334845712-3-10-2022-09-CC-AROS-CCUPGD-20220325111807

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 334845712
Report Date: 03/10/2022
Date Signed: 03/10/2022 11:37:22 AM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501

This is an official report of an unannounced visit/investigation of a complaint received in our office on
01/03/2022 and conducted by Evaluator Elyse Jones

PUBLIC

COMPLAINT CONTROL NUMBER: 09-CC-20220103154707

FACILITY NAME:	SHEIKH FAMILY CHILD CARE		FACILITY NUMBER:	334845712
ADMINISTRATOR:	RUBBIYA SHEIKH		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(714) 363-2440
CITY:	CORONA	STATE: CA	ZIP CODE:	92882
CAPACITY:	14	CENSUS: 5	DATE:	03/10/2022
		UNANNOUNCED	TIME BEGAN:	11:03 AM
MET WITH:	Rubbiya Sheikh, Licensee		TIME COMPLETED:	11:45 AM

ALLEGATION(S):

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Day care child sustained injuries while in care

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Elyse Jones arrived at the facility to deliver findings for a complaint regarding the above allegation. LPA met with the Licensee, Rubbiya Sheikh, to further discuss the
complaint/allegation. The facility was toured and census were taken.

This Department has investigated the complaint alleging a child sustained injuries while in care. It was reported that a child was picked-up from the facility with bruising and swelling to the face; it was unknown how the injures occurred. During the course of the investigation, interviews with all pertinent parties were conducted. The Department received additional documentation including medical records which indicate a conflict in the information provided. Medical documentation indicated it may have been a bite, but it was not a confirmation. The child was documented as having an existing skin condition. Facility staff noted there was another child standing within close proximity to this child when crying was heard. Facility staff was preparing bottles in preparation for naptime and did not observe what occurred. Facility staff noted the child did not have any marks/redness upon arrival but confirmed the child’s face was red when parents arrived for pickup.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Aaron Ross	TELEPHONE: (951) 320-2023
LICENSING EVALUATOR NAME: Elyse Jones	TELEPHONE: (951) 897-2468
LICENSING EVALUATOR SIGNATURE:	DATE: 03/10/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/10/2022

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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Control Number 09-CC-20220103154707

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501

FACILITY NAME: SHEIKH FAMILY CHILD CARE	FACILITY NUMBER: 334845712
	VISIT DATE: 03/10/2022

NARRATIVE

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Licensee stated that she believes the redness was caused by an allergic reaction or eczema flare up.

Based on the interviews conducted, the review of pertinent documentation, and conflicting
information, the allegation is UNSUBSTANTIATED. A finding that the allegation 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.

No deficiencies cited at this time.

Exit interview was conducted and a copy of this report and a Notice of Site Visit was provided to the
Licensee. Notice of Site Visit was issued and must be posted for 30 day. A copy of this report was
provided to the facility must be made available to the public for three years upon request.

SUPERVISOR'S NAME: Aaron Ross	TELEPHONE: (951) 320-2023
LICENSING EVALUATOR NAME: Elyse Jones	TELEPHONE: (951) 897-2468
LICENSING EVALUATOR SIGNATURE:	DATE: 03/10/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/10/2022

LIC9099 (FAS) - (06/04)

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