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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 414004999
Report Date: 10/10/2025
Date Signed: 10/10/2025 10:07:35 AM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN BRUNO CC RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
This is an official report of an unannounced visit/investigation of a complaint received in our office on
08/26/2025 and conducted by Evaluator Maria Olguin-Leon
COMPLAINT CONTROL NUMBER: 05-CC-20250826085220
FACILITY NAME:GHASEMZADEH, MOJGANFACILITY NUMBER:
414004999
ADMINISTRATOR:GHASEMZADEH, MOJGANFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(949) 545-1402
CITY:REDWOOD CITYSTATE: CAZIP CODE:
94061
CAPACITY:12CENSUS: 7DATE:
10/10/2025
UNANNOUNCEDTIME BEGAN:
08:30 AM
MET WITH:Mojgan GhasemzadehTIME COMPLETED:
10:15 AM
ALLEGATION(S):
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Licensee is advertising without listing facility number

INVESTIGATION FINDINGS:
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On October 10, 2025, at approximately 8:30am, Licensing Program Analyst (LPA) Maria Olguin-Leon conducted an unannounced complaint investigation to deliver the findings of the above allegation. LPA met with licensee, Mojgan Ghasemzadeh. Present during the inspection was licensee and assistant caring for 7 children (4 infants & 3 preschool age). Facility is operating within capacity of staff/child ratios. All adults present are fingerprint cleared and associated to the facility.

During the course of the investigation, LPA conducted interviews and reviewed pertinent documentation and conducted observations. Based on information gathered the allegation, Licensee is advertising without listing facility number, was determined to be SUBSTANTIATED.

LPA based determination on observations of advertisement banner on home and internet advertising, which did not include licensee’s facility number as required by title 22 regulations. Therefore, the allegation was determined to be SUBSTANTIATED, the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED.

Please see page LIC9099D for type B deficiency being cited today, under California Code of Regulations, Title 22, Division 12, Chapter 1.

Exit interview conducted and report was reviewed with Licensee, Mojgan Ghasemzadeh.Appeal rights were provided.
.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Marie Rodriguez
LICENSING EVALUATOR NAME: Maria Olguin-Leon
LICENSING EVALUATOR SIGNATURE:

DATE: 10/10/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/10/2025
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 05-CC-20250826085220
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN BRUNO CC RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME: GHASEMZADEH, MOJGAN
FACILITY NUMBER: 414004999
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/10/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
10/24/2025
Section Cited
CCR
102359(a)
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102359 Advertisements and License Number (a) Licensees shall reveal each facility license number in all advertisements, publications, or announcements made with the intent to attract clients.

This requirement is not met as evidenced by:
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Licensee will add facility number to banner and will include facility number on online advertisements and on business cards. Licensee will send photos of addition of facility number to advertising to LPA by POC due date.
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Based on observation, interview and record review, the licensee did not comply with the section cited above as
advertisement banner on home and online advertising did not include facility license number, which poses a potential health, safety or personal rights risk to 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: Marie Rodriguez
LICENSING EVALUATOR NAME: Maria Olguin-Leon
LICENSING EVALUATOR SIGNATURE:

DATE: 10/10/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/10/2025
LIC9099 (FAS) - (06/04)
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