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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 304312568
Report Date: 04/04/2024
Date Signed: 04/15/2024 10:48:28 AM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE CO CHILD CARE, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
This is an official report of an unannounced visit/investigation of a complaint received in our office on
11/09/2023 and conducted by Evaluator Giselle Lucero
PUBLIC
COMPLAINT CONTROL NUMBER: 06-CC-20231109151403
FACILITY NAME:SIDYELNIKOVA, SVITLANAFACILITY NUMBER:
304312568
ADMINISTRATOR:SIDYELNIKOVA, SVITLANAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(323) 470-1934
CITY:IRVINESTATE: CAZIP CODE:
92612
CAPACITY:14CENSUS: 0DATE:
04/04/2024
UNANNOUNCEDTIME BEGAN:
06:00 PM
MET WITH:Licensee Svitlana SidyelnikovaTIME COMPLETED:
06:20 PM
ALLEGATION(S):
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Licensee did not seek medical attention for daycare child
Licensee did not report incidents to appropriate parties
INVESTIGATION FINDINGS:
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On 04/04/2024 Licensing Program Analysts (LPAs) Lucero and Duron made an unannounced visit to the facility for the purpose of delivering findings of a complaint investigation conducted by Investigation Branch (IB) Investigator Angelica Medina. LPAs met with licensee, Svitlana Sidyelnikovia. LPAs explained the reason for today’s visit. There were no children present, as facility is currently inactive.

A review of the Facility Personnel Report Summary on today's date indicates all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions.

The department received a complaint on 11/09/2023 alleging (1) Licensee did not seek medical attention for daycare child and (2) Licensee did not report incidents to appropriate parties.
(Continue to page 2)
Substantiated
Estimated Days of Completion: 0
SUPERVISORS NAME: Judy Hanson
LICENSING EVALUATOR NAME: Giselle Lucero
LICENSING EVALUATOR SIGNATURE:

DATE: 03/13/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/13/2024
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 7
Control Number 06-CC-20231109151403
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE CO CHILD CARE, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
FACILITY NAME: SIDYELNIKOVA, SVITLANA
FACILITY NUMBER: 304312568
VISIT DATE: 04/04/2024
NARRATIVE
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(Page 2)
During the investigation, the IB investigator conducted interviews, obtained medical records, and obtained photos. IB investigator interviewed Staff #1 (S1) who stated the following: On 05/26/2023, at approximately 5:15 pm, C1 was getting four of the younger children ready to go to the park, outside of facility’s front door, and Child #1 (C1), got up from the chair and ran towards the street. As soon as S1 saw C1 running off, they chased after C1. S1 stated they managed to grab C1, but in doing so they both fell to the ground. S1 stated C1 bumped their head on the sidewalk and was bleeding. Licensee stated she immediately took C1 inside the house and rendered first aid. Licensee stated C1’s injury was not life threatening and injury looked like a scrape on the forehead. S1 stated once they finished attending to C1 within seven to 10 minutes, C1’s parent, Parent #1 (P1), arrived for pick up. S1 stated they didn’t get the chance to call P1 to inform her about C1’s accident because P1 arrived at the facility shortly after the accident. S1 stated P1 called S1 around 8:00 pm saying C1 was at Children’s Hospital of Orange County to get C1’s forehead checked. S1 stated the incident wasn’t reported to Licensing because they didn’t know they had to.

IB investigator interviewed Staff #2 (S2) on 01/22/2024. S1 stated C1 was a very active child who always needed supervision from staff. S2 stated C1 was a child who loved climbing on tables. S2 stated being present the day of the incident where C1 hit their head but didn’t witness it. S2 stated at the time of the incident S2 was on the way back from the park around 5:25 pm and S1 told S2 about C1’s incident and asked S2 to watch the rest of the younger children while S1 went inside to clean C1’s cut. S2 stated once C1’s injury was cleaned, S1 and S2 continued with their plans, and S1 took the younger children to the park and S2 was going to take the older children inside the facility. S2 stated as they were transitioning the children, P1 arrived to pick up C1 around 5:30 pm.

IB investigator interviewed P1 on 02/02/2024. P1 stated incident occurred on 05/26/2023. P1 stated around 4:30 pm, she arrived to pick up C1 and saw C1 crying with tape on C1’s forehead. P1 stated it appeared the kids were getting ready to go to the park because they all had their shoes on, sitting on their chairs and were outside the facility’s front door. P1 stated Licensee informed her C1 tried running to the front of the house and as she went after C1, C1 fell and hit their head and licensee provided first aid for C1. P1 asked licensee why licensee didn’t call, and licensee responded the incident had happened just before P1 arrived and didn’t have a chance to make a call. P1 stated once the bandages were removed from C1’s forehead, P1 observed a deep cut and knew C1 was going to need stitches. P1 took C1 to Children’s Hospital of Orange County (CHOC) where they gave C1 stiches. P1 stated C1’s laceration was not long in width but was very deep and C1 only needed two stiches.
(Continue to page 3)
SUPERVISORS NAME: Judy Hanson
LICENSING EVALUATOR NAME: Giselle Lucero
LICENSING EVALUATOR SIGNATURE:

DATE: 04/04/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/04/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 7
Control Number 06-CC-20231109151403
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE CO CHILD CARE, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
FACILITY NAME: SIDYELNIKOVA, SVITLANA
FACILITY NUMBER: 304312568
VISIT DATE: 04/04/2024
NARRATIVE
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(Page 3)
IB investigator did not interview C1 due to C1’s age.

