<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 304313556
Report Date: 01/28/2022
Date Signed: 01/31/2022 07:36:45 AM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
This is an official report of an unannounced visit/investigation of a complaint received in our office on
12/07/2021 and conducted by Evaluator Mahnaz Malek
PUBLIC
COMPLAINT CONTROL NUMBER: 06-CC-20211207090209
FACILITY NAME:YAZDANI, SARA NAZFACILITY NUMBER:
304313556
ADMINISTRATOR:YAZDANI, SARA NAZFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(949) 609-9097
CITY:MISSION VIEJOSTATE: CAZIP CODE:
92692
CAPACITY:14CENSUS: 0DATE:
01/28/2022
UNANNOUNCEDTIME BEGAN:
05:00 PM
MET WITH:LicenseeTIME COMPLETED:
06:00 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Firearm in the home is accessible to day care children.
Drugs in the home are accessible to day care children.
Minor in the home poses a risk to day care children.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Page 1 of 2
Orange County Regional Manager (RM), Bertha Manzanarez and Licensing Program Analyst (LPA) Mahnaz (Nancy) Malek conducted a follow up inspection to deliver the findings. RM and LPA met with licensee, Sara Naz Yazdani. The Covid-19 Emergency Response questionnaire was reviewed and answered. There were a no children present. According to licensee, she had 3 children today. A review of staff records on this date indicated that all facility staff or other individuals who required caregiver background checks have received criminal record and child abuse index clearances or exemptions.
The Orange County Childcare Office received a complaint. The complainant stated that on 12/5/2021 the Orange County Sheriff responded to the facility due to a domestic disturbance call., no children were in care. C#1 threatened to destroy property and beat-up the Licensee. The Deputies confiscated the following items during a search of C#1’s room.
Continued on page 2
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Rina Lopez
LICENSING EVALUATOR NAME: Mahnaz Malek
LICENSING EVALUATOR SIGNATURE:

DATE: 01/28/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/28/2022
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 4
Control Number 06-CC-20211207090209
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
FACILITY NAME: YAZDANI, SARA NAZ
FACILITY NUMBER: 304313556
VISIT DATE: 01/28/2022
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
Page 2 of 2
Ammunitions, semi-automatic shotgun, large amount of cash, drugs items related to identify theft and several cellphones. The Deputies arrested C#1, based on possession of a firearm capable of being concealed and possession of live ammunitions. The licensee informed the Deputy that C#1, helps in the daycare.

The investigation was conducted by Investigator, Ernestina Bellucco from Investigation Bureau (IB). Based on the Police Report which was obtained by Investigator Bellucco, licensee located a firearm while cleaning C# 1’s bedroom when the child was away from home on 12/4/21. C#1’s bedroom is located downstairs and everyone in the house has access to the room. C#1 was released to parents and is currently living in the home. On 01/26/2022 LPA conducted a visit to the home, it was confirmed that C#1 lives in the home, and that licensee is providing care to children. The licensee did not report the police activity to CCL, because she believed that she did not have to because it was on a Sunday and there were no children present. Based on the interviews conducted by Bellucco, information gathered from the law enforcement agency, the above allegations were found to be substantiated.


LPA Malek informed licensee, Licensee, Yazdani, Sara Naz that this report dated 1/28/22 documents 3 Type A citations. Type A citations which shall be posted for 30 consecutive days as there are immediate risks to the health, safety, or personal rights of children in care.

Also, LPA Malek informed the licensee to provide a copy of this licensing report dated 1/28/22 that documents any Type A citation(s) 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.

Please refer to LIC 9099D for the details of deficiencies.
SUPERVISORS NAME: Rina Lopez
LICENSING EVALUATOR NAME: Mahnaz Malek
LICENSING EVALUATOR SIGNATURE:

DATE: 01/28/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/28/2022
LIC9099 (FAS) - (06/04)
Page: 2 of 4
Control Number 06-CC-20211207090209
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME: YAZDANI, SARA NAZ
FACILITY NUMBER: 304313556
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/28/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
01/28/2022
Section Cited
CCR
102423(a)(2)
1
2
3
4
5
6
7
102423(a)(2) Personal Rights- Each child receiving services from a family childcare home shall have certain rights that shall not be waived or........These rights include, but are not limited to, the following: To receive safe, healthful, and comfortable accommodations, furnishings, and equipment. This requirement was not
1
2
3
4
5
6
7
Licensee indicated it would not occur again. She has gone to an agreement with the judge's order. The charges will be deferred pending completion of the program. It will be assessed after completion.
8
9
10
11
12
13
14
met as evidenced by law enforcement agency’s report and our Department’s investigation, C#1 was arrested at the home for possession of a firearm, ammunitions, and drugs. C#1 assist Licensee with the day care. This is an immediate risk to the health and safety of children in care.
8
9
10
11
12
13
14
Type A
01/28/2022
Section Cited
HSC
1596.885(c)
1
2
3
4
5
6
7
Health and Safety Code Section 1596.885(c): Conduct which is inimical to the health, morals, welfare, or safety of either an individual in or receiving services from the facility or the people of this state. This requirement was not met as evidenced by law enforcement agency’s report and our
1
2
3
4
5
6
7
Licensee indicated it would not occur again. She has gone to an agreement with the judge's order. The charges will be deferred pending completion of the program. It will be assessed after completion. There is conditions to the agreement and will be followed up with the probation officer.
8
9
10
11
12
13
14
Department’s investigation, C#1 was arrested at the home for possession of a firearm, ammunitions, items related to identity theft, and drugs. C # 1 resides in the home. This is an immediate risk to the health and safety of children in care.
8
9
10
11
12
13
14
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: Rina Lopez
LICENSING EVALUATOR NAME: Mahnaz Malek
LICENSING EVALUATOR SIGNATURE:

DATE: 01/28/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/28/2022
LIC9099 (FAS) - (06/04)
Page: 3 of 4
Control Number 06-CC-20211207090209
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME: YAZDANI, SARA NAZ
FACILITY NUMBER: 304313556
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/28/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
01/28/2022
Section Cited
HSC
1597.467(C)
1
2
3
4
5
6
7
Health and Safety Code Section 1597.467(C)
Any unusual incident or child absence that threatens the physical or emotional health or safety of any child."
This requirement was not met as evidenced by law enforcement agency’s report and

1
2
3
4
5
6
7
Licensee understands she would report any unusual incidents to our Department within 24 hours in the future. Her signature on this form verifies it.
8
9
10
11
12
13
14
our Department’s investigation, C # 1 was arrested at the home for possession of a firearm, ammunitions, and drugs. Licensee did not report to our Department when founded gun in C#1's room. This is an immediate risk to the health and safety of children in care.
8
9
10
11
12
13
14
1
2
3
4
5
6
7
1
2
3
4
5
6
7
1
2
3
4
5
6
7
1
2
3
4
5
6
7
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: Rina Lopez
LICENSING EVALUATOR NAME: Mahnaz Malek
LICENSING EVALUATOR SIGNATURE:

DATE: 01/28/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/28/2022
LIC9099 (FAS) - (06/04)
Page: 4 of 4