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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 334845544
Report Date: 04/04/2024
Date Signed: 04/04/2024 01:46:45 PM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501
This is an official report of an unannounced visit/investigation of a complaint received in our office on
01/25/2024 and conducted by Evaluator Anastasia Flores
PUBLIC
COMPLAINT CONTROL NUMBER: 10-CC-20240125142252
FACILITY NAME:GHOLIPOOR FAMILY CHILD CAREFACILITY NUMBER:
334845544
ADMINISTRATOR:GHOLIPOOR,MEHRNAZFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(951) 506-1915
CITY:TEMECULASTATE: CAZIP CODE:
92591
CAPACITY:14CENSUS: 9DATE:
04/04/2024
UNANNOUNCEDTIME BEGAN:
12:48 PM
MET WITH:Mehrnaz Gholipoor (Mary) TIME COMPLETED:
01:24 PM
ALLEGATION(S):
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Licensee uses inappropriate form of discipline to children in care

INVESTIGATION FINDINGS:
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On April 04, 2024, at 12:48 PM, Licensing Program Analyst’s (LPAs) Anastasia Flores and Gabriel Hernandez arrived for the purpose of delivering the findings of the above stated allegations. On February 2, 2024, at 9:42 AM, LPA’s Flores and Hamilton conducted a health and safety inspection of the facility and some concerns were noted and Licensee was asked to immediately correct. Copies of the child roster, photos of facility, was obtained. Confidential interviews were conducted as well as an interview with licensee.
On January 25, 2024, this agency received an allegation that licensee uses inappropriate form of discipline to children in care. Confidential interviews disclosed that six out of nine children’s interviews stated that licensee places children in time out in a separate room, described as the room the babies sleep in. Interview with licensee revealed that she places children in time out near her, or in the area of the kitchen bay window within her view. Confidential interviews with five out of nine children disclosed that licensee disciplined children for things such as having accidents, not eating all their food, and/or not sitting correctly (crisscross applesauce) during circle time.


Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Pauline Beschorner
LICENSING EVALUATOR NAME: Anastasia Flores
LICENSING EVALUATOR SIGNATURE:

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

DATE: 04/04/2024
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 5
Control Number 10-CC-20240125142252
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501
FACILITY NAME: GHOLIPOOR FAMILY CHILD CARE
FACILITY NUMBER: 334845544
VISIT DATE: 04/04/2024
NARRATIVE
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Based on confidential interviews the preponderance of evidence has been met, therefore. the above allegation that the licensee uses inappropriate form of discipline to children in care is substantiated. The facility is being cited for Title 22, division 12, chapter 1, article 06, continuing requirements; section 102423(a)(4) Personal Rights, which may pose a potential risk to children in care. Exit interview conducted and a copy of the report along with the appeal rights were provided to licensee, Mehrnaz (Mary) Gholipoor.

A NOTICE OF SITE VISIT WAS ISSUED AND LPAs VERIFIED THAT IT WAS POSTED IN A PROMINENT LOCATION AT THE FACILITY BEFORE LEAVING. THE LICENSEE UNDERSTANDS THAT IT MUST REMAIN POSTED FOR THE NEXT 30 DAYS.
SUPERVISORS NAME: Pauline Beschorner
LICENSING EVALUATOR NAME: Anastasia Flores
LICENSING EVALUATOR SIGNATURE:

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

DATE: 04/04/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 5
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501
This is an official report of an unannounced visit/investigation of a complaint received in our office on
01/25/2024 and conducted by Evaluator Anastasia Flores
PUBLIC
COMPLAINT CONTROL NUMBER: 10-CC-20240125142252

