073405959-11-29-2021-02-CC-SJON-CA8P2Y-20211231095644

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 073405959
Report Date: 11/29/2021
Date Signed: 11/29/2021 11:49:34 AM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612

This is an official report of an unannounced visit/investigation of a complaint received in our office on
10/13/2021 and conducted by Evaluator Monica Mathur

PUBLIC

COMPLAINT CONTROL NUMBER: 02-CC-20211013101913

FACILITY NAME:	KAZMI, SARAH		FACILITY NUMBER:	073405959
ADMINISTRATOR:	KAZMI, SARAH		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(510) 245-0678
CITY:	HERCULES	STATE: CA	ZIP CODE:	94547
CAPACITY:	14	CENSUS: 9	DATE:	11/29/2021
		UNANNOUNCED	TIME BEGAN:	09:30 AM
MET WITH:	Sarah Kazmi		TIME COMPLETED:	12:00 PM

ALLEGATION(S):

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Psersonal rights - Child was not provided to parent in a timely manner.

INVESTIGATION FINDINGS:

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On 11/29/21 at 9:30 am Licensing Program Analysts (LPAs) Monica Mathur and Ashley Curry conducted an unannounced Subsequent Complaint Investigation at Sarah Kazmi's family day care. LPAs met with Licensee, Sarah and explained the purpose of today’s inspection. The finding for the above allegation was delivered during the inspection. During the course of the investigation LPAs completed a home inspection, reviewed records and conducted interviews. Complainant alleges that child was not allowed to be picked up when parent arrived at facility. Based on information obtained parent arrived for pick up a few minutes early. Child was having snack and parent had to wait for few minutes while child was readied to leave, washed hands, put on shoes, helped by Assistant to get ready to leave. Chld got a little emotional and eager to leave while being helped. Based on the interviews and information obtained throughout the investigation, the allegation is UNSUBSTANTIATED which means 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. No Deficiency has been cited for this allegation. Exit interview conducted with Licensee, Sarah Kazmi. Appeal rights were provided. A NOTICE OF SITE VISIT WAS ISSUED AND MUST BE POSTED FOR 30 DAYS.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Sherelle Johnson	TELEPHONE: (510) 622-2592
LICENSING EVALUATOR NAME: Monica Mathur	TELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:	DATE: 11/29/2021

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/29/2021

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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