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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 343624271
Report Date: 09/09/2025
Date Signed: 09/09/2025 02:34:49 PM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
This is an official report of an unannounced visit/investigation of a complaint received in our office on
06/23/2025 and conducted by Evaluator Erwina Pascual-Golamco
PUBLIC
COMPLAINT CONTROL NUMBER: 03-CC-20250623121008
FACILITY NAME:KURPIEWSKI, ERNESTINAFACILITY NUMBER:
343624271
ADMINISTRATOR:KURPIEWSKI, ERNESTINAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(279) 345-0897
CITY:CARMICHAELSTATE: CAZIP CODE:
95608
CAPACITY:14CENSUS: 8DATE:
09/09/2025
UNANNOUNCEDTIME BEGAN:
02:15 PM
MET WITH:Ernestina KurpiewskiTIME COMPLETED:
02:45 PM
ALLEGATION(S):
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Adult hit a daycare child while in care
INVESTIGATION FINDINGS:
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Licensing Program Analyst Erwina Pascual-Golamco and Soleil Marx (LPAs) met with Licensee, Ernestina Kurpiewski (L), to deliver findings.

Throughout the course of the investigation, LPA toured the facility, including all areas accessible to children, observed L provide care to children, requested facility documents and conducted interviews. LPA interviews and statements were inconsistent to corroborate the above allegation. 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.

Exit interview was conducted and report was reviewed with Licensee, Ernestina Kurpiewski. Appeal rights were provided, and a Notice of Site visit was given to Licensee, who will post it where visible to parents/guardians for 30 days.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Jeevun Birk-Miller
LICENSING EVALUATOR NAME: Erwina Pascual-Golamco
LICENSING EVALUATOR SIGNATURE:

DATE: 09/09/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/09/2025
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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