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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 015700236
Report Date: 12/13/2023
Date Signed: 12/13/2023 03:05:58 PM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
OAKLAND SOUTH EAST, 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
11/30/2023 and conducted by Evaluator Jyoti Saini
PUBLIC
COMPLAINT CONTROL NUMBER: 52-CC-20231130091059
FACILITY NAME:MEHRA, SUMEDHA & TARUNFACILITY NUMBER:
015700236
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY:8CENSUS: 4DATE:
12/13/2023
UNANNOUNCEDTIME BEGAN:
02:40 PM
MET WITH:Licensee, Sumedha, Tarun Mehra.TIME COMPLETED:
03:40 PM
ALLEGATION(S):
1
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3
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5
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7
8
9
-Provider did not report injuries to child's authorized representative
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analyst (LPA) Jyoti Saini arrived unannounced to deliver the findings from a complaint investigation for the above allegation and met licensee, Sumedha, Tarun Mehra. Present during the inspection, there were four (4) children (3 infants and 1 preschooler) in care.
Based on the interview, observation, and record review, the facility denies any such Incident happened. Furthermore, interviews revealed that the Provider communicates daily with the family enrolled. Therefore, the alleged Provider did not report injuries to the child's authorized representative, may have happened or is valid; there is no preponderance of evidence to prove the alleged violation did or did not occur. Therefore, the allegation is unsubstantiated.

An exit interview was conducted with Licensee, Sumedha, Tarun Mehra.

A notice of site visit was posted and must remain posted for a period of 30 days.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Wynn Norona
LICENSING EVALUATOR NAME: Jyoti Saini
LICENSING EVALUATOR SIGNATURE:

DATE: 12/13/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/13/2023
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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