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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 434416923
Report Date: 10/08/2025
Date Signed: 10/08/2025 10:23:39 AM

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
09/19/2025 and conducted by Evaluator Jennifer Beehler
COMPLAINT CONTROL NUMBER: 07-CC-20250919143454
FACILITY NAME:JAFARNEJAD, KAVEHFACILITY NUMBER:
434416923
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY:8CENSUS: DATE:
10/08/2025
UNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Kaveh Jafarnejad - LicenseeTIME COMPLETED:
10:45 AM
ALLEGATION(S):
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Licensee does not reside in the home child care is provided
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Jennifer "Jen" Beehler conducted an unannounced Complaint investigation. Upon arrival, LPA was greeted by the Licensee and provided access to the facility. LPA conducted a visual inspection of the facility and collected the census.

There were two infants and three preschool aged children present with two staff which is compliant with the ratio and capacity requirements.

On 09/25/2025, an investigation was opened. LPA interviewed staff, observed the facility and collected relevant documentation. During this investigation, it was revealed that the licensee does not reside in the home through the absence of personal items such as a body towels and through observations of the licensee arriving to the facility after it opened. The Department has determined the preponderance of evidence standard has been met, therefore the above allegation is SUBSTANTIATED.

Due to this investigation, a deficiency has been cited. More details provided on the attached LIC9099-D. Exit interview conducted with Licensee, Kevah Jafarnejad. Report was reviewed and provided along with appeal rights. NOTICE OF SITE VISIT PROVIDED AND MUST REMAIN POSTED FOR 30 DAYS.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Jennifer Beehler
LICENSING EVALUATOR SIGNATURE:

DATE: 10/08/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/08/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
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Control Number 07-CC-20250919143454
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: JAFARNEJAD, KAVEH
FACILITY NUMBER: 434416923
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/08/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
10/17/2025
Section Cited
HSC
1597.45(f)
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H&S Small Family Day Care Homes (f) For purposes of this chapter, “small family day-care home or large family day-care home” includes a detached single-family dwelling, a townhouse, a dwelling unit within a dwelling, or a dwelling unit within a covered multi family dwelling in which the underlying zoning allows for residential uses. A small family day-care home or large family day-care home is where the family day-care provider resides, and includes a dwelling or dwelling unit that is rented, leased, or owned.
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Moving in more personal possessions effective 10/17/2025. Licensee will send photograph by POC date.
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This requirement has not been met as evidenced by: LPA observed licensee arriving to the facility in the morning from an alternate location after the day care facility was opened. LPA observed the absence of basic necessities like toothpaste, tooth brush, condiments in the fridge, seasonings in cupboards. Bath towels, extra linens, a dresser to store clothing for licensee or his young child that he stated also lived in the home.
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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: Gladys Kuizon
LICENSING EVALUATOR NAME: Jennifer Beehler
LICENSING EVALUATOR SIGNATURE:

DATE: 10/08/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/08/2025
LIC9099 (FAS) - (06/04)
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