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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 013422761
Report Date: 11/03/2022
Date Signed: 11/03/2022 01:54:39 PM


Document Has Been Signed on 11/03/2022 01:54 PM - 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:RAHIMI, HAMINAFACILITY NUMBER:
013422761
ADMINISTRATOR:RAHIMI, HAMINAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(925) 997-9460
CITY:DUBLINSTATE: CAZIP CODE:
94568
CAPACITY:14CENSUS: 7DATE:
11/03/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
11:35 AM
MET WITH:Licensee, Hamina RahimiTIME COMPLETED:
02:20 PM
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Licensing Program Analyst (LPA) Jyoti Saini met with Licensee, Hamina Rahimi for an unannounced Annual Random Inspection. LPA disclosed the purpose of the inspection and was granted entry into the facility by the licensee. The home is two story which consists of 4 bedrooms, 3 bathrooms, loft, living room, family room, dining area, kitchen, bathroom, office room, laundry room, front yard, backyard and garage. Licensee lives in the house with husband, three minor children. Present during this inspection was Licensee supervising 1 infant and 6 preschoolers. Licensee is within capacity limits of a Large License. The hours of operation are 8:30AM- 5:30PM, Monday -Friday. The facility has liability insurance through DCI company.

ON-LIMIT AREA: family room, dining room, living room, kitchen, loft (main day care area on the second floor) and bathroom (upstairs) and backyard.

OFF-LIMIT AREA: all the bedrooms, laundry room, and garage. All the off-limit areas are made inaccessible to children by locked doors, safety gates and visual supervision.

LPA observed the following: Daycare Area is orderly and equipped with age appropriate toys and equipment for children, indoors and outdoors. Home has a working telephone, a working smoke and carbon monoxide detector, and a fire extinguisher that meets the minimum requirements. There are no bodies of water in the daycare. There is a Fireplace located in the living room, however it is screened to prevent access to children. There are two entrances to the stairs, and both are barricaded to prevent access to children. LPA did not observe any hazardous materials or toxins accessible to children during today’s inspection. The napping room had cots in good condition and each child have their separate blankets. The blankets are washed weekly by the Parents. Licensee provides snacks and children bring their own lunch. The outdoor play area is fenced. Licensee states there are no guns or weapons of any kind in the home.

Licensee have valid CPR and expires in 8/2024. The licensee’s mandated reporter training is complete and active. Licensee conducted last emergency drill on 10/03/2022 and is properly logged. Discipline policy is redirection. LPA reviewed all children’s files. All the files are complete and up to date. The Facility roster was reviewed and complete.

see next page...

SUPERVISOR'S NAME: Wynn NoronaTELEPHONE: (510) 421-1324
LICENSING EVALUATOR NAME: Jyoti SainiTELEPHONE: 510-298-7052
LICENSING EVALUATOR SIGNATURE:
DATE: 11/03/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/03/2022
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: RAHIMI, HAMINA
FACILITY NUMBER: 013422761
VISIT DATE: 11/03/2022
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During Inspection, 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.

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 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.



Licensee was reminded about Mandated Reporter training available on CCLD website. Training must be completed every 2 years. Training can be taken online at www.mandatedreporterca.com

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

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.

No deficiency was cited today.

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

Exit interview conducted and report was reviewed with the licensee, Hamina Rahimi

SUPERVISOR'S NAME: Wynn NoronaTELEPHONE: (510) 421-1324
LICENSING EVALUATOR NAME: Jyoti SainiTELEPHONE: 510-298-7052
LICENSING EVALUATOR SIGNATURE:

DATE: 11/03/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/03/2022
LIC809 (FAS) - (06/04)
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