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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 343623526
Report Date: 11/03/2022
Date Signed: 11/03/2022 01:09:14 PM

Substantiated


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
10/11/2022 and conducted by Evaluator Amanda Blesi
COMPLAINT CONTROL NUMBER: 03-CC-20221011142401
FACILITY NAME:SHEVCHUK, OLENAFACILITY NUMBER:
343623526
ADMINISTRATOR:SHEVCHUK, OLENAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(916) 225-3690
CITY:CITRUS HEIGHTSSTATE: CAZIP CODE:
95621
CAPACITY:14CENSUS: 5DATE:
11/03/2022
UNANNOUNCEDTIME BEGAN:
12:30 PM
MET WITH:Olena ShevchukTIME COMPLETED:
01:30 PM
ALLEGATION(S):
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Personal Rights: safe sleep regulations not being followed
INVESTIGATION FINDINGS:
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LPA Amanda Blesi conducted an unannounced complaint inspection to conclude a complaint that was opened on 10/17/22. LPA met with licensee Olena Shevchuk and her 17 year old daughter Maryna. Also present were 5 day care children. It was alleged that licensee does not follow safe sleep practices by allowing children to sleep in a stroller. Licensee was interviewed and admitted that the child was new to the daycare and was having trouble falling asleep so she allowed the child to sleep in the stroller for a brief period so the child would get some sleep. The preponderance of evidence standard was met; therefore, the allegation is substantiated.

LPA Amanda Blesi informed licensee Olena Shevchuk that this report dated 11.03.22 document(s) one Type A citation(s) which shall be posted for 30 consecutive days as there is/are immediate risk(s) to the health, safety, or personal rights of children in care.

Continued on following page....LIC 9099-C
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Keven Peters
LICENSING EVALUATOR NAME: Amanda Blesi
LICENSING EVALUATOR SIGNATURE:

DATE: 11/03/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/03/2022
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 4
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
10/11/2022 and conducted by Evaluator Amanda Blesi
PUBLIC
COMPLAINT CONTROL NUMBER: 03-CC-20221011142401

FACILITY NAME:SHEVCHUK, OLENAFACILITY NUMBER:
343623526
ADMINISTRATOR:SHEVCHUK, OLENAFACILITY TYPE:
810
ADDRESS:7301 THALIA WAYTELEPHONE:
(916) 225-3690
CITY:CITRUS HEIGHTSSTATE: CAZIP CODE:
95621
CAPACITY:14CENSUS: 5DATE:
11/03/2022
UNANNOUNCEDTIME BEGAN:
12:30 PM
MET WITH:Olena ShevchukTIME COMPLETED:
01:30 PM
ALLEGATION(S):
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unqualified assistant providing care to children
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Blesi conducted an unannounced complaint inspection and met with the licensee, Olena Shevchuk. Also present were day care children and her 17 year old daughter who is also her assistant. It was alleged that licensee did not have a qualified assistant present when she had 7 preschool children and 1 school age child in care. The licensee, reporting party and staff were interviewed regarding the allegation. Licensee states she has two adult sons who are used as her assistants when needed. She states one of her sons was present in the home and her other son was out picking up a child when the alleged violation occurred. LPA received conflicting information during the interviews whether the son was home at the time. Although the allegation may or may not have occurred, there was not a preponderance of evidence to support the allegation, therefore the allegation is unsubstantiated.

Notice of site visit provided
Exit interview with licensee Olena Shevchuk
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Keven Peters
LICENSING EVALUATOR NAME: Amanda Blesi
LICENSING EVALUATOR SIGNATURE:

DATE: 11/03/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/03/2022
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 2 of 4
Control Number 03-CC-20221011142401
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833
FACILITY NAME: SHEVCHUK, OLENA
FACILITY NUMBER: 343623526
VISIT DATE: 11/03/2022
NARRATIVE
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Also, LPA Blesi informed the licensee to provide a copy of this licensing report dated 11.03.22 that documents any Type A citation(s) to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification.

Exit interview conducted and report was reviewed with the licensee, Olena Shevchuk.

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.
SUPERVISORS NAME: Keven Peters
LICENSING EVALUATOR NAME: Amanda Blesi
LICENSING EVALUATOR SIGNATURE:

DATE: 11/03/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/03/2022
LIC9099 (FAS) - (06/04)
Page: 3 of 4
Control Number 03-CC-20221011142401
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833

FACILITY NAME: SHEVCHUK, OLENA
FACILITY NUMBER: 343623526
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/03/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Request Denied
Type A
11/04/2022
Section Cited
CCR
102425(j)
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If an infant falls asleep before being placed in a crib or play yard, the provider shall move the infant to a crib or play yard as soon as possible.
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LPA did not observe infant children sleeping in strollers during inspections of 10/17/22 and 11/3/22. Licensee states she understands sleeping infants must be moved immediately and she no longer lets them sleep in a stroller. Licensee submitted a written statement of understanding to LPA which will be filed in the facility file.

Deficiency cleared during inspection.
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This requirement was not met as evidenced by: licensee failed to move a sleeping infant child to a crib or play yard and allowed the child to sleep in a stroller for a bried period of time. This is 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: Amanda Blesi
LICENSING EVALUATOR SIGNATURE:

DATE: 11/03/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/03/2022
LIC9099 (FAS) - (06/04)
Page: 4 of 4