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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 313622189
Report Date: 05/02/2024
Date Signed: 05/02/2024 03:59:14 PM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
This is an official report of an unannounced visit/investigation of a complaint received in our office on
04/03/2024 and conducted by Evaluator Dao Vang
COMPLAINT CONTROL NUMBER: 03-CC-20240403130637
FACILITY NAME:BILGI, AYSEFACILITY NUMBER:
313622189
ADMINISTRATOR:BILGI, AYSE & BILGI, AVNIFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(401) 612-4677
CITY:ROSEVILLESTATE: CAZIP CODE:
95678
CAPACITY:14CENSUS: DATE:
05/02/2024
UNANNOUNCEDTIME BEGAN:
02:23 PM
MET WITH:Bilgi, AyseTIME COMPLETED:
04:30 PM
ALLEGATION(S):
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Provider refused parent entry into the facility.
INVESTIGATION FINDINGS:
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On 5/2/2024 at 1:00p.m., LPA Pa Dao Vang met with Licensee Ayse Bilgi for the purpose of an unannounced complaint inspection regarding the above allegation of the provider refused parent entry into the facility. LPA observed the census of 7 children in care supervised by 2 staff.

During the course of the investigation LPA conducted interviews, made observations, and collected documentation. Based on 2 separate inspection days, LPA verified their background clearances through Guardian. Interviews and observations revealed that facility did allow parents in the home during facility hours. LPA learned children are bring dropped off and picked up at the front door daily.

Continue report on LIC9909-C...
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Seychelle De Luca
LICENSING EVALUATOR NAME: Dao Vang
LICENSING EVALUATOR SIGNATURE:

DATE: 05/02/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/02/2024
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 03-CC-20240403130637
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME: BILGI, AYSE
FACILITY NUMBER: 313622189
VISIT DATE: 05/02/2024
NARRATIVE
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Based on LPA interviews the preponderance of evidence standard has been met; therefore, the above allegation is substantiated. A Title 22 deficiency is cited on LIC 9099-D. An exit interview was conducted with Licensee Ayse Bilgi, a notice of site visit and appeal rights are provided. The Notice of Site Visit posted for 30 consecutive days for parents to view. Failure to comply with posting requirements can result in a $100 penalty.
SUPERVISORS NAME: Seychelle De Luca
LICENSING EVALUATOR NAME: Dao Vang
LICENSING EVALUATOR SIGNATURE:

DATE: 05/02/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/02/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 03-CC-20240403130637
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

FACILITY NAME: BILGI, AYSE
FACILITY NUMBER: 313622189
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/02/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Request Denied
Type B
06/03/2024
Section Cited
CCR
102419(a)(1)
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102419 Admission Procedures & Parental Authorized Representative's Rights
(a)(1) To enter and inspect the family child care home in accordance with Health & Safety Code Section 1596.857.

This requirement was not met, evidenced by:
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Licensee will email a statement to all parents about the right to enter & inpsect the on-limit areas, while their child(ren) is in care at the facility.
Licensee will forward the email to LPA to clear Plan of Correction.
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Based on observations and interviews, LPA learned children allowed to be dropped off & pick up at the front door. LIcensee stated she was not aware of parent's rights to enter & inspect the facilty, while children are in care. This posed a potential health, safety or personal rights risk to persons in care
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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: Seychelle De Luca
LICENSING EVALUATOR NAME: Dao Vang
LICENSING EVALUATOR SIGNATURE:

DATE: 05/02/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/02/2024
LIC9099 (FAS) - (06/04)
Page: 3 of 3