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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 483002942
Report Date: 01/06/2026
Date Signed: 01/06/2026 03:23:39 PM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SANTA ROSA CC RO, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405
This is an official report of an unannounced visit/investigation of a complaint received in our office on
12/02/2025 and conducted by Evaluator Robert Maciel
PUBLIC
COMPLAINT CONTROL NUMBER: 01-CC-20251202081855
FACILITY NAME:HEAD START - LARSENFACILITY NUMBER:
483002942
ADMINISTRATOR:HARVEY, JOYFACILITY TYPE:
850
ADDRESS:1707 CALIFORNIA DRIVE RM 3TELEPHONE:
(707) 304-2225
CITY:VACAVILLESTATE: CAZIP CODE:
95687
CAPACITY:28CENSUS: DATE:
01/06/2026
UNANNOUNCEDTIME BEGAN:
01:01 PM
MET WITH:Shahla ForsatiTIME COMPLETED:
03:33 PM
ALLEGATION(S):
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Staff do not prevent day care child(ren) from biting other day care child(ren).
INVESTIGATION FINDINGS:
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A subsequent complaint investigation was made to the facility today by Licensing Program Analysts (LPAs) Robert Maciel and Jessica Gaumann to deliver findings. It was alleged that facility staff do not prevent day care children from biting other day care children, specifically a child (C2) biting another child (C1) multiple times.

Today, LPA's met with Director Shahla Forsati to review the findings of the investigation. During the course of the investigation, LPAs requested documents and interviewed 4 staff (D1, S1, S2, and S3) between 12/9/25 and 1/6/26. LPA review of facility incident reports for C1 show that there were 3 incidents recorded between 10/1/25 and 11/12/25. During interviews, D1 stated that facility policy is to work with the parents of the child who is biting and create a plan to address the behvaiour.

Continued on LIC9099-C
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Melchisedeck Augustin
LICENSING EVALUATOR NAME: Robert Maciel
LICENSING EVALUATOR SIGNATURE:

DATE: 01/06/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/06/2026
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
Control Number 01-CC-20251202081855
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SANTA ROSA CC RO, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405
FACILITY NAME: HEAD START - LARSEN
FACILITY NUMBER: 483002942
VISIT DATE: 01/06/2026
NARRATIVE
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Continued from LIC9099

S1 and S2 stated that the policy for children who bite repeatedly is to shadow them more closely to prevent further incidents and to learn the triggers that cause the bitting and that in response to the biting incidents, staff used strategies listed in the facility positive discipline and guidance policy. S2 stated that no biting incidents have occurred since 11/12/25.

Based on available information and interviews conducted, although the allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur. Therefore, the allegations are determined to be unsubstantiated at this time. There were no Title 22 deficiencies cited. This report was reviewed and discussed with the director, Shahla Forsati. Appeal rights were provided. Notice of Site Visit shall be posted for 30 days from today's visit.
SUPERVISORS NAME: Melchisedeck Augustin
LICENSING EVALUATOR NAME: Robert Maciel
LICENSING EVALUATOR SIGNATURE:

DATE: 01/06/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/06/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 2