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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 197493765
Report Date: 05/15/2024
Date Signed: 05/15/2024 02:14:50 PM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
L.A. DAYCARE-NO.WEST, 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
04/09/2024 and conducted by Evaluator Loyce Phillips
PUBLIC
COMPLAINT CONTROL NUMBER: 30-CC-20240409154551
FACILITY NAME:NASIR FAMILY CHILD CAREFACILITY NUMBER:
197493765
ADMINISTRATOR:NASIR, SHAHINAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(424) 456-4080
CITY:HAWTHORNESTATE: CAZIP CODE:
90250
CAPACITY:14CENSUS: 4DATE:
05/15/2024
UNANNOUNCEDTIME BEGAN:
11:50 AM
MET WITH:SHAHINA NASIR, LICENSEETIME COMPLETED:
02:30 PM
ALLEGATION(S):
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Allegation: Personal Rights - Provider did not supervise daycare children resulting in daycare child biting other children causing an injury.
INVESTIGATION FINDINGS:
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On 5/15/2024, Licensing Program Analyst (LPA), Loyce Phillips, conducted an unannounced visit for the purpose of delivering the findings on the above allegations. LPA was greeted by Licensee, Shahina Nasir and toured the facility. LPA observed 4 children in care with Licensee and assistant. All adults have criminal record clearance.

LPA conducted a full investigation that included tours of the facility, observations of children and interviewing staff, children, and parents. During staff interviews, S1 admitted C1 bit C2. According to S1, S1 was sitting on the couch watching the children play. C1 and C2 began to fight over a toy and suddenly C1 quickly bit C2. S1 stated C1 has never bitten at the facility, and this was the first time. S1 stated she washed and applied ice to the bitten area. S2 stated they separated C1 from the other children. The children who were interviewed stated S1 was sitting on the couch when C1 bit C2. Although S1 was sitting 4 feet away from the children, S1 was unable to separate the children to prevent C1 from biting C2.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Karren Starks
LICENSING EVALUATOR NAME: Loyce Phillips
LICENSING EVALUATOR SIGNATURE:

DATE: 05/15/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/15/2024
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 3
Control Number 30-CC-20240409154551
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
L.A. DAYCARE-NO.WEST, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: NASIR FAMILY CHILD CARE
FACILITY NUMBER: 197493765
VISIT DATE: 05/15/2024
NARRATIVE
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Therefore, the allegation of provider did not supervise day-care children resulting in day-care child biting other children causing an injury is deemed substantiated. A Substantiated finding means that the allegation is valid because the preponderance of the evidence standard has been met.

Deficiency is cited in accordance with Title 22 of the California Code of Regulations and/or Health & Safety Codes (9099-D).

An exit interview was conducted, a copy of this report, appeals rights and a notice of site visit were discussed and provided to Licensee, Shahina Nasir.

SUPERVISORS NAME: Karren Starks
LICENSING EVALUATOR NAME: Loyce Phillips
LICENSING EVALUATOR SIGNATURE:

DATE: 05/15/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/15/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 30-CC-20240409154551
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
L.A. DAYCARE-NO.WEST, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME: NASIR FAMILY CHILD CARE
FACILITY NUMBER: 197493765
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/15/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
05/24/2024
Section Cited
CCR
102423(a)(2)
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Personal Rights (a) Each child receiving services from a family childcare home shall have certain rights that shall not be waived or abridged... (2) To receive safe, healthful, and comfortable accommodations, furnishings, and equipment. This requirement is not met as evidenced by:
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Licensee will read Title 22 Section 102423(a)(2)Personal Rights and write a statement with undersstanding of the regulation. Licensee will also write a statement on how she will handle children who bites and send to LPA by POC date.
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S1 admitted C1 bit C2. According to S1, she was sitting on the couch watching the children play. C1 and C2 began to fight over a toy and suddenly C1 quickly bit C2. S1 did not separate the children, preventing C1 from biting C2, which poses a potential health, safety or personal rights risk to persons in care, if not corrected.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISORS NAME: Karren Starks
LICENSING EVALUATOR NAME: Loyce Phillips
LICENSING EVALUATOR SIGNATURE:

DATE: 05/15/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/15/2024
LIC9099 (FAS) - (06/04)
Page: 3 of 3