304313656-8-23-2023-06-CC-JHAN-CV9M7V-20230901092210

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 304313656
Report Date: 08/23/2023
Date Signed: 08/23/2023 11:33:41 AM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

This is an official report of an unannounced visit/investigation of a complaint received in our office on
07/14/2023 and conducted by Evaluator Carmen Odom

PUBLIC

COMPLAINT CONTROL NUMBER: 06-CC-20230714135707

FACILITY NAME:	ZEIGHAMI, PEIMANEH & BEKR, ADAM		FACILITY NUMBER:	304313656
ADMINISTRATOR:	ZEIGHAMI, PEIMANEH & BEKR,		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(949) 246-3669
CITY:	LAKE FOREST	STATE: CA	ZIP CODE:	92630
CAPACITY:	14	CENSUS: 10	DATE:	08/23/2023
		UNANNOUNCED	TIME BEGAN:	10:40 AM
MET WITH:	Adam Bekr & Peimaneh Zeighami - licensees		TIME COMPLETED:	11:40 AM

ALLEGATION(S):

1
2
3
4
5
6
7
8
9

Facility is operating out of ratio.

INVESTIGATION FINDINGS:

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

Licensing Program Analyst (LPA) Odom conducted an unannounced complaint inspection to deliver the findings for the above allegations. This is a continuation of the investigation initiated on 07/20/23. At 10:40am, LPA met with licensees Adam Bekr and Peimaneh Zeighami who guided LPA on tour of the facility. Census was taken and there were 4 infants, and 6 preschool age children playing in the childcare area. Licensee was operating within the licensed capacity as specified on license.
A review of staff records on this date indicated that all facility staff or other individuals who required caregiver background checks have received criminal record and child abuse index clearances or exemptions.

The Department received a complaint on 7/14/22 alleging the facility is operating out of ratio. The complaining party (CP) stated, Licensee Peimaneh supervises 10 children by themselves when licensee Adam must leave to take one of the adults that live in the facility to their medical appointments.
Continue to page 2

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Judy Hanson	TELEPHONE: (714) 703-2807
LICENSING EVALUATOR NAME: Carmen Odom	TELEPHONE: (714) 703-2819
LICENSING EVALUATOR SIGNATURE:	DATE: 08/23/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/23/2023

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 3

Control Number 06-CC-20230714135707

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME: ZEIGHAMI, PEIMANEH & BEKR, ADAM	FACILITY NUMBER: 304313656
	VISIT DATE: 08/23/2023

NARRATIVE

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32

Page 2
During the investigation LPA Odom interviewed both Licensees, 1 child and 2 parents. LPA Odom reviewed the Children’s Roster, daily attendance sheet for the month of July, sign in and out sheets, children, and staff files.

During an interview on 07/20/23, Staff #1 (S1) stated, there is a total of 12 children enrolled in the childcare facility, but 3 children come occasionally to the childcare facility. Every day there are 8-9 children attending the childcare and on Fridays there are 4-5 children attending. S1 stated they will schedule any doctor appointments on Fridays when there are no more than 6 children, Staff #2 (S2) will stay at the facility with the children. S1 stated even though it is not required to have a daily attendance sheet they like to keep track of the days the children attend the childcare in case of an incident, they can go back to their records. S2 stated both licensees are always in the childcare facility throughout the week supervising the children, the only time one of them leave will be on Fridays when they have low numbers of children. S2 denied being over ratio.

On 07/20/23 LPA interviewed 1 child, out of the 6 children present only 1 child qualified. Child #1 (C1) disclosed both licensees are at the childcare facility and Ms. Pam takes care of them. C1 stated they like attending childcare.

LPA Odom attempted to interview 8 parents, however there were only 2 parents available for interviews on 08/18/23. Both parents disclosed that both licensees are at the facility during drop off and pick up, both supervise the children in care. None of the parents expressed any concerns, and they are satisfied with the childcare. P1 stated they are very happy with the childcare and their child loves attend the childcare.

LPA Odom reviewed 11 daily attendance sheets and sign in and out sheets for the dates of 07/05/23, 07/06/23, 07/07/23, 07/10/23, 07/11/23, 07/12/23, 07/13/23, 07/14/23, 07/17/23, 07/18/23, 07/19/23. According to the documents reviewed there wasn’t more than 8 children attending the childcare facility in one single day. On Fridays there was only 4-6 children in the childcare.

Continue to page 3

SUPERVISOR'S NAME: Judy Hanson	TELEPHONE: (714) 703-2807
LICENSING EVALUATOR NAME: Carmen Odom	TELEPHONE: (714) 703-2819
LICENSING EVALUATOR SIGNATURE:	DATE: 08/23/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/23/2023

LIC9099 (FAS) - (06/04)

Page: 2 of 3

Control Number 06-CC-20230714135707

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME: ZEIGHAMI, PEIMANEH & BEKR, ADAM	FACILITY NUMBER: 304313656
	VISIT DATE: 08/23/2023

NARRATIVE

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32

Page 3
Based on LPA facility inspection, observations, interviews conducted with licensees, 1 child, and 2 parents, records reviewed, it has been determined there was insufficient evidence that the facility is operating out of ratio. 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 Unsubstantiated.

Exit interview conducted and report was reviewed with the licensee Adam Bekr and Peimaneh Zeighami. A notice of site visit was given and must remain posted for 30 days.

Appeal Rights were explained. The Licensee was provided a copy of appeal rights (LIC 9058 01/16) and their signature on this form acknowledges receipt of these rights. All appeals must be in writing and received by the Regional Office within 15 business days. First level appeals should be sent to the regional manager to the address listed above.

SUPERVISOR'S NAME: Judy Hanson	TELEPHONE: (714) 703-2807
LICENSING EVALUATOR NAME: Carmen Odom	TELEPHONE: (714) 703-2819
LICENSING EVALUATOR SIGNATURE:	DATE: 08/23/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/23/2023

LIC9099 (FAS) - (06/04)

Page: 3 of 3