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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 376625549
Report Date: 06/13/2023
Date Signed: 06/13/2023 01:43:38 PM

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
06/08/2023 and conducted by Evaluator Selina Siao
PUBLIC
COMPLAINT CONTROL NUMBER: 51-CC-20230608082543
FACILITY NAME:EDRISAVIFEYAH, MALIHA FAMILY CHILD CAREFACILITY NUMBER:
376625549
ADMINISTRATOR:MALIHA EDRISAVIFEYAHFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(858) 705-9138
CITY:SAN DIEGOSTATE: CAZIP CODE:
92127
CAPACITY:14CENSUS: 26DATE:
06/13/2023
UNANNOUNCEDTIME BEGAN:
09:17 AM
MET WITH:Maliha EndrisavifeyahTIME COMPLETED:
10:30 AM
ALLEGATION(S):
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Facility is operating out of capacity
INVESTIGATION FINDINGS:
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On 06/13/2023 at 9:17am, Licensing Program Analyst (LPA) Selina Siao conducted an unannounced inspection to investigate the above allegation. Upon arrival, LPA met with licensee who unlocked the front gate lock for LPA to enter into the house. Upon arrival there were 11 children in the living room with helper Sanaz Aflaki. During the inspection LPA requested to tour the rest of the home due to the nature of the allegation. LPA observed 15 additional children including infants in a hallway room that leads to the sideyard with helpers Shirin Arya and Leyla Peirovisangari. There are a total of 26 children including 9 infants and no school age in care today. Licensee stated that 9 of the kids are guest/drop in only. Based on LPA’s observations the preponderance of evidence standard has been met, therefore the above allegation is found to be substantiated, California Code of Regulations, 102416.5(a) is being cited on the attached LIC 9099D. Licensee shall provide copies of this document to parents/guardians of children in care and to parents/guardians of children newly enrolled at the facility during the next 12 months. Appeal Rights were discussed and provided. Notice of Site Visit was posted during this visit and it shall remain posted for 30 days.

Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Monica Cuddy
LICENSING EVALUATOR NAME: Selina Siao
LICENSING EVALUATOR SIGNATURE:

DATE: 06/13/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/13/2023
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 2
Control Number 51-CC-20230608082543
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: EDRISAVIFEYAH, MALIHA FAMILY CHILD CARE
FACILITY NUMBER: 376625549
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/13/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
06/14/2023
Section Cited
CCR
102416.5(a)
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Staffing Ratio and Capacity
The capacity specified on the license shall be the maximum number of children for whom care may be provided at any one time.
This requirement is not met as evidence by:
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Licensee was provided with the capacity chart for a large license today. She stated that she understands that she cannot operate beyond the terms of her license. She understands that she
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LPA observed 26 children including 9 infants and no school age in care supervised by licensee and three helpers. This poses an immediate health and safety risk to clients in care.

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can only care for 12 children and no more than 4 infants at any given time. Licensee stated that she will talk to the parents and let LPA know which children will stay in her care by 06/14/2023.
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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: Monica Cuddy
LICENSING EVALUATOR NAME: Selina Siao
LICENSING EVALUATOR SIGNATURE:

DATE: 06/13/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/13/2023
LIC9099 (FAS) - (06/04)
Page: 2 of 2