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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 376100135
Report Date: 05/18/2022
Date Signed: 05/18/2022 04:19:05 PM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108
This is an official report of an unannounced visit/investigation of a complaint received in our office on
03/18/2022 and conducted by Evaluator Tyra Block
PUBLIC
COMPLAINT CONTROL NUMBER: 51-CC-20220318095242
FACILITY NAME:ESTTAIFAN, SALLY FAMILY CHILD CAREFACILITY NUMBER:
376100135
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY:8CENSUS: 3DATE:
05/18/2022
UNANNOUNCEDTIME BEGAN:
03:10 PM
MET WITH:TIME COMPLETED:
04:25 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Licensee is operating beyond the terms and conditions of the license
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analyst (LPA), Tyra Block, conducted an unannounced visit for the purpose of dellivering findings for the above allegation. Licensee was not present and no daycare children were in care only licensee's own children and spouse were at the home.
Based on the information obtained during interviews, observations, and documentation reviewed it is determined that allegation is UNSUBSTANTIATED. Although licensee admitted she has been operating over capacity there was no evidence to support that claim. During both visits to the home there were no additional children observed in care besides provider's own children. Since complaint opened, one infant has turned 2 years old, therefore, licensee would be within ratio and provider's husband stated 2 children have been disenrolled. An updated schedule was provided but did not account for licensee's own children and one other child listed on the roster. Children's records were not available for review during this visit.
Although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violation occurred. Appeal Rights (1/16) were discussed and provided. Notice of Site Visit was posted and will remain posted for 30 days.
Licensee's husband signed on her behalf.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Tashima Daniel
LICENSING EVALUATOR NAME: Tyra Block
LICENSING EVALUATOR SIGNATURE:

DATE: 05/18/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/18/2022
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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