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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 313622189
Report Date: 02/27/2024
Date Signed: 02/27/2024 07:41:45 AM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
This is an official report of an unannounced visit/investigation of a complaint received in our office on
12/05/2023 and conducted by Evaluator Katrina Owens
PUBLIC
COMPLAINT CONTROL NUMBER: 03-CC-20231205093930
FACILITY NAME:BILGI, AYSEFACILITY NUMBER:
313622189
ADMINISTRATOR:BILGI, AYSE & BILGI, AVNIFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(401) 612-4677
CITY:ROSEVILLESTATE: CAZIP CODE:
95678
CAPACITY:14CENSUS: 0DATE:
02/27/2024
UNANNOUNCEDTIME BEGAN:
07:00 AM
MET WITH:Ayse Bilgi - LicenseeTIME COMPLETED:
07:45 AM
ALLEGATION(S):
1
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9
PERSONAL RIGHTS: Day-care child sustained unexplained injuries while in care.
INVESTIGATION FINDINGS:
1
2
3
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12
13
An unannounced inspection was conducted today by Licensing Program Analyst Owens. LPA met with licensee Ayse Bilgi. No day-care children were present during the inspection. The purpose of the inspection is to close a complaint investigation that was originally opened on December 7, 2023.

Based on conflicting interviews, the allegation that a child sustained unexplained injuries while in care is unsubstantiated. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the allegation did or did not occur.

An exit interview was conducted. Appeal rights were given and explained to the licensee at time of inspection. No citation issued.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Keven Peters
LICENSING EVALUATOR NAME: Katrina Owens
LICENSING EVALUATOR SIGNATURE:

DATE: 02/27/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/27/2024
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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