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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 304313749
Report Date: 10/26/2022
Date Signed: 12/09/2022 09:23:56 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
09/19/2022 and conducted by Evaluator Nguyen K Tran
PUBLIC
COMPLAINT CONTROL NUMBER: 06-CC-20220919112817
FACILITY NAME:RASTEGARI, MAHINFACILITY NUMBER:
304313749
ADMINISTRATOR:RASTEGARI, MAHINFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(714) 349-7736
CITY:ANAHEIMSTATE: CAZIP CODE:
92802
CAPACITY:14CENSUS: 7DATE:
10/26/2022
UNANNOUNCEDTIME BEGAN:
12:15 PM
MET WITH:Mahin Rastegari, Licensee TIME COMPLETED:
03:00 PM
ALLEGATION(S):
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Licensee serves day care children spoiled food.
INVESTIGATION FINDINGS:
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*** This is an amended report to amend the finding of the investigation conducted on 10/26/2022. ***

Licensing Program Analyst (LPA) Nguyen Tran conducted an unannounced complaint visit to deliver the complaint findings. LPA met with licensee, Mahin Rastegari. The overall census observed was 2 staff and 7 children. A review of staff criminal clearance records on this date indicates that all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions.

On 09/19/2022, Regional Office received a complaint with allegation regarding Licensee serves day care children spoiled food.

During the course of investigation, LPA Tran inspected the facility’s food storage on 09/27/2022 and on 10/26/2022, interviewed 3 staff at the facility on 09/27/2022. (Continue next page)
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Rina Lopez
LICENSING EVALUATOR NAME: Nguyen K Tran
LICENSING EVALUATOR SIGNATURE:

DATE: 10/26/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/26/2022
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 06-CC-20220919112817
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: RASTEGARI, MAHIN
FACILITY NUMBER: 304313749
VISIT DATE: 10/26/2022
NARRATIVE
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(Page 2 of Report)

During the investigation on 09/27/2022, LPA Tran observed food items such as 3 loaves of bread: expired on 09/19/2022, 09/21/22 and 09/25/22; 2 bags of cheese: expired on 05/07/2022 and 02/22/22; 1 bag of bagel expired on 09/14/22. During the inspection, LPA Tran also observed staff served the breakfast for the children using the bread that was from the expired loaf.

During the interviews, all interviewed staff stated that they checked the food often and would throw out any expired items if they find them. When asked about the observed expired food items, Licensee admitted that they did not check those items and that she had just recently purchased them from Costco and did not know that they would be expired so soon.

Based on the information gathered from LPA's observation of staff serving the expired bread, but not spoiled food, to the children on 09/27/2022 and other expired food items, but not spoiled, in the storage and interviews conducted with 3 staff on 09/27/22, there is insufficient evidence to corroborate the allegation that Licensee serves day care children spoiled food . Although the allegation may have happened or are valid, there is not a preponderance of evidence to prove that the Licensee serves day care children spoiled food did or did not occur, therefore the allegation that Licensee serves day care children spoiled food is unsubstantiated.

Exit interview was conducted. The Notice of Site Visit was posted. Appeal Rights was explained. A copy of appeal rights (LIC 9058 03/22) was provided. First level appeal is to Regional Manager, address is above on the report. This report LIC 9099 was provided to the Licensee Mahin Rastegari.
SUPERVISORS NAME: Rina Lopez
LICENSING EVALUATOR NAME: Nguyen K Tran
LICENSING EVALUATOR SIGNATURE:

DATE: 10/26/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/26/2022
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, 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
09/19/2022 and conducted by Evaluator Nguyen K Tran
PUBLIC
COMPLAINT CONTROL NUMBER: 06-CC-20220919112817

