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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 434416773
Report Date: 07/20/2026
Date Signed: 07/20/2026 03:00:06 PM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN JOSE CC RO, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
This is an official report of an unannounced visit/investigation of a complaint received in our office on
07/15/2026 and conducted by Evaluator Marilou Monico
PUBLIC
COMPLAINT CONTROL NUMBER: 07-CC-20260715120615
FACILITY NAME:FARAHMAND POOR, ROZHINFACILITY NUMBER:
434416773
ADMINISTRATOR:ROZHIN, FARAHMAND POORFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(669) 251-6021
CITY:CUPERTINOSTATE: CAZIP CODE:
95014
CAPACITY:14CENSUS: 4DATE:
07/20/2026
UNANNOUNCEDTIME BEGAN:
01:20 PM
MET WITH:Rozhin Farahmand PoorTIME COMPLETED:
03:10 PM
ALLEGATION(S):
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Licensee does not ensure the home is in good repair.
INVESTIGATION FINDINGS:
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On July 20, 2026, Licensing Program Analyst (LPA) Marilou Monico made an unannounced complaint inspection. Present in the home when LPA arrived were Licensee's mom (A1), Licensee's adult helper (S1), and four daycare children including one infant and three preschool age. Licensee, Rozhin Farahmand Poor, arrived during the inspection and met with LPA.

LPA toured the home and conducted observations. LPA interviewed Licensee. Licensee stated that the chipped paint was identified by a parent during a tour of the home the previous week. The Licensee further stated that she temporarily covered the areas of chipped paint with tape and no children enrolled are using the cribs.

During the inspection, LPA observed chipped paint on the window frame within arm's reach of the child's crib in Bedroom 1. LPA observed no children present in Bedroom 1. Based on record review, the youngest child enrolled is 20 months old.

Based on interview and LPA's observations, the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Adam Hamer
LICENSING EVALUATOR NAME: Marilou Monico
LICENSING EVALUATOR SIGNATURE:

DATE: 07/20/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/20/2026
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 07-CC-20260715120615
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN JOSE CC RO, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME: FARAHMAND POOR, ROZHIN
FACILITY NUMBER: 434416773
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/20/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
07/27/2026
Section Cited
CCR
102417(g)
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Operation of a Family Child Care Home - (g) The home shall be free from defects or conditions which might endanger a child.

This requirement is not met as evidenced by:
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Licensee states that she will submit proof of repair by 07/27/26.
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LPA observed chipped paint on the window frame within arm's reach of the child's crib in Bedroom 1. This poses a potential risk to the health, safety, and personal rights 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.
SUPERVISOR'S NAME: Adam Hamer
LICENSING EVALUATOR NAME: Marilou Monico
LICENSING EVALUATOR SIGNATURE:

DATE: 07/20/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/20/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 2