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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197493782
Report Date: 03/06/2026
Date Signed: 03/06/2026 03:01:08 PM

Document Has Been Signed on 03/06/2026 03:01 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME:JAHANDIDEH FAMILY CHILD CAREFACILITY NUMBER:
197493782
ADMINISTRATOR/
DIRECTOR:		MASOUMEH PIR JAHANDIDEHFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(818) 625-2320
CITY:WEST HILLSSTATE: CAZIP CODE:
91307
CAPACITY: 14TOTAL ENROLLED CHILDREN: 22CENSUS: 22DATE:
03/06/2026
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
02:40 PM
MET WITH:Masoumeh JahandidehTIME VISIT/
INSPECTION COMPLETED:
03:15 PM
NARRATIVE
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Licensing Program Analyst (LPA) Tatiana Bickham conducted an unannounced Case Management Visit to this facility. At time of arrival 12:40 PM Licensee was not present. Present was Licensee's assistant three assistants. While conducting an alternate visit at Jahandideh Family Child Care on 03/06/26, the following deficiencies were observed.

At 12:40 PM LPA Bickham was refused entry into the home. LPA identified self and stated purpose of the visit but was denied entry by Licensee's assistant. At 12:50 PM LPA called and spoke with the Licensee and LPA informed the Licensee their assistant denied entry into the home, Licensee stated she would call her assistant and tell them to open the door. At 12:52 PM LPA text the Licensee and informed her the assistant did not open the door. LPA rung the door bell four times and no one answered. At 1:11 PM LPA was allowed to enter the home when the Licensee arrived..

At 1:11 PM LPA Bickham observed 22 children in care with 3 staff.

LPA conducted a file review at 1:30pm, Licensee has 15 out of 22 children files.

The following deficiencies were observed to be in violation of California code of Regulations, Title 22, (refer to 809D) A civil penalty of 500.00 has been accessed.

Upon receipt of this report, the Licensee shall post the Notice of Site Visit and any Licensing report
documenting a type “A” deficiency. The report and the Notice of Site Visit shall be posted for 30 consecutive
NAME OF LICENSING PROGRAM MANAGER: Raul Navarro
NAME OF LICENSING PROGRAM ANALYST: Tatiana Bickham
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 03/06/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/06/2026
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
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California Health & Human Services Agency
California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:
  • Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.
  • Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)
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Document Has Been Signed on 03/06/2026 03:01 PM - It Cannot Be Edited


Created By: Tatiana Bickham On 03/06/2026 at 01:10 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME: JAHANDIDEH FAMILY CHILD CARE
FACILITY NUMBER: 197493782

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/06/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
03/09/2026
Section Cited
CCR
102391(a)

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Inspection Authority of the Department
Any duly authorized officer, employee, or agent of the Department shall... enter and inspect any place providing personal care, supervision, and services at any time,
This requirement is not met as evidence by
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Licensee will write a deceleration stating she will not tell her staff to not open the door because she is out of capacity.
Licensee will print Inspection Authority regulation 102391(a) for staff and will have staff sign
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Based on observation staff did not comply with the section sited above in that the staff did not allow LPA to enter the home after identifying self which poses an immediate
health, safety or personal risk to children in care.
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as proof that they read and understand the regulation. Licensee will send signed copies to LPA by date listed.

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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.
Raul Navarro
NAME OF LICENSING PROGRAM MANAGER:
Tatiana Bickham
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 03/06/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/06/2026


LIC809 (FAS) - (06/04)
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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: JAHANDIDEH FAMILY CHILD CARE
FACILITY NUMBER: 197493782
VISIT DATE: 03/06/2026
NARRATIVE
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days. Failure to maintain posting as required, will result in an immediate $100 civil penalty. A copy of this
report shall be provided to the parent/guardian of children currently enrolled by the next business day or
immediately upon return. A copy of this report shall also be provided to the parent/guardian of any newly
enrolled children for the next 12 months (1 year). The Acknowledgement of Receipt (LIC 9224 form must be
maintained in each child’s file immediately upon receipt from parent. Licensee was provided with a copy of
the Acknowledgement of Receipt of Licensing Reports (LIC 9224) Form during this visit.

Page 2.
NAME OF LICENSING PROGRAM MANAGER: Raul Navarro
NAME OF LICENSING PROGRAM ANALYST: Tatiana Bickham
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 03/06/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/06/2026
LIC809 (FAS) - (06/04)
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