304200146-9-6-2023-06-CC-THOO-CVMUW5-20230913155611

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 304200146
Report Date: 09/06/2023
Date Signed: 09/06/2023 10:32:20 AM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

This is an official report of an unannounced visit/investigation of a complaint received in our office on
05/17/2023 and conducted by Evaluator Dianna ValdezSantana

COMPLAINT CONTROL NUMBER: 06-CC-20230517100958

FACILITY NAME:	BILLEH, LUSI, SAMIR, & VICTORIA		FACILITY NUMBER:	304200146
ADMINISTRATOR:	BILLEH, LUSI		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(714) 974-5734
CITY:	ORANGE	STATE: CA	ZIP CODE:	92865
CAPACITY:	14	CENSUS: 2	DATE:	09/06/2023
		UNANNOUNCED	TIME BEGAN:	09:45 AM
MET WITH:	Licensee, Samir Billeh		TIME COMPLETED:	10:30 AM

ALLEGATION(S):

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Child in home accessed a firearm and injuried themselves while day care children were in care.

INVESTIGATION FINDINGS:

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On 9/06/23 Licensing Program Analyst (LPA) Dianna Valdez Santana made an unannounced visit to the facility for the purpose of delivering findings of a complaint investigation conducted by Investigation Branch (IB) Investigator Angelica Medina. LPA was met with licensee, Samir Billeh, co-licensee Lucy was not present due to a doctor's visit. LPA explained the reason for today’s visit. LPA observed 2 children in care.

A review of the Facility Personnel Report Summary on today's date indicates all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions.

On 05/17/2023, the Regional Office received a complaint reporting licensee’s grandson had access to a firearm and injured themselves while day care children were in care.
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Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Thuy Ho
LICENSING EVALUATOR NAME: Dianna ValdezSantana
LICENSING EVALUATOR SIGNATURE:	DATE: 09/06/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/06/2023

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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Control Number 06-CC-20230517100958

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME: BILLEH, LUSI, SAMIR, & VICTORIA	FACILITY NUMBER: 304200146
	VISIT DATE: 09/06/2023

NARRATIVE

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During the investigation, the IB investigator conducted interviews, reviewed police report, and medical records. IB investigator interviewed licensee who stated the following: On the incident day, 5/16/2023, the weapon used by the grandson was stored in one safe and the ammunition was stored in a separate safe.
Three daycare children were present at the time of the incident but did not witness the shooting. The Licensee was completely unaware that her grandson was capable of doing something like this. This was something completely out of licensee’s control and there is no evidence to corroborate the allegation.
Based on the interviews and record reviews, there was no evidence or witnesses to corroborate or support that the above allegation. Although the allegation may have happened or is valid there is not a preponderance of evidence to prove the violation did or did not occur, therefore, the allegation is Unsubstantiated.

Exit interview was conducted with licensee, Samir Billeh. The Notice of Site Visit was posted. Facility representative was informed that the Notice of Site Visit must be posted for 30 consecutive days. Failure to post will result in civil penalty of $100. Facility representative was provided a copy of their appeal rights (LIC 9058) and their signature on this form acknowledges receipt of these rights.

SUPERVISORS NAME: Thuy Ho
LICENSING EVALUATOR NAME: Dianna ValdezSantana
LICENSING EVALUATOR SIGNATURE:	DATE: 09/06/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/06/2023

LIC9099 (FAS) - (06/04)

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