ren) in a rough manner. Also, to LS’s knowledge, no child(ren) sustained any injuries on the forehead or fell off any play structure or furniture either inside or outside the facility. LS claimed there was no incident involving another child pulling C1’s hair and, that she changed the children’s diapers every two hours, or sooner but never left any child in a soiled diaper for too long. LS felt C2’s blister may have been caused by an allergic reaction to a diaper. LS further claimed the facility’s indoor temperature was maintained between 70 to 72 degrees Fahrenheit.

Statements provided by children did not report any concerns. A statement reported LS never refused to change children’s diapers when it was needed, and it was described that the children did not go in or play in the garage but instead played in the living room which was not cold. S1 reported she did not see any child sustain a bump or bruise on the forehead or staff allow children to engage in inappropriate behavior(s); and that children got along with each other. S1 stated staff changed a child(ren)’s diaper three to four times daily and that C2’s blister may have been the result of allergic reaction to a diaper. S1 confirmed children played indoors and not in the garage; and it was not too cold or hot in the home. P1 claimed LS allegedly told her the children played in the garage, that was too cold, however; this statement was not corroborated by LS and P1 didn’t actually confirm the indoor temperature or observe any hazards. P3 did report her child injured their lip and a nail scratched the face while at the facility and she had concerns about LS providing inadequate diaper care because on a handful of times, P3 saw dried fecal residue in her child’s underwear. P3 did not know if the garage was cold but recalled in during summer; the children played in the garage.

On 01/18/23, LPA observed staff interacting well with the children in care, and the living room thermostat indicated the temperature was 70 degrees Fahrenheit. Furthermore, LPA saw multiple soiled diapers in the garbage container in the on-limit bathroom which indicated some children’s diapers were changed LPA took a tour of the garage which appeared to be setup for additional play space and the garage did not feel too cold. There was no conclusive evidence to confirm how C2 sustained a bump on the forehead.

Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation(s) did or did not occur, therefore the allegations are unsubstantiated. 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. There were no violation(s) of California Code of Regulations cited at this time. Appeal Rights were provided.

SUPERVISORS NAME: Leslie Lepori
LICENSING EVALUATOR NAME: Melchisedeck Augustin
LICENSING EVALUATOR SIGNATURE:	DATE: 04/19/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/19/2023

LIC9099 (FAS) - (06/04)

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