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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 334845544
Report Date: 02/11/2025
Date Signed: 02/11/2025 04:27:40 PM

Document Has Been Signed on 02/11/2025 04:27 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVERSIDE SE CC RO, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501
FACILITY NAME:GHOLIPOOR FAMILY CHILD CAREFACILITY NUMBER:
334845544
ADMINISTRATOR/
DIRECTOR:		GHOLIPOOR,MEHRNAZFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(951) 506-1915
CITY:TEMECULASTATE: CAZIP CODE:
92591
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 9DATE:
02/11/2025
TYPE OF VISIT:Case Management - Legal/Non-complianceUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
03:15 PM
MET WITH:Mehrnaz GholipoorTIME VISIT/
INSPECTION COMPLETED:
04:35 PM
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On February 11, 2025, at 3:15PM, Licensing Program Analyst (LPA) William Chancellor and Associate Governmental Program Analyst (AGPA) Breanna Saunders conducted an unannounced case management visit and met with licensee (LIC) Mehrnaz Gholipoor. LIC greeted LPA and AGPA and granted entry into the FCCH. The facility was placed on required visits during a Probationary license issued on February 20, 2023.
A recent Decision and Order issued on January 2, 2025, has extended the probationary license status for an additional two (2) years, effective through February 20, 2027. A probationary license requires strict compliance of all Title 22 Regulations and no repeat violations.

LPA observed that there was appropriate care and supervision during the visit and the facility was within capacity and ratio limitations. A tour of the facility was conducted and a census of nine children was taken. Licensee was present along with an assistant, all adults were appropriately cleared.

No deficiencies were cited during this visit. LPA reviewed stipulations of Decision and Order with Licensee and proof of enrollment in required training's were confirmed.

An exit interview was conducted with Licensee Mehrnaz Gholipoor, where a copy of this report was provided along with Appeal Rights. A Notice of Site Visit was provided, and Licensee stated they understand it must remain posted for 30 consecutive days in a prominent place.
SUPERVISORS NAME: Pauline Beschorner
LICENSING EVALUATOR NAME: William M Chancellor Jr.
LICENSING EVALUATOR SIGNATURE: DATE: 02/11/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/11/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
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