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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 013422559
Report Date: 09/17/2019
Date Signed: 09/17/2019 11:33:41 AM

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, SUITE 1102
OAKLAND, CA 94612
FACILITY NAME:MARASHI, MAHTAFACILITY NUMBER:
013422559
ADMINISTRATOR:MARASHI, MAHTAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(510) 922-1418
CITY:OAKLANDSTATE: CAZIP CODE:
94618
CAPACITY:14CENSUS: 10DATE:
09/17/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
09:12 AM
MET WITH:Mahta MarashiTIME COMPLETED:
11:50 AM
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Licensing Program Analyst Caroline Colson met with Mahta Marashi, licensee, Mosayeb Shafyee, father-in-law, Zahra Moradmand, mother-in-law, adult daughter, Negar Shafieifor, assistants, Natalie Huerta Lu and Lizveth A. Ocegueda for an unannounced annual random inspection at 9:12 AM. There are four (4) infants and six (6) preschool child present. One child's record and two (2) staff records were reviewed by the LPA and the licensee on 09/17/19 at 10:22 AM. The home was toured for a health and safety inspection.

The home is a two story home. The home has 2 downstairs bedrooms, 1 upstairs bedroom, 1 upstairs bathroom which is above the garage, 3 downstairs bathrooms, living room, dining room, family room, kitchen, garage, attic, unfenced front yard and fenced back yard. There are two downstairs bathrooms, an upstairs bedroom, an upstairs bathroom, garage and attic are the off-limit areas. She conducts fire/disaster drills every six months. There are no pools, spas, hot tubs, fish ponds or similar bodies of water. All poisons, detergents, cleaning compounds and medications are stored in areas which are inaccessible to children. There are no fireplaces or open face heaters accessible to children. The home is clean and orderly with heating and ventilation. There is a lock to prevent the children from going to the second floor. The second downstairs bedroom is the isolation room. Licensee is present and allowed LPA to inspect the entire facility. Children aren't left in parked vehicles. Each child has safe, healthful, comfortable accommodations, furnishings and equipment. The home has a current roster.

A review of staff records on 09/10/19 indicates that all facility staff or other individuals who required caregiver background checks have received criminal record and child abuse index clearances or exemptions.

See LIC 809 C for additional information
SUPERVISOR'S NAME: Ann RobinsonTELEPHONE: (510) 622-2591
LICENSING EVALUATOR NAME: Caroline ColsonTELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:

DATE: 09/17/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/17/2019
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, SUITE 1102
OAKLAND, CA 94612
FACILITY NAME: MARASHI, MAHTA
FACILITY NUMBER: 013422559
VISIT DATE: 09/17/2019
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All required posters are posted. Mrs. Marashi states that there are no firearms in the home. First Aid and CPR certificates are current and expires July 22, 2020. Mrs. Marashi will use her fenced back yard for outdoor play. There are two dogs.

Mandated Reporter Training was discussed. The website is www.mandatedreporterca.com. It is the AB Law 1207.

This facility provides Incidental Medical Services-IMS. LPA reviewed the storage of medication and equipment /supplies, and reviewed children and personnel records. LPA discussed the need to create a plan of operation. Specifics on the plan can be found in the family child care home evaluator manual (FCCH EM) Policy 102417.

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.

The childcareadvocatesprogram@dss.ca.gov is the email address for the applicant to sign up to receive PINS.

Licensee was asked to go to our website at www.ccld.ca.gov to ensure that she is informed of all new laws and regulations.

A site notice was posted. An exit interview was conducted. Appeal rights were discussed. This report must remain available for public review for 3 years.

There were no deficiencies cited during this inspection.
SUPERVISOR'S NAME: Ann RobinsonTELEPHONE: (510) 622-2591
LICENSING EVALUATOR NAME: Caroline ColsonTELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:

DATE: 09/17/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/17/2019
LIC809 (FAS) - (06/04)
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