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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 503911462
Report Date: 09/26/2022
Date Signed: 09/26/2022 10:03:29 AM

Document Has Been Signed on 09/26/2022 10:03 AM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
FRESNO-CC, 1310 E. SHAW AVE,
FRESNO, CA 93710
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: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 3DATE:
09/26/2022
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
09:20 AM
MET WITH:Dena NazarpourTIME COMPLETED:
10:15 AM
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On 9/26/22, Licensing Program Analyst, Caroline Harris conducted an unannounced case management visit. LPA met with licensee, Dena Nazarpour and a census was taken. The purpose of this visit was to inform Mrs. Nazarpour that effective 9/5/2022, Noal Nazarpour is excluded from being at the licensed facility. Mrs.Nazarpour was provided a copy of the default Decision and Order that was served on 8/24/2022, verifying Mrs.Nazarpour of the Notice of Exclusion.

Respondent Noal Nazarpour is prohibited from employment in, presence in, contact with clients of, any facility licensed by the Department, certified or approved by a licensed foster family agency, or any resource family home, and from holding the position of member of the board of directors, executive directors, or officer of the licensee of any facility licensed by the Department, for the remainder of Respondents life.

Per Title 22, Division 12, Chapter 3, of the California Code of Regulations, no deficiencies were cited. An exit interview was conducted and a copy of this report was given to Dena Nazarpour. A Notice of Site Visit was posted on the parent board and must remain for 30 days.

SUPERVISORS NAME: Juvenal Moctezuma
LICENSING EVALUATOR NAME: Caroline Harris
LICENSING EVALUATOR SIGNATURE: DATE: 09/26/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/26/2022
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
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