IB obtained medical records for C1. Medical records show C1 was treated for forehead laceration on 05/26/2023 at 20:01.

The Facility failed to inform the Licensing Office of the incident that occurred with C1. During the interview with the licensee, licensee stated being unaware the facility is required to report any incidents to the Licensing Office.

Based on the interviews conducted and records obtained it has been determined (1) Licensee did not seek medical attention for daycare child and (2) Licensee did not report incidents to appropriate parties. Therefore, the preponderance of evidence standard has been met, therefore the above allegations are found to be Substantiated. California Code of Regulations, Title 22, 102416.2(b)(1) Reporting Requirements and health & Safety 1568.082(3) Suspension or revocation of licenses; grounds; temporary suspension prior to hearing; removal & relocation of patient requiring care beyond terms of license or special permit are being cited on the attached LIC 9099D.

A copy of the report along with Appeal Rights will be emailed to the Licensee with a Read Receipt requested to acknowledge report was received. Licensee was asked to respond to the email by copying and pasting “I have read and received the Report and Appeal Rights, I acknowledge receipt."

End of Report.
SUPERVISORS NAME: Judy Hanson
LICENSING EVALUATOR NAME: Giselle Lucero
LICENSING EVALUATOR SIGNATURE:

DATE: 04/04/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/04/2024
LIC9099 (FAS) - (06/04)
Page: 3 of 7
Control Number 06-CC-20231109151403
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE CO CHILD CARE, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME: SIDYELNIKOVA, SVITLANA
FACILITY NUMBER: 304312568
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/04/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
04/04/2024
Section Cited
CCR
102416.2(b)(1)
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102416.2(b)(1) Reporting Requirements: The licensee shall report to the Department....(1)Medical treatment means treatment by a medical professional.
This requirement is not met as evidenced by: Based on interviews conducted and medical
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records obtained, Licensee failed to inform the licensing office of the incident that occurred with C1. This poses a potential health, safety or personal rights risk to persons in care.
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Type B
04/04/2024
Section Cited
HSC
1568.082(3)
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HS 1568.082(3) Suspension or revocation of licenses; grounds; temporary suspension prior to hearing; removal & relocation of patient requiring care beyond terms of license or special permit: Conduct which is inimical to the health, welfare, or safety of...
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either an individual in or receiving services from the facility or the people of the State of California. This requirement is not met as evidenced by: Based on interviews conducted and medical records obtained, the licensee failed to seek medical attention for daycare child.
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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: Judy Hanson
LICENSING EVALUATOR NAME: Giselle Lucero
LICENSING EVALUATOR SIGNATURE:

DATE: 04/04/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/04/2024
LIC9099 (FAS) - (06/04)
Page: 4 of 7
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE CO CHILD CARE, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
This is an official report of an unannounced visit/investigation of a complaint received in our office on
11/09/2023 and conducted by Evaluator Giselle Lucero
PUBLIC
COMPLAINT CONTROL NUMBER: 06-CC-20231109151403

FACILITY NAME:SIDYELNIKOVA, SVITLANAFACILITY NUMBER:
304312568
ADMINISTRATOR:SIDYELNIKOVA, SVITLANAFACILITY TYPE:
810
ADDRESS:25 REDWOOD TREE LANETELEPHONE:
(323) 470-1934
CITY:IRVINESTATE: CAZIP CODE:
92612
CAPACITY:14CENSUS: 0DATE:
04/04/2024
UNANNOUNCEDTIME BEGAN:
06:00 PM
MET WITH:Licensee Svitlana SidyelnikovaTIME COMPLETED:
06:20 PM
ALLEGATION(S):
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Child sustained unexplained bruising while in care
INVESTIGATION FINDINGS:
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On 04/04/2024 Licensing Program Analysts (LPAs) Lucero and Duron made an unannounced visit to the facility for the purpose of delivering findings of a complaint investigation conducted by Investigation Branch (IB) Investigator Angelica Medina. LPA met with licensee, Svitlana Sidyelnikovia. LPAs explained the reason for today’s visit. There were no children present, as facility is currently inactive.
A review of the Facility Personnel Report Summary on today's date indicates all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions.

The department received a complaint on 11/09/2023 alleging child sustained unexplained bruising while in care.