FACILITY NAME:GHOLIPOOR FAMILY CHILD CAREFACILITY NUMBER:
334845544
ADMINISTRATOR:GHOLIPOOR,MEHRNAZFACILITY TYPE:
810
ADDRESS:41859 SKYWOOD DR.TELEPHONE:
(951) 506-1915
CITY:TEMECULASTATE: CAZIP CODE:
92591
CAPACITY:14CENSUS: 9DATE:
04/04/2024
UNANNOUNCEDTIME BEGAN:
12:48 PM
MET WITH:Mehrnaz Gholipoor (Mary) TIME COMPLETED:
01:24 PM
ALLEGATION(S):
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Licensee forced fed a minor while in care
Licensee yells at the daycare children
INVESTIGATION FINDINGS:
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On April 04, 2024, at 12:48 PM, Licensing Program Analyst’s (LPAs) Anastasia Flores and Gabriel Hernandez arrived for the purpose of delivering the findings of the above stated allegations. On February 2, 2024 at 9:42 AM, LPA’s Flores and Hamilton conducted a health and safety inspection of the facility and some concerns were noted and Licensee was asked to immediately correct. Copies of the child roster, photos of facility, was obtained. Confidential interviews were conducted as well as an interview with licensee.
On January 25, 2024, this agency received an allegation that licensee forced fed a minor while in care, and licensee yells at daycare children in care. Confidential interviews disclosed that licensee makes children sit during mealtimes and makes children eat before getting up. Other confidential interviews revealed that licensee only puts food in the mouth of the infants in care. Interview with licensee disclosed that if a child does not want to eat what was made for a meal, she will offer other items to ensure the children do not go hungry. It was reported that licensee has been heard disciplining a child in a very stern/mean voice. Confidential interviews disclosed that licensee yells at the children in care for having accidents during naptime or wearing diapers instead of pullups when being potty trained. Interview with licensee denied allegation of yelling at children in care. Other confidential interviews denied allegation that licensee yells at the children in care, and that they feel safe in the facility.

Based on interviews the allegations that licensee forced fed a minor while in care, and licensee yells at the day care children, are unsubstantiated meaning that although the allegations may have happened or is valid there is not a preponderance of evidence to prove the alleged violations did or did not occur.

An exit interview was conducted and copy of this report, appeal rights and Notice of Site Visit were provided to licensee. Licensee was reminded that the Notice of Site Visit must be posted in the facility in a visible area for 30 days.

Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Pauline Beschorner
LICENSING EVALUATOR NAME: Anastasia Flores
LICENSING EVALUATOR SIGNATURE:

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

DATE: 04/04/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 4 of 5
Control Number 10-CC-20240125142252
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501
FACILITY NAME: GHOLIPOOR FAMILY CHILD CARE
FACILITY NUMBER: 334845544
VISIT DATE: 04/04/2024
NARRATIVE
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It was reported that licensee has been heard disciplining a child in a very stern/mean voice. Confidential interviews disclosed that licensee yells at the children in care for having accidents during naptime or wearing diapers instead of pullups when being potty trained. Interview with licensee denied allegation of yelling at children in care. Other confidential interviews denied allegation that licensee yells at the children in care, and that they feel safe in the facility.

Based on interviews the allegations that licensee forced fed a minor while in care, and licensee yells at the day care children, are unsubstantiated meaning that although the allegations may have happened or is valid there is not a preponderance of evidence to prove the alleged violations did or did not occur.

An exit interview was conducted and copy of this report, appeal rights and Notice of Site Visit were provided to licensee. Licensee was reminded that the Notice of Site Visit must be posted in the facility in a visible area for 30 days.
SUPERVISORS NAME: Pauline Beschorner
LICENSING EVALUATOR NAME: Anastasia Flores
LICENSING EVALUATOR SIGNATURE:

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

DATE: 04/04/2024
LIC9099 (FAS) - (06/04)
Page: 5 of 5
Control Number 10-CC-20240125142252
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501

FACILITY NAME: GHOLIPOOR FAMILY CHILD CARE
FACILITY NUMBER: 334845544
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/04/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
05/04/2024
Section Cited
CCR
102423(a)(4)
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102423(a)(4) Personal Rights: Each child receiving services from a family childcare home shall have certain rights that shall not be waived or abridged by the licensee regardless of consent or authorization from the child's authorized representative. These rights include, but are not limited to, the following: To be free from corporal or unusual punishment, infliction of pain, humiliation, intimidation, ridicule, coercion, threat, mental abuse, or other actions of a punitive nature, including, but not limited to: interference with eating, sleeping or toileting; or withholding shelter, clothing, medication or aids to physical functioning. This was not met as evidenced by….
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Licensee will take a course on personal rights for children in care and infant safe sleep course. Licensee will look up courses through RCOE due to having subsidized children and submit proof of course taken to LPA Flores by 5/04/24
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Based on confidential interviews with six out of nine children in care, stated that licensee places children in time out in a separate room, described as the room the babies sleep in. This is a potential health, safety, and personal rights risk to children in care.
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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: Pauline Beschorner
LICENSING EVALUATOR NAME: Anastasia Flores
LICENSING EVALUATOR SIGNATURE:

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

DATE: 04/04/2024
LIC9099 (FAS) - (06/04)
Page: 3 of 5