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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 376624004
Report Date: 06/19/2025
Date Signed: 06/19/2025 09:34:40 AM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVERSIDE SE CC RO, 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
05/02/2025 and conducted by Evaluator Kelly Gerth
PUBLIC
COMPLAINT CONTROL NUMBER: 10-CC-20250502083953
FACILITY NAME:IMTIAZ, SYEDA FAMILY CHILD CAREFACILITY NUMBER:
376624004
ADMINISTRATOR:SYEDA IMTIAZFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(559) 451-7658
CITY:OCEANSIDESTATE: CAZIP CODE:
92057
CAPACITY:14CENSUS: 5DATE:
06/19/2025
UNANNOUNCEDTIME BEGAN:
08:38 AM
MET WITH:Syeda ImtiazTIME COMPLETED:
09:51 AM
ALLEGATION(S):
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Provider did not prevent inappropriate interaction(s) between day care children
Provider speaks inappropriately to day care child
INVESTIGATION FINDINGS:
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 On the above listed date and time, Licensing Program Analyst (LPA) Kelly Gerth made an unannounced visit and met with Licensee Syeda Imtiaz to deliver the findings from a complaint made to Community Care Licensing (CCL) on May 02, 2025. The complaint CCL received stated the following allegations: Provider did not prevent inappropriate interaction(s) between day care children, Provider speaks inappropriately to day care child
On 05/05/25 LPA Kelly Gerth made an unannounced visit to conduct investigations regarding the complaint of the above allegations. During the investigation, confidential interviews were conducted, evidence reviewed and copies of pertinent records that included a facility sketch, LIC 700 forms and Admission Agreements were obtained. Additional interviews and visits were conducted on 05/16/25, 05/23/25 and 05/28/25 with both children and staff.
Regarding the allegation, Provider did not prevent inappropriate interaction(s) between day care children. During the visits made to the home daycare on 05/25/25, 05/16/25 and 05/23/25, Licensee was within ratio as well as had an assistant on 2 dates, as extra support. See Next Page
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Carlos Martinez
LICENSING EVALUATOR NAME: Kelly Gerth
LICENSING EVALUATOR SIGNATURE:

DATE: 06/19/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/19/2025
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 5
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVERSIDE SE CC RO, 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
05/02/2025 and conducted by Evaluator Kelly Gerth
PUBLIC
COMPLAINT CONTROL NUMBER: 10-CC-20250502083953

FACILITY NAME:IMTIAZ, SYEDA FAMILY CHILD CAREFACILITY NUMBER:
376624004
ADMINISTRATOR:SYEDA IMTIAZFACILITY TYPE:
810
ADDRESS:5164 VIA MINDANAOTELEPHONE:
(559) 451-7658
CITY:OCEANSIDESTATE: CAZIP CODE:
92057
CAPACITY:14CENSUS: 5DATE:
06/19/2025
UNANNOUNCEDTIME BEGAN:
08:38 AM
MET WITH:Syeda ImtiazTIME COMPLETED:
09:51 AM
ALLEGATION(S):
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9
Licensee has children nap in an off-limit area
INVESTIGATION FINDINGS:
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 On the above listed date and time, Licensing Program Analyst (LPA) Kelly Gerth made an unannounced visit and met with Licensee Syeda Imtiaz to deliver the findings from a complaint made to Community Care Licensing (CCL) on May 02, 2025. The complaint CCL received stated the following allegation: Licensee has children nap in an off-limit area.
On 05/05/25 LPA Kelly Gerth made an unannounced visit to conduct investigations regarding the complaint of the above allegation. During the investigation, confidential interviews were conducted, evidence reviewed and copies of pertinent records that included a facility sketch, LIC 700 forms and Admission Agreements were obtained. Additional interviews and visits were conducted on 05/16/25, 05/23/25 and 05/28/25 with both children and staff.
Regarding the allegation, Licensee has children nap in an off-limit area. During the visit conducted on 05/05/25, Licensee was forthcoming and stated that 2 enrolled daycare children sleep on the second floor of the home during daycare hours and that Licensee remains on the first floor to monitor the other children in care while a family member remains on the second floor with the 2 children napping on floor 2.
See next page
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Carlos Martinez
LICENSING EVALUATOR NAME: Kelly Gerth
LICENSING EVALUATOR SIGNATURE:

DATE: 06/19/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/19/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 2 of 5
Control Number 10-CC-20250502083953
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVERSIDE SE CC RO, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501

