Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 197419929
Report Date: 04/23/2019
Date Signed: 04/23/2019 09:26:13 AM


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
This is an official report of an unannounced visit/investigation of a complaint received in our office on
02/26/2019 and conducted by Evaluator Marina Pilossian
PUBLIC
COMPLAINT CONTROL NUMBER: 30-CC-20190226123520
FACILITY NAME:MUSICAL GANFACILITY NUMBER:
197419929
ADMINISTRATOR:SORAYA SADIGHIMFACILITY TYPE:
850
ADDRESS:13624 BURBANK BLVDTELEPHONE:
(818) 786-7800
CITY:SHERMAN OAKSSTATE: CAZIP CODE:
91401
CAPACITY:36CENSUS: 0DATE:
04/23/2019
UNANNOUNCEDTIME BEGAN:
08:00 AM
MET WITH:Sapir AdaniTIME COMPLETED:
09:30 AM
ALLEGATION(S):
1
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9
1) Physical Plant: Facility has bugs
2) Personal Rights: Facility staff failed to assist child with toileting
3) Physical Plant: Facility is unkempt
INVESTIGATION FINDINGS:
1
2
3
4
5
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13
Licensing Program Analyst (LPA) Marina Pilossian conducted a visit to the facility for the purpose of delivering the findings on the above allegations. LPA met with licensee/owner Ms. Sapir Adani. The facility is closed for a week. LPA contacted the licensee and licensee met with LPA on 4/23/19 at 8: 30am. LPA and licensee toured the facility inside and outside. LPA did not observe any children at the facility due to being closed for Jewish Holiday.

Based upon the evidence obtained through the course of reviewing documentations and interviews, there is insufficient evidence to support or disprove that the facility has bugs, facility staff failed to assist child with toileting, and facility is unkept. Therefore, the allegations have been determined unsubstantiated. A finding that the complaint is unsubstantiated means that although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violation occurred.
An exit interview was conducted, and a copy of this report was provided to the licensee.
Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Mary RuizTELEPHONE: (424) 301-3061
LICENSING EVALUATOR NAME: Marina PilossianTELEPHONE: (424) 301-3065
LICENSING EVALUATOR SIGNATURE:

DATE: 04/23/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/23/2019
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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