FACILITY NAME:RASTEGARI, MAHINFACILITY NUMBER:
304313749
ADMINISTRATOR:RASTEGARI, MAHINFACILITY TYPE:
810
ADDRESS:1593 WEST CERRITOS AVENUETELEPHONE:
(714) 349-7736
CITY:ANAHEIMSTATE: CAZIP CODE:
92802
CAPACITY:14CENSUS: 7DATE:
10/26/2022
UNANNOUNCEDTIME BEGAN:
12:15 PM
MET WITH:Mahin Rastegari, Licensee TIME COMPLETED:
03:00 PM
ALLEGATION(S):
1
2
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Licensee exposed day care children to harmful chemicals.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Nguyen Tran conducted an unannounced complaint visit to further investigate and deliver the complaint findings. LPA met with licensee, Mahin Rastegari. The overall census observed was 2 staff and 7 children. A review of staff criminal clearance records on this date indicates that all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions.

On 09/19/2022, Regional Office received a complaint with allegation regarding Licensee exposed day care children to harmful chemicals.

During the course of investigation, LPA Tran interviewed 3 staff at the facility on 09/27/2022, and 4 children on 10/26/2022. LPA Tran also reviewed footage of the fumigation from the licensee and documentation regarding fumigation service.
(Continue next page)
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Rina Lopez
LICENSING EVALUATOR NAME: Nguyen K Tran
LICENSING EVALUATOR SIGNATURE:

DATE: 10/26/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/26/2022
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 06-CC-20220919112817
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: RASTEGARI, MAHIN
FACILITY NUMBER: 304313749
VISIT DATE: 10/26/2022
NARRATIVE
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(Page 2 of Report)

During the interviews, all interviewed staff provided consistent statements about the fumigation service on 08/26/2022: The children were staying inside while the fumigation staff was spraying outside and teachers only allowed the children to go outside when the fumigation staff gave the okay for the children to go outside; and the children were asked to go outside and stayed outside while the fumigation was completed in the childcare room and staff waited until they were given permission from the fumigation staff to go inside. LPA Tran attempted to interview 4 children on 10/26/2022, the children were not qualified for the interview.

During record review, LPA Tran reviewed the footage on 08/26/2022, LPA observed that when the fumigation staff sprayed the outside of the facility, no children were present in the footage. LPA Tran was not able to obtain the footage from the inside of the childcare room due to the camera was not working appropriately. LPA Tran also reviewed document from Preventive Pest Control service with notes indicated that: The exterior perimeter of the home was treated and allowed to dry while children were inside and the interior perimeter was treated and allowed to dry while the children were outside.

Based on the information gathered from LPA's interviews conducted with 3 staff on 09/27/22, and record reviews of the camera footage as well as Preventive Pest Control’s invoice, there is insufficient evidence to corroborate the allegation that Licensee exposed day care children to harmful chemicals. Although the allegation may have happened or are valid, there is not a preponderance of evidence to prove that the Licensee exposed day care children to harmful chemicals did or did not occur, therefore the allegation that Licensee exposed day care children to harmful chemicals is unsubstantiated are UNSUBSTANTIATED.

Exit interview was conducted. The Notice of Site Visit was posted. Facility representative was informed that the Notice of Site Visit must be posted for 30 consecutive days. Failure to post will result in civil penalty of $100. “The licensee was provided a copy of their appeal rights (LIC 9058) and their signature on this form acknowledges receipt of these rights.” This report LIC 9099 was provided to the Licensee Mahin Rastegari. First level appeal is to Regional Manager, address is above on the report.

(End of Report)
SUPERVISORS NAME: Rina Lopez
LICENSING EVALUATOR NAME: Nguyen K Tran
LICENSING EVALUATOR SIGNATURE:

DATE: 10/26/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/26/2022
LIC9099 (FAS) - (06/04)
Page: 4 of 5
Control Number 06-CC-20220919112817
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: RASTEGARI, MAHIN
FACILITY NUMBER: 304313749
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/26/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B

Section Cited
CCR
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISORS NAME: Rina Lopez
LICENSING EVALUATOR NAME: Nguyen K Tran
LICENSING EVALUATOR SIGNATURE:

DATE: 10/26/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/26/2022
LIC9099 (FAS) - (06/04)
Page: 5 of 5