073408859-3-5-2024-02-CC-SBLE-D33TS8-20240305135843

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 073408859
Report Date: 03/05/2024
Date Signed: 03/05/2024 01:59:37 PM

Document Has Been Signed on 03/05/2024 01:59 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
OAKLAND CC RO, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612

FACILITY NAME:	AMANYAR, ZUHAL		FACILITY NUMBER:	073408859
ADMINISTRATOR:	AMANYAR, ZUHAL		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(510) 305-6909
CITY:	ANTIOCH	STATE: CA	ZIP CODE:	94531
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 10	CENSUS: 9	DATE:	03/05/2024
TYPE OF VISIT:	Required - 3 Year	UNANNOUNCED	TIME BEGAN:	11:15 AM
MET WITH:	ZUHAL AMANYAR		TIME COMPLETED:	02:00 PM

NARRATIVE

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On 03/05/2024 at 11:15 AM, Licensing Program Analyst (LPA) Sikia Blue arrived for an unannounced required annual inspection for FCCH of Zuhal Amanyar. LPA met with licensee Zuhal Amanyar and guided analyst on a tour of the facility. Upon arrival there were 9 children present with 10 children enrolled and licensee 2 assistants. Facility hours of operations are Monday through Friday from 6:00 AM – 7:00 PM. LPA toured all areas used by children during this visit.

Areas accessible to children were inspected to ensure that they are clean and orderly with ventilation. There is a working telephone in the home. Detergents, poisons, cleaning compounds, medications, and other items which can pose a danger to children are made inaccessible in the home.

Per licensee, there are no weapons or firearms in the home. Licensee has an up to code 3A40BC fire extinguisher and working smoke/carbon monoxide detector on the premises.

LPA inspected the backyard and observed a fully fenced backyard safe for children in care. LPA observed an ample supply of age-appropriate toys, equipment and furniture that appear to be safe and in good condition. LPA DID NOT observe any bodies of water. LPA discussed with licensee when outside of facility, 100% supervision of children in care is required.

Facility does provide transportation for children, but licensee understands that children cannot be left alone, unattended in parked vehicles.

Last drill conducted and documented on 10/18/2023

*CONTINUED ON PAGE 2*

SUPERVISORS NAME: Loretta Dyson
LICENSING EVALUATOR NAME: Sikia Blue
LICENSING EVALUATOR SIGNATURE:	DATE: 03/05/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/05/2024

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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Document Has Been Signed on 03/05/2024 01:59 PM - It Cannot Be Edited

Created By: Sikia Blue On 03/05/2024 at 12:23 PM

Link to Parent Document Below:

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612

FACILITY NAME: AMANYAR, ZUHAL	FACILITY NUMBER: 073408859
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 03/05/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

HSC

1597.622(c)

Administration of Child Day Care Licensing

(c) The family day care home shall maintain documentation of the required immunizations or exemptions from immunization, as set forth in this section, in the person's personnel record that is maintained by the family day care home. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on [(observation) (interview) (record review)], the licensee did not comply with the section cited above, LPA did not observe MMR immunization record for assistant working with children in care in the FCCH, which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 03/08/2024
	Plan of Correction
1 2 3 4	Proof of appointment for immunization MMR by 03/08/2024 and proof of completion will be submitted by 03/15/2024 or reach out to LPA is this CAN NOT be completed by 03/15/2024.

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

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:

Loretta Dyson

LICENSING EVALUATOR NAME:

Sikia Blue

LICENSING EVALUATOR SIGNATURE:

DATE: 03/05/2024

I acknowledge receipt of this form and understand my appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/05/2024

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
OAKLAND CC RO, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612

FACILITY NAME: AMANYAR, ZUHAL	FACILITY NUMBER: 073408859
	VISIT DATE: 03/05/2024

NARRATIVE

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*PAGE 2*

Children’s records were reviewed to ensure that each child has an Identification and Emergency form. Personnel records were reviewed to ensure all employees’ files and certifications are up to date. LPA DID NOT observe MMR immunization for one employee. Licensee was informed to have this completed and sent to LPA by 03/15/2024. Licensee’s Pediatric First Aid and CPR certificate will expire in 6/2024. Required postings were observed near the entrance.

LPA reminded licensee day care needs to be operated within the limitations and capacity of a Large Family Child Care Home with regards to ratios and that Licensee has to be present in the day care for 80% of the operation hours.

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.

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) Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm.

*CONTINUED ON PAGE 3*

SUPERVISORS NAME: Loretta Dyson
LICENSING EVALUATOR NAME: Sikia Blue
LICENSING EVALUATOR SIGNATURE:	DATE: 03/05/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/05/2024

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
OAKLAND CC RO, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612

FACILITY NAME: AMANYAR, ZUHAL	FACILITY NUMBER: 073408859
	VISIT DATE: 03/05/2024

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*PAGE 3*

On or before March 30, 2018, any person who works in a childcare facility shall complete Mandated Reporter training and renew the training every 2 years. Website provided: https://www.mandatedreporterca.com/training/child-care-providers. Licensee has provided Mandated Reporter certificate and will expire 07/2025.

Licensee was reminded that all adults 18 and over living in the home, persons who provide care and supervision to children, and staff who have contact with children, 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.

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/process

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

Exit interview conducted and report was reviewed with the licensee, Zuhal Amanyar.

SUPERVISORS NAME: Loretta Dyson
LICENSING EVALUATOR NAME: Sikia Blue
LICENSING EVALUATOR SIGNATURE:	DATE: 03/05/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/05/2024

LIC809 (FAS) - (06/04)

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