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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 434414604
Report Date: 09/03/2021
Date Signed: 09/08/2021 08:18:51 AM



STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
This is an official report of an unannounced visit/investigation of a complaint received in our office on
07/14/2021 and conducted by Evaluator Anna Morales
COMPLAINT CONTROL NUMBER: 07-CC-20210714131009
FACILITY NAME:MOHAMMED, FETHYAFACILITY NUMBER:
434414604
ADMINISTRATOR:MOHAMMED, FETHYAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(408) 241-3263
CITY:SANTA CLARASTATE: CAZIP CODE:
95050
CAPACITY:14CENSUS: 7DATE:
09/03/2021
UNANNOUNCEDTIME BEGAN:
03:38 PM
MET WITH:Fethya MohammedTIME COMPLETED:
04:40 PM
ALLEGATION(S):
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1.Provider locked daycare child in the garage.
2. Daycare child is offered money to do the work in the daycare.
3. Provider leaves the children alone with a babysitter.
4. Provider is not providing adequate supervision.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Anna Morales conducted a Subsequent visit to deliver the findings for the above allegations. LPA was greeted by Licensee Fethya Mohammed, and one staff. Present were two infant( under two years old), four toddlers and one school aged child.
Complainant alleges that Licensee/ Provider locked day care child in the garage.
Day care child is offered money to do the work in the day care, Provider leaves the children alone with a babysitter and Provider is not providing adequate supervision. LPA obtained information from the interviews that were conducted with the Licensee, parents, and other parties involved. LPA, also, reviewed supporting documentation, which included the Facility Roster and police report,
Based on the information obtained, although the allegations may have happened or is valid, there is not a preponderance of evidence to prove that the alleged violation did or did not occur. Therefore, the allegation is found to be UNSUBSTANTIATED.
Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Sandy KnightTELEPHONE: (408) 324-2151
LICENSING EVALUATOR NAME: Anna MoralesTELEPHONE: (408) 334-8325
LICENSING EVALUATOR SIGNATURE:

DATE: 09/03/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/03/2021
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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