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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 503911462
Report Date: 06/09/2022
Date Signed: 06/09/2022 12:39:50 PM


Document Has Been Signed on 06/09/2022 12:39 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1310 E. SHAW AVE,
FRESNO, CA 93710



FACILITY NAME:NAZARPOUR, DENA FAMILY CHILD CAREFACILITY NUMBER:
503911462
ADMINISTRATOR:NAZARPOUR, DENAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(209) 202-6480
CITY:TURLOCKSTATE: CAZIP CODE:
95382
CAPACITY:14CENSUS: 4DATE:
06/09/2022
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
12:00 PM
MET WITH:Licensee - Dena NazarpourTIME COMPLETED:
12:50 PM
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On 06/09/2022, Licensing Program Analyst (LPA) Luisa Gavoutian conducted an unannounced case management inspection. LPA was greeted by Licensee Dena Nazarpour. Present during today’s inspection were four children and a fingerprint-cleared live-in adult relative. The purpose of this inspection was to verify Licensee’s adult son, Noel Nazarpour, was not living, or present, at the facility.

On 04/11/2022, Licensee was provided with an Order of Exclusion informing Licensee that her son, Noel, is excluded from having contact with day care children or being physically present at any facility licensed by the Department. Today, LPA inspected the facility and verified that Noel was not living, or present, at the facility. Licensee stated that Noel has rented a home effective 05/01/2022 and is living in a different location. LPA obtained the address of Noel's current residence.

Per Title 22, Division 12, Chapter 3, of the California Code of Regulations, no deficiencies were cited. Exit interview conducted and report was reviewed with the licensee Dena Nazarpour.

A notice of site visit was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.
SUPERVISOR'S NAME: Juvenal MoctezumaTELEPHONE: (559) 650-7869
LICENSING EVALUATOR NAME: Luisa GavoutianTELEPHONE: (559) 341-4725
LICENSING EVALUATOR SIGNATURE:
DATE: 06/09/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/09/2022
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
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