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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 073409195
Report Date: 04/17/2024
Date Signed: 04/17/2024 01:59:00 PM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
OAKLAND CC RO, 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
04/15/2024 and conducted by Evaluator Tasha Hackett-Alexander
COMPLAINT CONTROL NUMBER: 02-CC-20240415162059
FACILITY NAME:SARBAZ, AFSHINFACILITY NUMBER:
073409195
ADMINISTRATOR:SARBAZ, AFSHINFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(925) 497-8986
CITY:CONCORDSTATE: CAZIP CODE:
94518
CAPACITY:14CENSUS: 11DATE:
04/17/2024
UNANNOUNCEDTIME BEGAN:
08:15 AM
MET WITH:Afshin SarbazTIME COMPLETED:
02:15 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
PERSONAL RIGHTS- Day care child(ren) are being left in a car seat for extended periods of time
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On 4/17/2024 Licensing Program Analyst (LPA) Tasha Alexander met with Licensee Afshin Sarbaz for a 10 day initial inspection to discuss the above complaint allegation.

Upon arrival there are 2 assistants present along with 11 children in care, consisting of 4 infants and 7
preschoolers. Licensee arrived approximately 5 minutes later. Today a tour of the facility and observation of the daily activities/routines was conducted. An interview was also conducted with the licensee. Today, licensee denies children are left in car seats/strollers for extended periods of time.

Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is unsubstantiated.

An exit interview was conducted. A notice of site visit was posted.

Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Mayla Mendoza
LICENSING EVALUATOR NAME: Tasha Hackett-Alexander
LICENSING EVALUATOR SIGNATURE:

DATE: 04/17/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/17/2024
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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