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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 393621889
Report Date: 05/28/2026
Date Signed: 05/28/2026 03:34:11 PM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO S. CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
This is an official report of an unannounced visit/investigation of a complaint received in our office on
03/25/2026 and conducted by Evaluator Sarah Tibbett
PUBLIC
COMPLAINT CONTROL NUMBER: 53-CC-20260325164728
FACILITY NAME:KHAN, SHAZIAFACILITY NUMBER:
393621889
ADMINISTRATOR:KHAN, SHAZIAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(209) 263-9371
CITY:LODISTATE: CAZIP CODE:
95240
CAPACITY:14CENSUS: 2DATE:
05/28/2026
UNANNOUNCEDTIME BEGAN:
03:00 PM
MET WITH:Shazia KhanTIME COMPLETED:
04:00 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Personal Rights: Facility staff hit child in care.
Personal Rights: Licensee speaks inappropriately to children in care.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On 5/28/2026, Licensing Program Analysts (LPA) Sarah Tibbett and Deborah Khashe met with Licensee, Shazia Khan, to deliver the findings of the complaint investigation regarding the above allegations. There were 2 children who arrived during the time of the visit.
During the course of the investigation, LPA Tibbett conducted interviews and obtained information pertaining to the allegations. It was alleged that the Licensee hit a child in care and speaks inappropriately to children in care. LPA interviewed 5 parents, 5 out of 5 reported having no concerns about the facility or disciplinary practices. Licensee denied hitting children and explained that she and her staff give children time-outs only to correct their behaviors. 3 parents reported the Licensee using a nickname for children, but due to a language barrier, it appears to be a misunderstanding as the nickname is more offensive in other languages.
Based on the information obtained, the above allegation could not be substantiated or dismissed. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the findings are UNSUBSTANTIATED. A notice of site was posted, and must remain posted for 30 days.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Bettina Engelman
LICENSING EVALUATOR NAME: Sarah Tibbett
LICENSING EVALUATOR SIGNATURE:

DATE: 05/28/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/28/2026
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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