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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 393620834
Report Date: 09/18/2026
Date Signed: 09/18/2026 12:09:25 PM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO S. CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
This is an official report of an unannounced visit/investigation of a complaint received in our office on
09/16/2026 and conducted by Evaluator Stacey Williams
PUBLIC
COMPLAINT CONTROL NUMBER: 53-CC-20260916151245
FACILITY NAME:RAI, SUSHMA KUMARIFACILITY NUMBER:
393620834
ADMINISTRATOR:RAI, SUSHMA KUMARIFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(209) 666-3021
CITY:MOUNTAIN HOUSESTATE: CAZIP CODE:
95391
CAPACITY:14CENSUS: 5DATE:
09/18/2026
UNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Sushma Kumari RaiTIME COMPLETED:
12:15 PM
ALLEGATION(S):
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License: Licensee is providing care in the off-limits garage
INVESTIGATION FINDINGS:
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On September 18, 2026, Licensing Program Analysts (LPAs) Stacey Williams and Elvira Sierra met with Licensee, Sushma Kumari Rai for the purpose of a complaint investigation. LPAs observed Licensee and her Assistant supervising five children. Licensee's husband was also present in the home.

LPAs obtained a facility roster and toured the home including the garage. LPAs discussed the complaint allegation with the Licensee. It was alleged that the Licensee is providing care in the garage; which when licensed for a large capacity was deemed off limits. Licensee acknowledged there were approximately eight days that she operated the childcare in her garage.

LPA Williams informed Licensee, Sushma Kumari Rai, this report dated 9/18/2026 documents 1 Type-A citation.


Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Bettina Engelman
LICENSING EVALUATOR NAME: Stacey Williams
LICENSING EVALUATOR SIGNATURE:

DATE: 09/18/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/18/2026
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 53-CC-20260916151245
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO S. CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME: RAI, SUSHMA KUMARI
FACILITY NUMBER: 393620834
VISIT DATE: 09/18/2026
NARRATIVE
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LPA Williams informed the Licensee to provide a copy of this licensing report dated 9/18/2026 that documents any Type-A citation 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.


Exit interview was conducted, and the report was reviewed with Licensee Susham Kumari Rai, Appeal rights were provided.

A notice of site visit was posted and must remain posted on, or immediately adjacent to, the interior side of the main door for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100
SUPERVISORS NAME: Bettina Engelman
LICENSING EVALUATOR NAME: Stacey Williams
LICENSING EVALUATOR SIGNATURE:

DATE: 09/18/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/18/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 53-CC-20260916151245
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO S. CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

FACILITY NAME: RAI, SUSHMA KUMARI
FACILITY NUMBER: 393620834
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/18/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
09/21/2026
Section Cited
CCR
102416.3(a)(6)
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(a) Prior to making alterations or additions to a family child care home or grounds, the licensee shall notify the Department of the proposed changed, including, but not limited to, the following:(6) Any change from an area of the family child care home previously identified as "off limits" to an area where care and supervision will be provided to children in care.
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Licensee will no longer use the garage in any capacity for daycare. Licensee will provide written statement to CCL by plan of correction date that the mentioned above items have been done.
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This requirement was not met as evidenced by: Licensee used the off limits garage area as daycare space to provide care and supervision to children. This is an immediate risk to the health and safety of children in care.
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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: Bettina Engelman
LICENSING EVALUATOR NAME: Stacey Williams
LICENSING EVALUATOR SIGNATURE:

DATE: 09/18/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/18/2026
LIC9099 (FAS) - (06/04)
Page: 3 of 3