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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 033620542
Report Date: 10/07/2022
Date Signed: 10/07/2022 12:07:08 PM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO SOUTH, 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
09/23/2022 and conducted by Evaluator Mariya Melnichuk
COMPLAINT CONTROL NUMBER: 53-CC-20220923145903
FACILITY NAME:DRAKE, ALYSHIAFACILITY NUMBER:
033620542
ADMINISTRATOR:DRAKE, ALYSHIAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(209) 740-7898
CITY:SUTTER CREEKSTATE: CAZIP CODE:
95685
CAPACITY:14CENSUS: 8DATE:
10/07/2022
UNANNOUNCEDTIME BEGAN:
11:10 AM
MET WITH:licensee, Alyshia DrakeTIME COMPLETED:
12:15 PM
ALLEGATION(S):
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Facility is not maintained clean and sanitary.
Facility does not provide a safe environment for day care children.
INVESTIGATION FINDINGS:
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Licensing Program Analysts (LPA’s) Mariya Melnichuk and Lauren Scott met with Licensee, Alycia Drake to deliver the findings of the complaint investigation regarding the above allegation.
During the course of the investigation, LPA Melnichuk conducted interviews, and obtained information pertaining to allegation. It was alleged that the facility is not maintained clean and sanitary and the facility does not provide a safe environment for day care children. On September 29th, LPA’s Melnichuk and Scott observed the home environment to be disorderly and soiled which causes a potential health and safety risk to those in care.

Report continues on 9099-C.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Chayntel Hunter
LICENSING EVALUATOR NAME: Mariya Melnichuk
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)
Page: 1 of 5
Control Number 53-CC-20220923145903
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO SOUTH, 2525 NATOMAS PARK DR. STE 250
SACRAMENTO, CA 95833
FACILITY NAME: DRAKE, ALYSHIA
FACILITY NUMBER: 033620542
VISIT DATE: 10/07/2022
NARRATIVE
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Based on the interviews and review of records that revealed that the physical plant was not the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED. Title 22 regulations are being cited on the attached 9099-D page.

An exit interview was conducted with the Licensee. A notice of site visit was provided and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.
SUPERVISORS NAME: Chayntel Hunter
LICENSING EVALUATOR NAME: Mariya Melnichuk
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
LIC9099 (FAS) - (06/04)
Page: 2 of 5
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO SOUTH, 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
09/23/2022 and conducted by Evaluator Mariya Melnichuk
COMPLAINT CONTROL NUMBER: 53-CC-20220923145903

FACILITY NAME:DRAKE, ALYSHIAFACILITY NUMBER:
033620542
ADMINISTRATOR:DRAKE, ALYSHIAFACILITY TYPE:
810
ADDRESS:235 PATRICIA LANETELEPHONE:
(209) 740-7898
CITY:SUTTER CREEKSTATE: CAZIP CODE:
95685
CAPACITY:14CENSUS: 8DATE:
10/07/2022
UNANNOUNCEDTIME BEGAN:
11:10 AM
MET WITH:licensee, Alyshia DrakeTIME COMPLETED:
12:15 PM
ALLEGATION(S):
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A day care provider is not adequately supervising while on their phone.
INVESTIGATION FINDINGS:
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Licensing Program Analysts (LPA’s) Mariya Melnichuk and Lauren Scott met with Licensee, Alycia Drake to deliver the findings of the complaint investigation regarding the above allegation.
During the course of the investigation, LPA Melnichuk conducted interviews, and obtained information pertaining to allegation. It was alleged that a daycare provider was using her phone and not adequately supervising while on their phone. Interviews conducted did not reveal that staff were inconsistent with supervision.

Report continues on 9099-C.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Chayntel Hunter
LICENSING EVALUATOR NAME: Mariya Melnichuk
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)
Page: 3 of 5
Control Number 53-CC-20220923145903
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO SOUTH, 2525 NATOMAS PARK DR. STE 250
SACRAMENTO, CA 95833
FACILITY NAME: DRAKE, ALYSHIA
FACILITY NUMBER: 033620542
VISIT DATE: 10/07/2022
NARRATIVE
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Based on the information obtained throughout the course of this investigation the above allegations could not be substantiated or dismissed. LPA learned that staff were allowed to use their phones during breaks, but not in front of the children. The allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the finding is UNSUBSTANTIATED.
Exit interview was conducted. A notice of site visit was provided and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.
SUPERVISORS NAME: Chayntel Hunter
LICENSING EVALUATOR NAME: Mariya Melnichuk
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
LIC9099 (FAS) - (06/04)
Page: 4 of 5
Control Number 53-CC-20220923145903
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

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

FACILITY NAME: DRAKE, ALYSHIA
FACILITY NUMBER: 033620542
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/07/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
10/07/2022
Section Cited
CCR
102417(b)
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102417(b)
The home shall be kept clean and orderly, with heating and ventilation for safety and comfort.

This requirement was not as evidenced by:
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Licensee agrees to sanitizing and cleaning of the home. Licensee stated she will submit photos of the cleaned areas to licensing by the plan of correction date of 11/7/2022.
LPA will return to conduct a follow up inspection to ensure compliance.
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On September 29th, LPA’s Melnichuk and Scott observed the home environment to be disorderly and soiled which causes a potential health and safety risk to those 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: Chayntel Hunter
LICENSING EVALUATOR NAME: Mariya Melnichuk
LICENSING EVALUATOR SIGNATURE:

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

DATE: 10/07/2022
LIC9099 (FAS) - (06/04)
Page: 5 of 5