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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 343623240
Report Date: 10/25/2021
Date Signed: 10/25/2021 01:45:27 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
10/06/2021 and conducted by Evaluator Karyn Guerra
PUBLIC
COMPLAINT CONTROL NUMBER: 03-CC-20211006145129
FACILITY NAME:ESKANDARI, SIMAFACILITY NUMBER:
343623240
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY:8CENSUS: 3DATE:
10/25/2021
UNANNOUNCEDTIME BEGAN:
01:15 PM
MET WITH:Sima Eskandari TIME COMPLETED:
02:15 PM
ALLEGATION(S):
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Large blanket is used to cover daycare child inside play pen
INVESTIGATION FINDINGS:
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At 1:15 p.m. on Monday, October 25th, 2021, Licensing Program Analyst (LPA) Karyn Guerra Met with Licensee, Sima Eskandari, for the purpose of a complaint inspection to deliver findings. Census consisted of 2 infant children and 1 preschool aged child. It was alleged that a large blanket is used to cover a daycare child inside a play pen. Throughout the course of the investigation, LPA conducted interviews and made observations. Licensee denied the allegation. LPA did not observe blanket covering children during inspections to the facility. The allegation is unsubstantiated. Although the alleged violation may have happened or is vaild, the preponderance of evidence standard was not met to fully prove or disprove that the alleged violation ocurred, therefore, it is unsubstantiated. An exit interview was conducted. LPA reviewed infant safe sleep regulations with Licensee and provided a printed copy. A notice of site visit was provided and shall remain posted for a period of 30 days for parental review.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Seychelle De Luca
LICENSING EVALUATOR NAME: Karyn Guerra
LICENSING EVALUATOR SIGNATURE:

DATE: 10/25/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/25/2021
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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