<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 073405959
Report Date: 07/16/2025
Date Signed: 07/16/2025 04:12:03 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, SUITE 1102
OAKLAND, CA 94612
This is an official report of an unannounced visit/investigation of a complaint received in our office on
04/17/2025 and conducted by Evaluator Nyeesha Blount
COMPLAINT CONTROL NUMBER: 02-CC-20250417084406
FACILITY NAME:KAZMI, SARAHFACILITY NUMBER:
073405959
ADMINISTRATOR:KAZMI, SARAHFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(510) 245-0678
CITY:HERCULESSTATE: CAZIP CODE:
94547
CAPACITY:14CENSUS: 5DATE:
07/16/2025
UNANNOUNCEDTIME BEGAN:
01:50 PM
MET WITH:KAZMI, SARAH TIME COMPLETED:
04:20 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Personal Rights ~ Provider forced day care child to eat resulting in over feeding.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On July 16, 2025 at 01:50 PM Licensing Program Analyst (LPA) Nyeesha Blount, conducted an Unannounced Complaint site inspection to deliver complaint findings. LPA met with licensee Kazmi, Sarah, also present was (1) staff member who is background cleared. LPA advised Licensee of the nature of the inspection. Current Census today is 5 children which consists of (5) preschool age children present. LPA obtained a copy of the children's roster, observations and staff interviews were conducted. Staff advised that they do not force children to eat at the facility.

Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation(s) did or did not occur. Therefore, the allegation is Unsubstantiated. Exit interview conducted. Appeal rights were discussed and given. This report must be kept available for public review for (3) years. Notice of site visit given.
Unsubstantiated
Estimated Days of Completion: 60
SUPERVISORS NAME: Mayla Mendoza
LICENSING EVALUATOR NAME: Nyeesha Blount
LICENSING EVALUATOR SIGNATURE:

DATE: 07/16/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/16/2025
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 1