197492885-1-20-2022-30-CC-CESO-CAVR9W-20220121115011

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197492885
Report Date: 01/20/2022
Date Signed: 01/20/2022 06:55:35 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

This is an official report of an unannounced visit/investigation of a complaint received in our office on
10/28/2021 and conducted by Evaluator Laticia S Thompson

PUBLIC

COMPLAINT CONTROL NUMBER: 30-CC-20211028132131

FACILITY NAME:	JAVADI FAMILY CHILD CARE		FACILITY NUMBER:	197492885
ADMINISTRATOR:	JAVADI, FARZANEH		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(310) 254-0753
CITY:	WOODLAND HILLS	STATE: CA	ZIP CODE:	91364
CAPACITY:	14	CENSUS:	DATE:	01/20/2022
		UNANNOUNCED	TIME BEGAN:	06:30 PM
MET WITH:	FARZANEH JAVADI		TIME COMPLETED:	06:50 PM

ALLEGATION(S):

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9

Provider restrains daycare child.
Provider is aggressive with daycare child.

INVESTIGATION FINDINGS:

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13

Due to the current public health crisis Covid19, recent spike in positive cases and exposures this contact was conducted by tele-visit. On 1/20/22, Licensing Program Analyst (LPA) Laticia Thompson conducted a tele-visit with Farzaneh Javadi, the reason for the visit today is to deliver the findings of the complaint received on 10/28/2021 regarding the allegations referenced above.

Based on interviews conducted with the licensee, parents and the reporting party, there was not enough evidence found to prove that the allegations referenced above occurred, therefore the allegation is Unsubstantiated

Unsubstantiated: A finding that the complaint is unsubstantiated means that although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the allegation occurred

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Peter Flores	TELEPHONE: (424) 301-3077
LICENSING EVALUATOR NAME: Laticia S Thompson	TELEPHONE: (424) 301-3048
LICENSING EVALUATOR SIGNATURE:	DATE: 01/20/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/20/2022

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

Control Number 30-CC-20211028132131

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME: JAVADI FAMILY CHILD CARE	FACILITY NUMBER: 197492885
	VISIT DATE: 01/20/2022

NARRATIVE

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An exit interview was conducted via Tele-Visit with the Licensee, Farzaneh , in which this report was read to her. A copy of this report, a Notice of Site Visit (LIC 9213) and Appeal rights will be emailed to Licensee today. LPA explained to licensee to reply to the email as acknowledgment of receipt. Licensee must print and sign the Facility Evaluation Report (LIC 9099) (LIC 9099C)

The licensee is required to mail or deliver the signed report to the El Segundo Regional Office within 3 business days

SUPERVISOR'S NAME: Peter Flores	TELEPHONE: (424) 301-3077
LICENSING EVALUATOR NAME: Laticia S Thompson	TELEPHONE: (424) 301-3048
LICENSING EVALUATOR SIGNATURE:	DATE: 01/20/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/20/2022

LIC9099 (FAS) - (06/04)

Page: 2 of 5

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

This is an official report of an unannounced visit/investigation of a complaint received in our office on
10/28/2021 and conducted by Evaluator Laticia S Thompson

COMPLAINT CONTROL NUMBER: 30-CC-20211028132131

FACILITY NAME:	JAVADI FAMILY CHILD CARE		FACILITY NUMBER:	197492885
ADMINISTRATOR:	JAVADI, FARZANEH		FACILITY TYPE:	810
ADDRESS:	21008 COSTANSO STREET		TELEPHONE:	(310) 254-0753
CITY:	WOODLAND HILLS	STATE: CA	ZIP CODE:	91364
CAPACITY:	14	CENSUS:	DATE:	01/20/2022
		UNANNOUNCED	TIME BEGAN:	06:30 PM
MET WITH:	FARZANEH JAVADI		TIME COMPLETED:	06:50 PM

ALLEGATION(S):

1
2
3
4
5
6
7
8
9

Provider yells at the daycare children.
Provider uses inappropriate discipline.

