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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 503911462
Report Date: 05/16/2022
Date Signed: 05/16/2022 01:24:13 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, 1310 E. SHAW AVE,
FRESNO, CA 93710
This is an official report of an unannounced visit/investigation of a complaint received in our office on
04/05/2022 and conducted by Evaluator Luisa Gavoutian
PUBLIC
COMPLAINT CONTROL NUMBER: 04-CC-20220405104715
FACILITY NAME:NAZARPOUR, DENA FAMILY CHILD CAREFACILITY NUMBER:
503911462
ADMINISTRATOR:NAZARPOUR, DENAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(209) 202-6480
CITY:TURLOCKSTATE: CAZIP CODE:
95382
CAPACITY:14CENSUS: 8DATE:
05/16/2022
UNANNOUNCEDTIME BEGAN:
12:30 PM
MET WITH:Licensee - Dena NazarpourTIME COMPLETED:
01:35 PM
ALLEGATION(S):
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Adult residing in the home was arrested for a crime.
INVESTIGATION FINDINGS:
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On 05/16/2022, Licensing Program Analyst (LPA) Luisa Gavoutian conducted an unannounced complaint visit to provide findings for the above-mentioned allegation. LPA met with Licensee Dena Nazarpour who accompanied LPA during tour of facility inside and took a census.

Investigator Elisia Rippe (Badge #244) with the California Department of Social Services (CDSS) Investigations Branch (IB) conducted the investigation into the above allegation. During the course of the investigation, Investigator Rippe toured the facility, interviewed staff, children, and witnesses, reviewed facility records and police reports. Information obtained from these interviews and reviewed records verify that an adult residing in the Licensee’s home, Adult 1, was arrested for crime(s). On 04/11/2022, Adult 1 was issued an Immediate Exclusion Order, which informed that Adult 1 was not to have contact with clients or be present in any child care center or residential facility licensed by CDSS. Licensee was provided with a copy of this order on the same date. (Continued on LIC 9099-C)

Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Juvenal Moctezuma
LICENSING EVALUATOR NAME: Luisa Gavoutian
LICENSING EVALUATOR SIGNATURE:

DATE: 05/16/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/16/2022
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 04-CC-20220405104715
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1310 E. SHAW AVE,
FRESNO, CA 93710
FACILITY NAME: NAZARPOUR, DENA FAMILY CHILD CARE
FACILITY NUMBER: 503911462
VISIT DATE: 05/16/2022
NARRATIVE
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Based upon observations and information gathered through interviews, the preponderance of evidence standard has been met, therefore the above allegation is found to be substantiated.

LPA Gavoutian informed licensee Dena Nazarpour that this report dated 05/16/2022 documents one Type A citation which shall be posted for 30 consecutive days as there is immediate risk to the health, safety, or personal rights of children in care.

Also, LPA Gavoutian informed the licensee to provide a copy of this licensing report dated 05/16/2022 that documents any Type A citation to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification.

Exit interview conducted and report was reviewed with the licensee Dena Nazarpour.
A notice of site visit was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.
SUPERVISORS NAME: Juvenal Moctezuma
LICENSING EVALUATOR NAME: Luisa Gavoutian
LICENSING EVALUATOR SIGNATURE:

DATE: 05/16/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/16/2022
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 04-CC-20220405104715
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1310 E. SHAW AVE,
FRESNO, CA 93710

FACILITY NAME: NAZARPOUR, DENA FAMILY CHILD CARE
FACILITY NUMBER: 503911462
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/16/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
05/16/2022
Section Cited
HSC
1596.8897(a)(2)
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The department may prohibit… a licensee from… allowing in a licensed facility, or allowing contact with clients of a licensed facility by, any… person who... has: (2) Engaged in conduct that is inimical to the health, morals, welfare, or safety of either an individual in or receiving services from the
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Licensee stated that Adult 1 is no longer residing in the home and is not allowed in the home. Licensee submitted a written statement confirming Adult 1’s removal from the home, and how she ensures that Adult 1 does not return to the home.
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facility.... This requirement was not met as evidenced by: Based on interviews and records reviewed, Licensee did not meet the section cited above in that Adult 1, who was residing in the home, was arrested for crime(s), which poses an immediate risk to the health, safety, or personal rights of children.
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An informal meeting will be scheduled at the Fresno Child Care Regional Office in the near future.
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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: Juvenal Moctezuma
LICENSING EVALUATOR NAME: Luisa Gavoutian
LICENSING EVALUATOR SIGNATURE:

DATE: 05/16/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/16/2022
LIC9099 (FAS) - (06/04)
Page: 3 of 3