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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 376620667
Report Date: 06/13/2024
Date Signed: 06/13/2024 10:31:43 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, 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
06/04/2024 and conducted by Evaluator Patrick Ma
PUBLIC
COMPLAINT CONTROL NUMBER: 51-CC-20240604121309
FACILITY NAME:ARSALAN, SADAF FAMILY CHILD CAREFACILITY NUMBER:
376620667
ADMINISTRATOR:SADAF ARSALANFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(858) 222-1997
CITY:CARLSBADSTATE: CAZIP CODE:
92010
CAPACITY:14CENSUS: 8DATE:
06/13/2024
UNANNOUNCEDTIME BEGAN:
08:50 AM
MET WITH:Sadaf ArsalanTIME COMPLETED:
10:45 AM
ALLEGATION(S):
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Licensee is using an off limit area for the daycare children
INVESTIGATION FINDINGS:
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On 6/13/24 at 8:50AM LPA Patrick Ma made an unannounced visit to initiate an investigation, for the complaint received on 6/4/24, regarding the above allegation. LPA met with Helpers Erica Silva and Neyva Hernandez and explained purpose of visit. Licensee, Sadaf Arsalan, was not present but was contacted by phone during inspection. Present in the home were 8 daycare children. LPA conducted interviews with staff.

Based on the information obtained during investigation interviews, observations, and video provided to the Department the Licensee was observed using the garage, which is off-limit, to provide child care on at least 3 occasions 12/2/23, 3/14/24, and 5/15/24. Video recorded on 12/2/23 shows young child being feed by a helper in the garage. During todays inspection visit, LPA observed 2 children eating in the garage.

Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Renesha Askew
LICENSING EVALUATOR NAME: Patrick Ma
LICENSING EVALUATOR SIGNATURE:

DATE: 06/13/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/13/2024
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 3
Control Number 51-CC-20240604121309
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108

FACILITY NAME: ARSALAN, SADAF FAMILY CHILD CARE
FACILITY NUMBER: 376620667
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/13/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
06/14/2024
Section Cited
CCR
102416.3(a)(6)
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102416.3(a)(6) Any changes from an area of the family child care home previously identified as "off limits" to an area where care and supervision will be provided to children in care. This requirement was not met as evidenced by:
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Garage was added to license per Licensee’s request as correction to deficiency. Deficiency was cleared during inspection.
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Based on the information obtained during interviews and video Licensee was observed using the garage, which is off-limit, to provide child care on at least 4 occasions 12/2/23, 3/14/24, 5/15/24, and 6/13/24 which poses an immediate health and safety 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: Renesha Askew
LICENSING EVALUATOR NAME: Patrick Ma
LICENSING EVALUATOR SIGNATURE:

DATE: 06/13/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/13/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 51-CC-20240604121309
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108
FACILITY NAME: ARSALAN, SADAF FAMILY CHILD CARE
FACILITY NUMBER: 376620667
VISIT DATE: 06/13/2024
NARRATIVE
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During inspection, Licensee requested to add garage to license. LPA inspected the garage to ensure an environment safe for the care and supervision of children. No hazards were observed and comfortable accommodations such as carpets, activity storage, children’s table and chairs were present in the garage. Garage was added to license during site investigation.

The allegation is valid because the preponderance of the evidence has been met, therefore, the above allegation is found to be SUBSTANTIATED. Deficiency is being cited on the attached LIC 9099D.

Exit interview conducted and report was reviewed with the licensee Sadaf Arsalan and helper....... A notice of site visit was given and must remain posted for 30 days.
SUPERVISORS NAME: Renesha Askew
LICENSING EVALUATOR NAME: Patrick Ma
LICENSING EVALUATOR SIGNATURE:

DATE: 06/13/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/13/2024
LIC9099 (FAS) - (06/04)
Page: 3 of 3