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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 493009337
Report Date: 01/14/2020
Date Signed: 01/15/2020 02:18:18 PM



STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 101 GOLF COURSE DR. STE. A-230
ROHNERT PARK, CA 94928
This is an official report of an unannounced visit/investigation of a complaint received in our office on
11/15/2019 and conducted by Evaluator Yang Yang
PUBLIC
COMPLAINT CONTROL NUMBER: 01-CC-20191115140502
FACILITY NAME:ZAKI, SHERINE FCCHFACILITY NUMBER:
493009337
ADMINISTRATOR:ZAKI, SHERINEFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(707) 280-3144
CITY:ROHNERT PARKSTATE: CAZIP CODE:
94928
CAPACITY:14CENSUS: 6DATE:
01/14/2020
UNANNOUNCEDTIME BEGAN:
12:50 PM
MET WITH:Sherine ZakiTIME COMPLETED:
04:33 PM
ALLEGATION(S):
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-Licensee does not spend the required amount of time in the childcare

-Licensee does not live in the childcare home.
INVESTIGATION FINDINGS:
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A follow-up complaint investigation visit was made to the facility by Licensing Program Analyst (LPA), Y. Yang to deliver complaint investigation findings. A previous investigation visit was made to the facility on 11/21/19. It was alleged that the licensee does not spend the required amount of time in the childcare and that the licensee does not live in the childcare home. Specifically, it was alleged that the licensee moved out of the home at the end of July 2019 and the home is now occupied by an assistant of the licensee.

During the initial investigation visit to the facility on 11/21/19, LPA interviewed the licensee at 01:33pm. The licensee denied the allegations. The licensee stated that she spends at least 80 percent of her family child care home’s (FCCH) operating hours at the facility or engaged in childcare related tasks outside of the facility. The licensee stated that these tasks include school pick up and drop off and purchasing supplies and food for the FCCH. The licensee stated that whenever she is away from the facility, the facility is always within ratio. The facility’s operating hours are Monday-Friday 07:30am-06:00pm. The licensee stated that she does not have any employment outside of her FCCH.
Continued on LIC 9099-C
Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Alexis HollonTELEPHONE: (707) 588-5036
LICENSING EVALUATOR NAME: Yang YangTELEPHONE: 707-588-5026
LICENSING EVALUATOR SIGNATURE:

DATE: 01/14/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/14/2020
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 2
Control Number 01-CC-20191115140502
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 101 GOLF COURSE DR. STE. A-230
ROHNERT PARK, CA 94928
FACILITY NAME: ZAKI, SHERINE FCCH
FACILITY NUMBER: 493009337
VISIT DATE: 01/14/2020
NARRATIVE
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 At this time, with the information available, LPA was unable to determine the amount of time the licensee spends at the FCCH or outside of the FCCH engaging in non-childcare related activities or attending to personal appointments.

The licensee stated that she is a renter of the home of which the FCCH is located at and the only adult that resides in the home. The licensee stated that her FCCH is her primary and only residence and that she does not rent or own any additional properties elsewhere. The licensee stated that although this address is her primary domicile, she does on occasion stay at a different address during non-childcare hours. Interviews were conducted with staff S2-S4 at the facility on 11/21/19 beginning at 12:45pm. Based on interviews conducted, LPA did not receive corroborating information to support the allegations against the facility. Staff interviewed all corroborated the licensee’s statements. In addition, LPA obtained affidavits of residency from the licensee’s assistants. The licensee provided LPA with a current utility billing statement from the City of Rohnert Park along with other current financial documents establishing proof of residency. Interviews with childcare children and clients were also conducted during the investigation and did not reveal any corroborating information to support the allegations.

During the investigation, LPA toured all downstairs rooms including the garage. With the consent of the licensee, LPA toured the home’s “off-limits” second floor with the licensee. LPA observed the licensee’s personal effects in the home’s master bedroom. LPA did not observe any evidence to suggest that there are other adults residing in the home. During the visit to the FCCH on 11/21/19 and 01/14/20, staff were observed to be providing appropriate care and supervision and operating within ratio.

Based on available information, 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. All licensing reports are public information and must be made available upon request for at least three years. This report was read and reviewed with the licensee. There were no Title 22 deficiencies cited during today's inspection. Appeal rights were provided.

Notice of Site Visit shall be posted for 30 days from today's visit.

SUPERVISOR'S NAME: Alexis HollonTELEPHONE: (707) 588-5036
LICENSING EVALUATOR NAME: Yang YangTELEPHONE: 707-588-5026
LICENSING EVALUATOR SIGNATURE:

DATE: 01/14/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/14/2020
LIC9099 (FAS) - (06/04)
Page: 2 of 2