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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 376300064
Report Date: 10/12/2022
Date Signed: 10/12/2022 10:48:02 AM

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
07/12/2022 and conducted by Evaluator Cindy Hamilton
PUBLIC
COMPLAINT CONTROL NUMBER: 10-CC-20220712093152
FACILITY NAME:MOOSAVI-TABARSHIYADE FAMILY CHILD CAREFACILITY NUMBER:
376300064
ADMINISTRATOR:M. MOOSAVI-TABARSHIYADEFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(858) 228-7616
CITY:ESCONDIDOSTATE: CAZIP CODE:
92025
CAPACITY:14CENSUS: 11DATE:
10/12/2022
UNANNOUNCEDTIME BEGAN:
09:40 AM
MET WITH:Mahsan Moosavi-Tabarshiyade, LicenseeTIME COMPLETED:
10:47 AM
ALLEGATION(S):
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Facility did not report an outbreak as required
INVESTIGATION FINDINGS:
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On October 12, 2022, at 10:28 a.m., Licensing Program Analyst (LPA), Cindy Hamilton met with licensee Mahsan Moosavi-Tabarshiyade (FCCH) to deliver the findings for the above stated allegation.  During the investigation, LPA Hamilton conducted interviews with three staff and three parents.  LPA Hamilton and LPA Nasha King conducted health and safety inspections of the FCCH on 07/18/2022, 08/04/2022 and 09/20/2022 and no safety concerns were noted.  LPA obtained and reviewed pertinent documents from the facility’s staff and children’s files. LPA Hamilton was unable to interview Parent #5 (P5) due to P5 did not return LPA’s telephone calls.

On July 12, 2022, Community Care Licensing (CCL) received information stating the facility did not report an outbreak as required. It was alleged that licensee did not let parents know that a child in care had Hand, Foot and Mouth disease (HFM) promptly. Licensee confirmed there were at least two cases of HFM on or around May 26, 2022 and other children with symptoms. During complaint investigation, LPA
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Carlos Martinez
LICENSING EVALUATOR NAME: Cindy Hamilton
LICENSING EVALUATOR SIGNATURE:

DATE: 10/12/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/12/2022
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-20220712093152
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: MOOSAVI-TABARSHIYADE FAMILY CHILD CARE
FACILITY NUMBER: 376300064
VISIT DATE: 10/12/2022
NARRATIVE
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conducted a file review that revealed the licensee did not notify the Department of the FCCH’s exposure to the infectious disease. Confidential interviews resulted in conflicting information being provided to LPA regarding parents being provided notification of HFM exposure and LPA was unable to determine whether or not parents were notified by licensee promptly.

Based on confidential interviews and records review, the preponderance of evidence has been met and the allegation that the facility did not report an outbreak as required is substantiated. The FCCH is being cited for Title 22, Section 102416.2 (d) Reporting Requirements which poses a potential health and safety risk to children in care. This requirement was not met as evidenced by records review and confidential interviews that the licensee did not report to the Department that children in care contracted and were exposed to Hand, Foot and Mouth Disease.

An exit interview was conducted, this report, appeal rights and Notice of Site Visit was explained and provided to licensee Licensee was reminded that the “Notice of Site Visit” must be posted for 30 consecutive days. Failure to post will result in Civil Penalties of $100.00.
SUPERVISORS NAME: Carlos Martinez
LICENSING EVALUATOR NAME: Cindy Hamilton
LICENSING EVALUATOR SIGNATURE:

DATE: 10/12/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/12/2022
LIC9099 (FAS) - (06/04)
Page: 5 of 5
Control Number 10-CC-20220712093152
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: MOOSAVI-TABARSHIYADE FAMILY CHILD CARE
FACILITY NUMBER: 376300064
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/12/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
10/18/2022
Section Cited
CCR
102416.2(d)
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102416.2 Reporting Requirements (d) The licensee shall report to the Department as provided by Health and Safety Code Sections 1597.467(b)(1) and (2). This requirement was not met as evidenced by:




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Licensee will submit an unusual incident report in regard to the incident(s) in question. Also, the licensee will submit a letter acknowledging an understanding of reporting requirements. Both documents shall be submitted to the department by October 18, 2022
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Based on confidential interviews and document review, the Licensee did not report to the Department that children in care contracted and were exposed to Hand, Foot and Mouth Disease. This poses a potential risk to health, safety or personal rights of persons 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: Carlos Martinez
LICENSING EVALUATOR NAME: Cindy Hamilton
LICENSING EVALUATOR SIGNATURE:

DATE: 10/12/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/12/2022
LIC9099 (FAS) - (06/04)
Page: 4 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
07/12/2022 and conducted by Evaluator Cindy Hamilton
PUBLIC
COMPLAINT CONTROL NUMBER: 10-CC-20220712093152

