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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 015700227
Report Date: 07/02/2021
Date Signed: 07/09/2021 04:01:40 PM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
This is an official report of an unannounced visit/investigation of a complaint received in our office on
05/05/2021 and conducted by Evaluator James Sampair
PUBLIC
COMPLAINT CONTROL NUMBER: 52-CC-20210505102407
FACILITY NAME:ELDEEB, SAHARFACILITY NUMBER:
015700227
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY:8CENSUS: 3DATE:
07/02/2021
UNANNOUNCEDTIME BEGAN:
05:29 PM
MET WITH:Sahar EldeebTIME COMPLETED:
06:08 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Day care child was inappropriately touched by another child in care.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
THIS IS AN AMENDED REPORT OF THE ORIGINAL POC VISIT LIC 9099 ON 07/02/2021.
On 07/02/2021 at 5:29 PM, Licensing Program Analyst (LPA) James Sampair met with Licensee to deliver the findings of the investigation into the above allegations. Present during today's visit were the Licensee, Staff #2 (S2), and 3 children in care. The LPA presented the findings to the Licensee, which included interviewing the Complainant, the Licensee herself, Staff, Social Workers, and Parents. When asked, no one interviewed had any complaints personally nor from the children in care about the Licensee nor any reports of abuse from other children at the facility.

The allegation may have happened or is valid, but there is not a preponderance of evidence to prove the alleged violation did or did not occur. Therefore, the allegation was found to be UNSUBSTANTIATED.

An exit interview was conducted with Licensee at 5:53 PM. A notice of site visit was provided to the Licensee and must remain posted for a period of 30 days.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Jason Jang
LICENSING EVALUATOR NAME: Manel Estoesta
LICENSING EVALUATOR SIGNATURE:

DATE: 07/02/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/02/2021
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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