<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 313622440
Report Date: 08/23/2021
Date Signed: 08/23/2021 01:45:30 PM

Unsubstantiated


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
07/12/2021 and conducted by Evaluator Jeremey McClain
PUBLIC
COMPLAINT CONTROL NUMBER: 03-CC-20210712135359
FACILITY NAME:KHODAIE, AZITAFACILITY NUMBER:
313622440
ADMINISTRATOR:KHODAIE, AZITAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(916) 705-7275
CITY:ROCKLINSTATE: CAZIP CODE:
95765
CAPACITY:14CENSUS: 7DATE:
08/23/2021
UNANNOUNCEDTIME BEGAN:
12:45 PM
MET WITH:Azita KhodaieTIME COMPLETED:
01:45 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Licensee mishandled a child in care
Licensee is operating out of ratio
Unqualified adults providing care to children
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On August 23rd, 2021 at 12:45 pm, Licensing Program Analyst (LPA) Jeremey McClain met with Licensee Azita Khodaie to close a complaint investigation. Upon arrival, LPA observed seven children, including three infants. Licensee’s mother was present and providing care during today’s inspection. The following was alleged against the licensee: 1) licensee is operating out of ratio 2) licensee mishandled a child in care 3) unqualified adults are providing care to children. During the investigation, LPA made observations at the home, conducted interviews with parents, assistants, and children, and reviewed files. Evidence did not indicate that the licensee operates out of ratio or that she leaves the children alone without an assistant. There was not enough evidence to support that the licensee mishandled a child in care. Based on the evidence that was gathered, LPA determined the allegations. The preponderance of evidence standard has not been met, therefore, the allegations are determined to be unsubstantiated.

There were no Title 22 deficiencies during today’s investigation. LPA reviewed this report with the Licensee and provided a Notice of Site Visit that must be posted for 30 days.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Keven Peters
LICENSING EVALUATOR NAME: Jeremey McClain
LICENSING EVALUATOR SIGNATURE:

DATE: 08/23/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/23/2021
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 2