Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 376627064
Report Date: 04/30/2019
Date Signed: 04/30/2019 05:18:29 PM


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108
This is an official report of an unannounced visit/investigation of a complaint received in our office on
04/09/2019 and conducted by Evaluator Vicky Williamson
PUBLIC
COMPLAINT CONTROL NUMBER: 20-CC-20190409181515
FACILITY NAME:GHOLAMI, GHOLAM & HOSEINI, MARYAM FCCFACILITY NUMBER:
376627064
ADMINISTRATOR:MARYAM H,& GHOLAMI GHOLAMFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(619) 792-8995
CITY:EL CAJONSTATE: CAZIP CODE:
92019
CAPACITY:14CENSUS: 5DATE:
04/30/2019
UNANNOUNCEDTIME BEGAN:
04:05 PM
MET WITH:Maryam HoseiniTIME COMPLETED:
05:30 PM
ALLEGATION(S):
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Facility operating overcapacity
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Vicky Williamson conducted an unannounced complaint inspection for the purpose of delivering complaint findings in regard to the above allegation. LPA met with Licensee, Maryam Hoseini and Co-licensee Gholam Gholami. Also present during the time of inspection were applicant's two minor children (ages 8 and 12 years) and adult daughter Zahra Gholami who aided as a translator due to applicant's primary language being Farsi. There were 4 children (1 of whom is under 24 months of age) present during time of inspection. It was alleged that the facility is operating over capacity. Interviews were conducted with licensee, co-licensee, licensee’s daughter Zahra Gholami, outside agencies, and day care parents. Documentation obtained from an outside agency provides proof that during the month of February, between approximately 3:30PM and 3:50PM on Monday – Thursday, licensees provided care to 16 children at one time which included 4 infants. On February 19, 21, 25 and 26 between the hours of 3:30PM and 3:50PM, licensees exceeded license capacity by providing care for a total of 18 children (ages 2 weeks old - 9 years of age, 4 of whom were under 24 months) at one time. Licensees’ current Family Child Care license specifies a capacity for 14 children. On the same above dates, between the hours of 6:00PM and 6:30PM, licensees exceeded capacity by providing care for a total of 15 children (ages 1 years - 11 years of age, 2 of whom were under 24 months) at one time.
Substantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Tulam VuTELEPHONE: (619) 767-2212
LICENSING EVALUATOR NAME: Vicky WilliamsonTELEPHONE: (619) 767-2214
LICENSING EVALUATOR SIGNATURE:

DATE: 04/30/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/30/2019
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 20-CC-20190409181515
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108

FACILITY NAME: GHOLAMI, GHOLAM & HOSEINI, MARYAM FCC
FACILITY NUMBER: 376627064
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/30/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
05/06/2019
Section Cited
CCR
102416.5(f)
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Staffing Ratio and Capacity.The total licensed capacity for a Large Family Child Care Home shall not exceed fourteen children. Requirement is not met as evidence by: Based on Licensees own admission and LPA's review of documentation obtained from an outside agency, it was determined that on February 19, 21, 25 and 26 between the hours of 3:30PM and 3:50PM, licensees exceeded
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Licensees states that they will review regulation section 102416.5 (f) Staffing Ratio and Capacity and submit a sign copy of regulation to the Department. In addition, both licensees shall submit a written statement








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license capacity by providing care for a total of 18 children (ages 2 weeks old - 9 years of age, 4 of whom were under 24 months) at one time. Licensees’ current Family Child Care license specifies a capacity for 14 children. On the same above dates, between the hours of 6:00PM and 6:30PM, licensees exceeded capacity by providing care for a total of 15 children (ages 1 years - 11 years of age, 2 of whom were under 24 months) at one time. This poses an immediate health and safety risk to children in care.
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explaining how they will eliminate the facility from becoming overcapacity and a list of the children enrolled and their scheduled hours of attendance, no later than 5/6/19.




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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: Tulam VuTELEPHONE: (619) 767-2212
LICENSING EVALUATOR NAME: Vicky WilliamsonTELEPHONE: (619) 767-2214
LICENSING EVALUATOR SIGNATURE:

DATE: 04/30/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/30/2019
LIC9099 (FAS) - (06/04)
Page: 3 of 3
Control Number 20-CC-20190409181515
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108
FACILITY NAME: GHOLAMI, GHOLAM & HOSEINI, MARYAM FCC
FACILITY NUMBER: 376627064
VISIT DATE: 04/30/2019
NARRATIVE
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Licensee and Co-Licensee acknowledged that on the above dates they exceeded current Family Child Care license and were over capacity. LPA, licensee and co-licensee discussed capacity/ratio for a large Family Child Care homes and capacity/ratio pamphlet was provided to licensees.

Based on licensee’s admission, interviews with witnesses, day care parents, and documentation from outside agency obtained and reviewed the preponderance of evidence standard has been met that the facility operated over capacity, therefore the allegation is found to be SUBSTANTIATED.

California Code of Regulations, Title 22, Division 12, Chapter 3, is being cited on the attached LIC 9099D.

Licensee was provided appeal rights (LIC 9058 01/16) and their signature on this form acknowledges receipt of these rights. Notice of Site Visit (LIC 9213) was provided to be posted at the facility for 30 days. LPA observed form LIC 9213 posted.

AB633 requires upon receipt, Licensee shall post (observed by LPA) and provide copies of this licensing report to parents/guardians of children in care at the facility and to parents/guardians of children newly enrolled at the facility during the next 12 months. An Acknowledgment of Receipt of Licensing Reports, Form LIC 9224 must be signed and placed in each child’s file.
SUPERVISOR'S NAME: Tulam VuTELEPHONE: (619) 767-2212
LICENSING EVALUATOR NAME: Vicky WilliamsonTELEPHONE: (619) 767-2214
LICENSING EVALUATOR SIGNATURE:

DATE: 04/30/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/30/2019
LIC9099 (FAS) - (06/04)
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