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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 334845675
Report Date: 11/17/2021
Date Signed: 11/17/2021 01:24:26 PM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501
This is an official report of an unannounced visit/investigation of a complaint received in our office on
09/03/2021 and conducted by Evaluator Taadhimeka Zeigler
PUBLIC
COMPLAINT CONTROL NUMBER: 09-CC-20210903164853
FACILITY NAME:FAROOQUI FAMILY CHILD CAREFACILITY NUMBER:
334845675
ADMINISTRATOR:FAROOQUI,ASMAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(562) 219-1045
CITY:EASTVALESTATE: CAZIP CODE:
91752
CAPACITY:14CENSUS: 8DATE:
11/17/2021
UNANNOUNCEDTIME BEGAN:
11:20 AM
MET WITH:Asma FarooquiTIME COMPLETED:
01:15 PM
ALLEGATION(S):
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- Day care child sustained an unexplained injury while in care.
- Licensee yelled at day care child.
- Licensee left day care child in soiled diaper for extended period of time.

INVESTIGATION FINDINGS:
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Licensing Program Analysts (LPAs) Taadhimeka Zeigler and Justin Giese arrived at the facility to complete a complaint investigation into the above allegations. LPAs met with Licensee, Asma Farooqui. LPAs discussed the purpose of the visit. The facility was toured and the census was taken.

During the investigation, LPA Zeigler reviewed facility documentation and conducted interviews with children and Licensee. It was alleged that day care child sustained an unexplained injury while in care, Licensee yelled at day care child, and Licensee left day care child in a soiled diaper for extended period of time.

Interviews revealed conflicting information regarding the above allegations.
Con't on LIC9099C
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Kimberly Williams
LICENSING EVALUATOR NAME: Taadhimeka Zeigler
LICENSING EVALUATOR SIGNATURE:

DATE: 11/17/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/17/2021
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 2
Control Number 09-CC-20210903164853
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501
FACILITY NAME: FAROOQUI FAMILY CHILD CARE
FACILITY NUMBER: 334845675
VISIT DATE: 11/17/2021
NARRATIVE
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Licensee denies that the child sustained any injuries while in care and the child did not leave the facility injured with a cut on the leg. Licensee stated that the child's diaper was changed about two hours before the child was picked up and there was no injury or cut on the child's leg. Licensee denies yelling at any children in care. Licensee also denies leaving day care child in a soiled diaper for an extended period of time. Licensee stated that the child was dropped off without diapers, however, Licensee had two spare diapers and used them to change the child. The child was dropped off around 10:00 am and picked up at 7:00 pm. Licensee changed the child's diaper twice that day, between 11:00 am and 12:00 pm, then again between 4:00 pm and 5:00 pm. Per Licensee, the child went to sleep after the last diaper change and when the child awoke, the parents arrived to pick up the child, and the child's diaper was not soiled at that time.

Based on the information obtained during this investigation, it has been determined that although the allegations may have happened or is valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegations are UNSUBSTANTIATED.

No deficiencies are being cited at this time. An exit interview was conducted, appeal rights were issued and discussed, and a copy of this report and a Notice of Site was provided to the Director.

This report must be available to the public for three years.
SUPERVISORS NAME: Kimberly Williams
LICENSING EVALUATOR NAME: Taadhimeka Zeigler
LICENSING EVALUATOR SIGNATURE:

DATE: 11/17/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/17/2021
LIC9099 (FAS) - (06/04)
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