FACILITY NAME:MOOSAVI-TABARSHIYADE FAMILY CHILD CAREFACILITY NUMBER:
376300064
ADMINISTRATOR:M. MOOSAVI-TABARSHIYADEFACILITY TYPE:
810
ADDRESS:2002 ALEXANDER DRTELEPHONE:
(858) 228-7616
CITY:ESCONDIDOSTATE: CAZIP CODE:
92025
CAPACITY:14CENSUS: DATE:
10/12/2022
UNANNOUNCEDTIME BEGAN:
09:40 AM
MET WITH:Mahsan Moosavi-Tabarshiyade, LicenseeTIME COMPLETED:
10:47 AM
ALLEGATION(S):
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Facility is operating over capacity
Facility did not separate children with signs of illness from other children
INVESTIGATION FINDINGS:
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On October 12, 2022, at 9:57 a.m., Licensing Program Analyst (LPA), Cindy Hamilton met with licensee Mahsan Moosavi-Tabarshiyade (FCCH) to deliver the findings for the above stated allegations.  During the investigation, LPA Hamilton conducted interviews with three staff and three parents.  LPA Hamilton and LPA Nasha King conducted health and safety inspections of the FCCH on 07/18/2022, 08/04/2022 and 09/20/2022 and no safety concerns were noted.  LPA obtained and reviewed pertinent documents from the facility’s staff and children’s files. LPA Hamilton was unable to interview Parent #5 (P5) due to P5 did not return LPA’s telephone calls.

On July 12, 2022, Community Care Licensing (CCL) received information stating the facility is operating over capacity and the facility did not separate children with signs of illness.  Regarding the allegation that facility is operation over capacity, it was alleged that the facility had 23 children present at one time with two teachers and one assistant. Confidential interviews resulted in LPA being provided conflicting information. Confidential interviews revealed to LPA that the facility has never been over capacity and the


Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Carlos Martinez
LICENSING EVALUATOR NAME: Cindy Hamilton
LICENSING EVALUATOR SIGNATURE:

DATE: 10/12/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/12/2022
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 2 of 5
Control Number 10-CC-20220712093152
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: MOOSAVI-TABARSHIYADE FAMILY CHILD CARE
FACILITY NUMBER: 376300064
VISIT DATE: 10/12/2022
NARRATIVE
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maximum number of children present at the facility at one time was 10 to 13 children; whereas a confidential interview disclosed there were 23 children present at FCCH. In addition, the licensee denies this allegation. The facility is licensed as a large family childcare home, which means the home can have up to 14 children present with an assistant. The licensee has two qualified assistants, who parents stated were frequently seen at the facility even though parents were not allowed inside the FCCH. LPAs Hamilton and LPA King were present at the FCCH and observed 10 children present on 07/18/2022, 13 children present and 14 enrolled; 13 children present on 08/04/2022 and 14 enrolled; and 11 children present on 09/20/2022 and 14 enrolled. LPA Hamilton also observed four infants present on 08/04/2022 and 09/20/2022 with three adults present on both dates.

In regard to the allegation, facility did not separate children with signs of illness from other children, it was alleged that on or around May 26, 2022, the FCCH had a Hand, Foot and Mouth (HFM) outbreak and lice outbreak on an unknown date. It was also alleged that the children with symptoms were still allowed to interact with the other children in care. Licensee confirmed there were two confirmed cases of HFM and those children were picked up by the parent. Again, confidential interviews resulted in conflicting information being provided to LPA. Confidential interviews disclosed to LPA that the child(ren) with symptoms were separated from the other children in care by taking the other children outdoors and were supervised by an adult until the child(ren) with symptoms was picked up by a parent and FCCH cleaned and sanitized; whereas another confidential interview disclosed that the children with symptoms were in the same room and interacting with the other child(ren) in care. Additionally, LPA was advised that the FCCH’s policy is to separate a child who is ill from all children in care until parent arrives to pick-up the child. LPA was also advised that it is the FCCH’s policy for parents to pick-up children that are ill within one hour. In regard to the lice, confidential interview disclosed that a former employee had bed bugs, all the children were checked and did not have bed bugs or lice.

Based on confidential interviews and record reviews, the allegations that facility is operating over capacity and the facility did not separate children with signs of illness, may have occurred, however are not supported or proven by evidence. Therefore, the allegations are unsubstantiated. A copy of this report, appeal rights and Notice of Site Visit were provided to licensee Mahsan Moosavi-Tabarshiyade.

The Notice of Site Visit was posted prior to LPA leaving the facility and the licensee was reminded this notice must be posted for 30 days.
SUPERVISORS NAME: Carlos Martinez
LICENSING EVALUATOR NAME: Cindy Hamilton
LICENSING EVALUATOR SIGNATURE:

DATE: 10/12/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/12/2022
LIC9099 (FAS) - (06/04)
Page: 3 of 5