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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 013415534
Report Date: 03/18/2022
Date Signed: 03/18/2022 11:08:22 AM


Document Has Been Signed on 03/18/2022 11:08 AM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612



FACILITY NAME:SALIMEI, OZRAFACILITY NUMBER:
013415534
ADMINISTRATOR:SALIMEI, OZRAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(510) 657-3651
CITY:FREMONTSTATE: CAZIP CODE:
94536
CAPACITY:14CENSUS: DATE:
03/18/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
08:14 AM
MET WITH:Ozra SalimeiTIME COMPLETED:
11:13 AM
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On March 18, 2022 at approximately 8:14am Licensing Program Analyst (LPA) Haderer arrived and met with the licensee Ozra Salimei for the purpose of conducting an unannounced 1-year annual inspection for Health and Safety compliance. Present for today’s inspection was the licensee and 5 children in care (ages 18mo to 3 years-old). Also living in the home are licensee’s fingerprint and TB test cleared husband and their adult son. Hours of operation are Monday -Friday 8:00am 6:00pm.

The facility is a single-story home with 3 bedrooms; 2 bathrooms; living room; family room; dining room; kitchen; laundry room; attached 2-car garage; front, back and side yards. There is water feature fountain in the off-limits area of the back yard, children are never allowed in the area. There is a screened fireplace in the off-limits living room. The home has heating and ventilation for safety and comfort. Per the licensee, the ISOLATION AREA will be in the hallway area away from the other children in care. All required postings are present. The licensee has a friendly small toy poodle (4 months old). Per licensee, the poodle is current with his canine shots.

ON LIMIT AREAS: Master bedroom (converted to a day care area); the master bathroom for children; hallway leading from the front door to the master bedroom; and the enclosed patio area with a picket fence and artificial turf that is accessible only from the master bedroom (day care area). Cabinets in the children’s bathroom have child-proof latched on all doors. Licensee was reminded that other than wipes or things used for the children in the on limits children’s bathroom, they need to be empty of most all items (or locked up) such as cleaning products.



OFF LIMIT AREAS: Remaining 2 bedrooms in the home; main house bathroom; kitchen; living room; family room; dining room; laundry room; attached 2-car garage; and backyard areas outside of the fenced in children’s area. The off-limit areas will be inaccessible by child gates, closed and/or locked doors and adult supervision.
SUPERVISOR'S NAME: Chandra CharlesTELEPHONE: (510) 286-0966
LICENSING EVALUATOR NAME: Russell HadererTELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:
DATE: 03/18/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/18/2022
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME: SALIMEI, OZRA
FACILITY NUMBER: 013415534
VISIT DATE: 03/18/2022
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The home has a fully charged 3A40BC fire extinguisher in the kitchen (lasted tested on 6-17-2021), smoke and carbon monoxide detectors (tested and working) and a working telephone. Fire drills are conducted monthly, the last drill was completed in February 2022.

Licensee has ample age-appropriate toys and learning materials inside and outside the home. The outdoor play area is free from defects and dangerous conditions. Per licensee, there are no firearms in the home. Drop-down cribs are not allowed at the day-care facility. Toxins, medicines, and hazardous items were inaccessible during today's inspection.

At 9:20am, LPA reviewed facility files including records for licensee and Children’s files.

Licensee has required immunizations. CPR/1st Aid was available for licensee, expires 3/9/2022. Mandated Reporter was completed n 6/20/2021. Licensee was reminded that CPR/1st Aide and Mandated Reporter is to be renewed every two years.

Children’s files were complete and well organized. The facility roster was reviewed, and a copy obtained. All files were organized and complete. The licensee owns the property and has liability insurance provided by Farmers Insurance.

Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual – Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. When any IMS is provided, a Plan for Providing IMS must be submitted to the Department. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice)/ (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm

Licensee was reminded that all adults 18 and over living or working in the home, including employees and volunteers, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a licensed Family Child Care Home. A civil penalty of $100.00 minimum/day up to $500.00 maximum per day/per person will be assessed if this regulation is violated.
SUPERVISOR'S NAME: Chandra CharlesTELEPHONE: (510) 286-0966
LICENSING EVALUATOR NAME: Russell HadererTELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:

DATE: 03/18/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/18/2022
LIC809 (FAS) - (06/04)
Page: 2 of 4
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME: SALIMEI, OZRA
FACILITY NUMBER: 013415534
VISIT DATE: 03/18/2022
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LPA discussed the safe sleep regulations with licensee and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed licensee [facility representative] of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

To improve the quality and value of the new inspection process, a survey will be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or tools, please send them by email to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/inspection-process.

There were no deficiencies issued today. The report will remain on file for three years.

A notice of site visit was given and must remain posted for 30 days.



Exit interview conducted and report was reviewed with the licensee Ozra Salimei.
SUPERVISOR'S NAME: Chandra CharlesTELEPHONE: (510) 286-0966
LICENSING EVALUATOR NAME: Russell HadererTELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:

DATE: 03/18/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/18/2022
LIC809 (FAS) - (06/04)
Page: 3 of 4