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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 503904174
Report Date: 10/10/2022
Date Signed: 10/10/2022 12:35:24 PM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1310 E. SHAW AVE,
FRESNO, CA 93710
This is an official report of an unannounced visit/investigation of a complaint received in our office on
10/06/2022 and conducted by Evaluator Cynthia Brannon
PUBLIC
COMPLAINT CONTROL NUMBER: 04-CC-20221006161026
FACILITY NAME:KHOSHABA, NAHRAIN FAMILY CHILD CAREFACILITY NUMBER:
503904174
ADMINISTRATOR:KHOSHABA, NAHRAINFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(209) 622-0244
CITY:MODESTOSTATE: CAZIP CODE:
95355
CAPACITY:14CENSUS: 9DATE:
10/10/2022
UNANNOUNCEDTIME BEGAN:
10:30 AM
MET WITH:Nahrain KhoshabaTIME COMPLETED:
01:00 PM
ALLEGATION(S):
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Day care child not provided their personal rights.
INVESTIGATION FINDINGS:
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 Licensing Program Analysts (LPAs) Brannon and Vang conducted an unannounced complaint inspection to investigate the above allegation. LPAs met with licensee, Nahrain Khoshaba. LPA Brannon explained the allegation, and toured the facility, inside and outside. LPA Brannon observed 9 children that included two infants under the age of 24 months with licensee and one staff. During today’s visit, LPA Brannon interviewed licensee, staff and children.
LPA reviewed with licensee Title 22, section 102423(a)(4), Personal Rights. Interview with licensee reflects she did take a photograph of day care child sitting on the toilet. A form of social media was used to send to photograph to parent. LPA reviewed with licensee why this is not acceptable to send photos of children using the toilet. During the course of this investigation, LPA received documentation and conducted interviews. Based upon documentation and interviews, the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED.
Per California Code of Regulations, Title 22, Division 12, Chapter 3, this deficiency is to be cited. Exit interview conducted with licensee, Nahrain Khoshaba. Plan Of Correction/Appeal Rights were given and discussed. A Notice of Site Visit was posted on parent board in the presence of LPA Brannon.
A COPY OF THIS REPORT IS TO REMAIN IN THE FACILITY FOR PUBLIC REVIEW.
THIS REPORT SHALL BE MADE AVAILABLE TO THE PUBLIC UPON REQUEST.
To order forms, etc. visit our website at www.ccld.ca.gov
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Michael Duarte
LICENSING EVALUATOR NAME: Cynthia Brannon
LICENSING EVALUATOR SIGNATURE:

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

DATE: 10/10/2022
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 2
Control Number 04-CC-20221006161026
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1310 E. SHAW AVE,
FRESNO, CA 93710

FACILITY NAME: KHOSHABA, NAHRAIN FAMILY CHILD CARE
FACILITY NUMBER: 503904174
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/10/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Request Denied
Type B
10/17/2022
Section Cited
CCR
102423(a)(4)
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Personal Rights. Each child receiving services from a family child care home shall have certain rights that shall not be waived or abridged by the licensee regardless of consent or authorization from the child's authorized representative. These rights include, but are not limited to, the following: To be free from corporal
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Per licensee, she will provide a written statement stating that she will not provide pictures of day care children using the toilet to adults/parents/guardians. The statement will be sent to the Fresno Community Care Licensing office by 10/17/2022.
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or unusual interference with eating, sleeping or toileting; or withholding shelter, clothing, medication or aids to physical functioning.This requirement was not met as evidenced by documentation and information obtained during the investigation. This is a potential risk to the health, safety and personal rights of children 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: Michael Duarte
LICENSING EVALUATOR NAME: Cynthia Brannon
LICENSING EVALUATOR SIGNATURE:

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

DATE: 10/10/2022
LIC9099 (FAS) - (06/04)
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