(Continue to page 2)
Unsubstantiated
Estimated Days of Completion: 0
SUPERVISORS NAME: Judy Hanson
LICENSING EVALUATOR NAME: Giselle Lucero
LICENSING EVALUATOR SIGNATURE:

DATE: 04/04/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/04/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 5 of 7
Control Number 06-CC-20231109151403
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE CO CHILD CARE, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
FACILITY NAME: SIDYELNIKOVA, SVITLANA
FACILITY NUMBER: 304312568
VISIT DATE: 04/04/2024
NARRATIVE
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(Page 2)
During the investigation, the IB investigator conducted interviews, obtained medical records, and obtained photos.

IB investigator interviewed Reporting Party (RP) on 02/02/2024 and RP stated Child #1 (C1) came home numerous times with unexplained scratches, bruises, and bumps on their body. RP stated licensee would notify RP when C1 would injure themself during daycare hours and RP would confront the licensee regarding C1’s injuries. RP stated licensee never had valid explanations for how C1’s injuries occurred, and sometimes the licensee would respond being unsure how the injuries happened. RP started noticing scratches on C1 but knew C1 was a very active child and didn’t think anything of it. RP disclosed Staff #1 (S1) informed RP that C1 was holding a Lego block and another child had pushed C1 and C1’s face hit the block. RP also stated there was a time where C1 came home with a bruise on the neck and when RP asked licensee what happened, licensee responded she wasn’t sure because C1 hadn’t cried during the day. RP disclosed that the licensee teaches the older children at the daycare to be her little supervisors and thinks the older children were the ones hurting C1 while also trying to tell C1 what to do. RP stated observing an older child grab C1 by the collar and thinks that is how the bruise on C1’s neck happened. RP stated the last incident that happened in August 2023 is what made the RP decide to take C1 out of the childcare. RP disclosed while giving C1 a bath, RP felt a bump on the back of C1’s head and asked licensee about it. Licensee told RP she forgot to inform during pick up that C1 and other children were running around, and C1 stepped on a wooden car and fell and hit their head.

IB investigator interviewed Staff #1 (S1) on 12/28/2023. Licensee stated C1 would hit and pick on other children and when it was reported to P1, P1 would respond that C1 would be talked to at home and the next day C1 would continue doing the same thing. S1 stated C1 behaved very aggressively at times compared to the other children and it was daily at pick up S1 told P1 something happened, or inappropriate behavior of C1 that occurred during the day. S1 stated C1 would push, fight, and throw toys at the other children. S1 stated other children C1’s age were afraid of C1. S1 stated C1 would jump on the tables and chairs and try to climb on everything. S1 disclosed in July of 2023, they reached out to P1 stating she didn’t think C1 was the right fit for the facility and offered to reimburse the month of tuition back to P1 if P1 decided to disenroll C1.
(Continue to page 3)
SUPERVISORS NAME: Judy Hanson
LICENSING EVALUATOR NAME: Giselle Lucero
LICENSING EVALUATOR SIGNATURE:

DATE: 04/04/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/04/2024
LIC9099 (FAS) - (06/04)
Page: 6 of 7
Control Number 06-CC-20231109151403
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE CO CHILD CARE, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
FACILITY NAME: SIDYELNIKOVA, SVITLANA
FACILITY NUMBER: 304312568
VISIT DATE: 04/04/2024
NARRATIVE
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(Page 3)
S1 stated P1 continued to bring C1 to the day care. S1 stated on July 24, 2023, C1 and other children were playing with a pull string wooden play car and C1 playfully wrapped it around C1’s neck. S1 stated another child was gently pulled the string and S1 immediately grabbed the toy and cut the rope off and threw it away. S1 also disclosed there was another time when children were playing with toys and wooden Legos and the toys were spread throughout the whole room and C1 stepped on a toy and fell.

IB investigator interviewed Staff #2 (S2) on 01/22/2024. S2 stated C1 was a very active child who always needed supervision from staff. S2 stated C1 was a child who loved climbing on tables. S2 stated it was a challenge getting C1 to listen to staff.

IB investigator interviewed Staff #3 (S3) on 01/22/2024. S3 stated C1 was a very hyperactive child who was a lot of work. C1 would always get on tables and chairs and jump on everything. S3 was informed by S1 about the incident with a wooden car and C1 falling on their head. S3 stated not being present at the facility the day of this incident.

IB investigator did not interview C1 due to C1’s age.

Based on the interviews conducted by IB investigator and record reviewed, it has been determined there was insufficient evidence that child sustained unexplained bruising while in care. Although 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 allegation is Unsubstantiated.

A copy of the report along with Appeal Rights will be emailed to the Licensee with a Read Receipt requested to acknowledge report was received. Licensee was asked to respond to the email by copying and pasting “I have read and received the Report and Appeal Rights, I acknowledge receipt."

End of Report.
SUPERVISORS NAME: Judy Hanson
LICENSING EVALUATOR NAME: Giselle Lucero
LICENSING EVALUATOR SIGNATURE:

DATE: 04/04/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/04/2024
LIC9099 (FAS) - (06/04)
Page: 7 of 7