FACILITY NAME: IMTIAZ, SYEDA FAMILY CHILD CARE
FACILITY NUMBER: 376624004
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/19/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
06/26/2025
Section Cited
CCR
102416.3(a)(6)
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102416.3 (a)(6) Alteration to Existing Building or Grounds.
Prior to any alteration, the licensee shall notify the Department of any change from an area of the home previously identified as “off limits” to an area where care and supervision will be provided to children in care. This requirement was not met as evidenced by:
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LPA spoke with the Licensee regarding the fire clearance, which does not permit the use of the second floor for child care. LPA explained that the area is off-limits and cannot be used for daycare-related activities to include nap. The Licensee agreed to submit a written statement confirming that the second floor will not be used for sleeping or any part of the daycare operation.
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Based on record review the licensee did not comply with the section cited above, where the Fire Clearance granted by the Oceanside Fire Department on 09/20/2024 states the daycare including sleeping areas are to be on first floor only, and the LIC 999 Sketch indicate the second floor is off limits and not to be used by children in care, however the second floor was used for some napping children during daycare hours, poses/posed a potential health, safety or personal rights risk to persons in care.
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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.
SUPERVISORS NAME: Carlos Martinez
LICENSING EVALUATOR NAME: Kelly Gerth
LICENSING EVALUATOR SIGNATURE:

DATE: 06/19/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/19/2025
LIC9099 (FAS) - (06/04)
Page: 3 of 5
Control Number 10-CC-20250502083953
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVERSIDE SE CC RO, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501
FACILITY NAME: IMTIAZ, SYEDA FAMILY CHILD CARE
FACILITY NUMBER: 376624004
VISIT DATE: 06/19/2025
NARRATIVE
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Page 2/2

Licensee stated this has been occurring for approximately 1.5 months and that she was unaware this was not in compliance with regulation, given her relationship to the children. LPA confirmed the approved Fire Clearance from the Oceanside Fire Department dated 9/20/24 states under specific conditions, “Daycare Use/Sleeping Areas shall be located on the First Level of the home only”. Licensee confirmed she was also aware of the fire clearance conditions.
Additionally, LPA found the current LIC 999 Facility Sketch, confirmed to be the most recent LIC 999 by Licensee on 05/05/25, reflects that all sleeping areas for children are to be on first floor area of the home. Upon further review, LPA found that the original LIC 999 Facility Sketch received by CCL dated 07/07/13 reflects the first floor to be used for the daycare only and there were no previous documents reflecting sleeping/nap areas to be in any other location of the home. Based on the LPA’s observation, record review and corroborating interviews, the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED. A deficiency will be issued.
See 9099 D for citation issued.
An exit interview was conducted with Licensee Syeda Imtiaz and a copy of this report and Notice of Site Visit was provide. Licensee was also reminded Notice of Site Visit must be posted for 30 days
SUPERVISORS NAME: Carlos Martinez
LICENSING EVALUATOR NAME: Kelly Gerth
LICENSING EVALUATOR SIGNATURE:

DATE: 06/19/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/19/2025
LIC9099 (FAS) - (06/04)
Page: 4 of 5
Control Number 10-CC-20250502083953
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVERSIDE SE CC RO, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501
FACILITY NAME: IMTIAZ, SYEDA FAMILY CHILD CARE
FACILITY NUMBER: 376624004
VISIT DATE: 06/19/2025
NARRATIVE
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Page 2/2

LPA observed the children to be supervised at all times as well as interviews with the children revealed that the Licensee and/or assistant are present with children at all times. LPA also observed that the indoor and outdoor activity space used for children in care allows for visual supervision, which is also labeled on the Licensees facility sketch. Therefore, at this time there is not a preponderance of evidence to prove the alleged violations did occur, therefore the allegation is UNSUBSTANTIATED.
Regarding the allegation, Provider speaks inappropriately to day care child. During the course of the investigation, LPA conducted interviews with 5 children and 3 adults. Interviews could not corroborate that the providers use of language is inappropriate to children in care, however when LPA conducted observations on each visit date, LPA observed that English is the licensee’s second language, which may contribute to some challenges in verbal communication with the children and could at times be perceived as overly direct or rough in tone. Additionally, while the licensee’s teaching methods appeared somewhat firm and may differ from commonly used approaches in early childhood education, no violations of regulations were observed and was not deemed as inappropriate. Therefore, at this time there is not a preponderance of evidence to prove the alleged violations did occur, therefore the allegation is UNSUBSTANTIATED.
An exit interview was conducted with Licensee Syeda Imtiaz and a copy of this report and Notice of Site Visit was provide. Licensee was also reminded Notice of Site Visit must be posted for 30 days
SUPERVISORS NAME: Carlos Martinez
LICENSING EVALUATOR NAME: Kelly Gerth
LICENSING EVALUATOR SIGNATURE:

DATE: 06/19/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/19/2025
LIC9099 (FAS) - (06/04)
Page: 5 of 5