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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 336300385
Report Date: 05/03/2023
Date Signed: 05/03/2023 03:56:31 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, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501
This is an official report of an unannounced visit/investigation of a complaint received in our office on
04/04/2023 and conducted by Evaluator Sumayya Habeebulla
COMPLAINT CONTROL NUMBER: 10-CC-20230404132731
FACILITY NAME:MOHAMMED FAMILY CHILD CAREFACILITY NUMBER:
336300385
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY:8CENSUS: 1DATE:
05/03/2023
UNANNOUNCEDTIME BEGAN:
02:30 PM
MET WITH:Andrea MohammedTIME COMPLETED:
04:15 PM
ALLEGATION(S):
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- Licensee hit daycare child.
- Licensee handled daycare child in a rough manner.
- Licensee used inappropriate form of discipline.
- Licensee administered unauthorized medication to daycare child.
INVESTIGATION FINDINGS:
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Licensing Program Analysts (LPAs) Sumayya Habeebulla and Jeanette Sanchez arrived at the facility for the purpose of conducting a subsequent complaint visit, which includes concluding the investigation and delivering the investigation findings regarding the compliant investigation initiated on 04/04/23. LPAs met with Licensee Andrea Mohammed and discussed the above allegations.

On 04/06/23 LPA Habeebulla conducted interviews with Licensee and her daughter and on 04/20/23 interviewed a childcare student and Parent. Along with interviews, the investigation revealed that:

See LIC 9099C for continuation
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Carlos Martinez
LICENSING EVALUATOR NAME: Sumayya Habeebulla
LICENSING EVALUATOR SIGNATURE:

DATE: 05/03/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/03/2023
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 3
Control Number 10-CC-20230404132731
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501
FACILITY NAME: MOHAMMED FAMILY CHILD CARE
FACILITY NUMBER: 336300385
VISIT DATE: 05/03/2023
NARRATIVE
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There is an allegation that Licensee hit daycare child. Pertinent interviews revealed that there have been no eyewitnesses to any of the childcare children ever being hit at the facility by the Licensee or staff. During investigation, LPA confirmed that the facility had 3 children enrolled, but was only able to interview one child as the other two were unavailable. Due to complaint being anonymous, LPA was unable to gather pertinent and/or specific information about the incident and was unable to corroborate allegation.

The 2nd allegation is Licensee handled daycare child in a rough manner. Due to complaint being anonymous, LPA was unable to collect pertinent information about the child in question and was only able to interview one of the three children enrolled who denied the allegation. In addition, per further interviews conducted, the Licensee denied allegation and stated that children were not disciplined in that way and were instead placed on time-outs to allow the child to cool down and reflect on their behavior. Due to insufficient evidence, LPA was unable to corroborate allegation.

The 3rd Allegation is Licensee used inappropriate form of discipline. As per the interviews, Licensee admitted that she does give the children time outs for a few minutes or briefly takes away their favorite toy. As per the interviews, Licensee denied allegation and stated that she does yell at children at times while reminding them to follow the facility rules, but only did so when they were being loud and she had to get their attention. Per interviews conducted, it was revealed that the Licensee does give time outs, but they did not last more than 5 minutes and the child was allowed to rejoin the group after a brief cool down period.



See LIC 9099C for continuation
SUPERVISORS NAME: Carlos Martinez
LICENSING EVALUATOR NAME: Sumayya Habeebulla
LICENSING EVALUATOR SIGNATURE:

DATE: 05/03/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/03/2023
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 10-CC-20230404132731
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501
FACILITY NAME: MOHAMMED FAMILY CHILD CARE
FACILITY NUMBER: 336300385
VISIT DATE: 05/03/2023
NARRATIVE
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The 4th allegation is that Licensee administered unauthorized medication to daycare children. Interviews revealed that Licensee has not administered any medication at the facility and does not have any children enrolled at this time who are on medication. LPA conducted a review of children records and confirmed that there were no children who required medication. In addition, the Licensee denied allegation that the child was given over the counter medication and stated that she would never provide a child with medication that was not authorized by a parent and/or physician.

From the information received through interviews with pertinent parties the above allegations of Personal Rights cannot be verified. Although the allegations may have happened or are valid, there is not a preponderance of evidence to prove the allegation did or did not occur, therefore the allegations are UNSUBSTANTIATED.

An exit interview was conducted with Licensee Andrea Mohammed, a Notice of Site Visit posted, and a copy of this report was provided to the facility on this date and time.

The licensee understands the Notice of Site Visit must be posted for 30 days.
SUPERVISORS NAME: Carlos Martinez
LICENSING EVALUATOR NAME: Sumayya Habeebulla
LICENSING EVALUATOR SIGNATURE:

DATE: 05/03/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/03/2023
LIC9099 (FAS) - (06/04)
Page: 3 of 3