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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 195700039
Report Date: 09/05/2023
Date Signed: 09/05/2023 08:31:20 PM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
This is an official report of an unannounced visit/investigation of a complaint received in our office on
06/13/2023 and conducted by Evaluator Judy Laureano
PUBLIC
COMPLAINT CONTROL NUMBER: 58-CC-20230613084845
FACILITY NAME:MOJABI FAMILY CHILD CAREFACILITY NUMBER:
195700039
ADMINISTRATOR:ZIA MOJABIFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(310) 596-0353
CITY:NORTH HOLLYWOODSTATE: CAZIP CODE:
91602
CAPACITY:14CENSUS: 11DATE:
09/05/2023
UNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Zia MojabiTIME COMPLETED:
10:00 AM
ALLEGATION(S):
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9
Personal Rights: Staff hit daycare child
INVESTIGATION FINDINGS:
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13
On 9/5/2023 Licensing Program Analyst (LPAs) Judy Laureano and Cristina Castellanos arrived at aboved mentioned facilty to deliver findings regarding above mentioned allegation.

LPAs met with Zia Mojabi and toured the facility both indoors and outdoors. LPAs observed 11 children and 2 staff members and licensee providing care and supervision.

On 6/19/2023 Licensing Program Analysts (LPA) Judy Laureano and Sarah Garcia conducted an unannounced complaint investigation regarding the above allegation. LPAs met with Zia Mojabi. LPAs toured the facility indoor and outdoors and observed 12 children in care and 3 staff members and licensee providing care and supervision.
LPA interviewed Licensee, assistants and children. The following was requested by LPA: Children's roster, staff roster, parent handbook, sign in/out sheets and sample daily report.

Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Claudia Escobedo
LICENSING EVALUATOR NAME: Judy Laureano
LICENSING EVALUATOR SIGNATURE:

DATE: 09/05/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/05/2023
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 2
Control Number 58-CC-20230613084845
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: MOJABI FAMILY CHILD CARE
FACILITY NUMBER: 195700039
VISIT DATE: 09/05/2023
NARRATIVE
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Page 2
On 9/5/2023 LPAs concluded interviews of all relevant parties. Based on interviews of staff, parents and children, no information was disclosed that children's personal rights were violated, therefore, the allegation is UNSUBSTANTIATED, meaning although the allegations may have happened or are valid, the preponderance of the evidence standard has not been met.

Exit interview was conducted and a copy of the report was provided with a Notice of Site Visit
SUPERVISORS NAME: Claudia Escobedo
LICENSING EVALUATOR NAME: Judy Laureano
LICENSING EVALUATOR SIGNATURE:

DATE: 09/05/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/05/2023
LIC9099 (FAS) - (06/04)
Page: 2 of 2