INVESTIGATION FINDINGS:

1
2
3
4
5
6
7
8
9
10
11
12
13

Due to the current public health crisis Covid19, recent spike in positive cases and exposures this contact was conducted by tele-visit. On 1/20/22, Licensing Program Analyst (LPA) Laticia Thompson conducted a tele-visit with Farzaneh Javadi, the reason for the visit today is to deliver the findings of the complaint received on 10/28/2021 regarding the allegations referenced above.

During the course of the investigation based on LPA observation and interviews revealed that allegation 1 Provider yells at the daycare children is substantiated.

During the course of the investigation LPA observation and interviews with children revealed that allegation 2
Provider uses inappropriate discipline is substantiated.

A finding that the complaint is substantiated means that the allegation is valid because the preponderance of the evidence standard has been met

Substantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Peter Flores	TELEPHONE: (424) 301-3077
LICENSING EVALUATOR NAME: Laticia S Thompson	TELEPHONE: (424) 301-3048
LICENSING EVALUATOR SIGNATURE:	DATE: 01/20/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/20/2022

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

Page: 3 of 5

Control Number 30-CC-20211028132131

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME: JAVADI FAMILY CHILD CARE	FACILITY NUMBER: 197492885
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 01/20/2022

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 01/20/2022 Section Cited CCR 102423(a)(1)	1 2 3 4 5 6 7	102423(a)(1) Personal Rights (1)To be treated with dignity in his/her personal relationship with staff and other persons. This requirement was not met as evidence by	1 2 3 4 5 6 7	Licensee has agreed to review CCLD provider resource video by 1/31/2022, regarding personal rights at the following link https://ccld.childcarevideos.org/family-child-care-providers/childrens-personal-rights-in-child-care/
	8 9 10 11 12 13 14	Based on observation and interviews licensee yells at children which poses a potential Health, Safety, or Personal Rights Risk to children in care.	8 9 10 11 12 13 14	Licensee will contact the Child Care Resource Center and request training or workshops related to disciplining children
Type B 01/20/2022 Section Cited CCR 102423(a)(4)	1 2 3 4 5 6 7	102423(a) Personal Rights (4)To be free from corporal or unusual punishment, infliction of pain, humiliation. This requirement was not met as evidence by	1 2 3 4 5 6 7	Licensee has agreed to review CCLD provider resource video by 1/31/2022 Licensee will contact the Child Care Resource Center and request training or workshops related to disciplining children
	8 9 10 11 12 13 14	Based on interviews Provider has children to sit alone in a room a form a discipline, which poses a potential Health, Safety, or Personal Rights Risk to children in care.	8 9 10 11 12 13 14

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

SUPERVISOR'S NAME: Peter Flores	TELEPHONE: (424) 301-3077
LICENSING EVALUATOR NAME: Laticia S Thompson	TELEPHONE: (424) 301-3048
LICENSING EVALUATOR SIGNATURE:	DATE: 01/20/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/20/2022

LIC9099 (FAS) - (06/04)

Page: 4 of 5

Control Number 30-CC-20211028132131

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME: JAVADI FAMILY CHILD CARE	FACILITY NUMBER: 197492885
	VISIT DATE: 01/20/2022

NARRATIVE

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The licensee is required to mail or deliver the signed report to the El Segundo Regional Office within 3 business days

The Licensee was advised that the Notice of Site Visit and a copy of this report must be posted at the entrance of the facility for a period of 30 days.

**In addition; A copy of this report must be provided to the authorized representatives of all currently enrolled children and any newly enrolled child for the following 12 months.

The ACKNOWLEDGEMENT OF RECEIPT OF LICENSING REPORTS (LIC9224) shall be signed and kept in each of the children’s records. The report shall be provided no later than the next business day or the next day the child is in care.

SUPERVISOR'S NAME: Peter Flores	TELEPHONE: (424) 301-3077
LICENSING EVALUATOR NAME: Laticia S Thompson	TELEPHONE: (424) 301-3048
LICENSING EVALUATOR SIGNATURE:	DATE: 01/20/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/20/2022

LIC9099 (FAS) - (06/04)

Page: 5 of 5