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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 334845544
Report Date: 02/20/2025
Date Signed: 02/20/2025 03:45:52 PM

Document Has Been Signed on 02/20/2025 03:45 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: 7DATE:
02/20/2025
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
03:10 PM
MET WITH:Mehrnaz GholipoorTIME VISIT/
INSPECTION COMPLETED:
04:00 PM
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On February 20, 2025, at 3:10PM, Licensing Program Analyst (LPA) William Chancellor arrived unannounced to Gholipoor Family Childcare (FCCH). LPA was greeted by Licensee, Mehrnaz Gholipoor and LPA shared the reason for the visit was to conduct a case management visit, regarding the terms of facilities current probationary license and outstanding fee's.

To remain in substantial compliance, licensee agrees to pay the outstanding fee's immediately. LPA provided a contact to the accounting department to confirm if original payment was received when sent in December 2024. Licensee stated they will send a new payment immediately if the original payment was not received. Licensee stated they agree and understand the terms of the probationary licensee valid through February 20, 2027.

A census of seven (7) children were present during inspection, including two (2) infants and one (1) assistant. No deficiencies were cited during this visit.

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: 02/20/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/20/2025
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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