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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 343623526
Report Date: 10/07/2022
Date Signed: 10/07/2022 09:49:38 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, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833
This is an official report of an unannounced visit/investigation of a complaint received in our office on
09/14/2022 and conducted by Evaluator Arianna Manabat
COMPLAINT CONTROL NUMBER: 03-CC-20220914083249
FACILITY NAME:SHEVCHUK, OLENAFACILITY NUMBER:
343623526
ADMINISTRATOR:SHEVCHUK, OLENAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(916) 225-3690
CITY:CITRUS HEIGHTSSTATE: CAZIP CODE:
95621
CAPACITY:14CENSUS: 4DATE:
10/07/2022
UNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Olena ShevchukTIME COMPLETED:
10:00 AM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Facility is operating over ratio
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analyst (LPA) Arianna Manabat met with Licensee Olena Shevchuk on October 7th, 2022 at approximately 9:00AM to deliver complaint finding for the allegation mentioned above. LPA observed 4 children, three infants and one preschooler, in care being supervised by the Licensee. It was alleged that the facility was operating over ratio. Through interviews and record review with the Licensee, LPA found that the Licensee has maintatined documentation indicating that the facility is operating within ratio requirements. Through interviews with parents, it was found that children who were alledged to be at the facility during the time of the allegation were not present.
Based on the information obtained, LPA was not able to determine that the facility was operating over ratio, therefore, the allegation is determined to be UNSUBSTANTIATED, meaning that although the allegation may have happened or is valid, there is not a preponderance of evidence to prove it. An exit interview was conducted. Notice of site visit and appeal rights were also addressed.
The Notice of site visit shall remain posted for 30 days for guardian/parental review.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Natalie Dunaway
LICENSING EVALUATOR NAME: Arianna Manabat
LICENSING EVALUATOR SIGNATURE:

DATE: 10/07/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/07/2022
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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