073409070-1-21-2021-02-CC-CFES-BXH289-20210121160959

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 073409070
Report Date: 01/21/2021
Date Signed: 01/21/2021 04:10:22 PM

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:	SARTIP, NAEEMEH		FACILITY NUMBER:	073409070
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY:	8	CENSUS: 4	DATE:	01/21/2021
TYPE OF VISIT:	Case Management - Other	ANNOUNCED	TIME BEGAN:	02:09 PM
MET WITH:	Naeemah Sartip		TIME COMPLETED:	04:14 PM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	On January 21, 2021 at 2:09PM, Licensing Program Analyst (LPA) Catherine Fernandes conducted an announced increase in capacity inspection with Licensee Naeemeh Sartip. Residing in the home is the Licensee, her finger print cleared husband and her underage teen daughter. Present during the inspection was licensee's daughter, one infant and three preschoolers. Due to COVID-19 the home was virtually toured with the Licensee to conduct a health and safety inspection via Facetime. Operating hours will be 7:00AM to 5:30PM, Monday through Friday. The home is a two story house that consists of four bedrooms and two and a half bathrooms. The OFF LIMIT AREAS the entire second floor and the garage, which will be inaccessible by closed and/or locked doors or visual supervision. The ON LIMIT AREAS are the living room/dining room combo which is the main area of the day care, the kitchen, the downstairs bathroom, the laundry room, the family room and the fenced in backyard that wraps around to the front yard. The ISOLATION AREA will be the family room. Outdoor play area will be in the fenced wrap around yard. There are toys and play equipment for the children. There are no pools, hot tubs or any other bodies of water during today's inspection. The home has a fully charged 3A40BC fire extinguisher in the kitchen and pull down fire alarm on the wall in next to the front door, a working smoke detector in the main area of the day care and a working carbon monoxide detector in the the hallway upstairs. Licensee has a working telephone and complete First Aid Kit. The Licensee's CPR and First Aid certificate is current and expires on 04/27/2021. There is a fire place in the living room that is covered to prevent access by children. Per Licensee, there are no firearms in the home. The Licensee was reminded of the responsibility as a mandated reporter and has provided proof of the required training for child care providers, which has been completed on 10/16/2020. REPORT CONTINUES ON LIC 809C

SUPERVISOR'S NAME: Mayla Mendoza	TELEPHONE: (510) 873-6408
LICENSING EVALUATOR NAME: Catherine Fernandes	TELEPHONE: (510) 725-7002
LICENSING EVALUATOR SIGNATURE:	DATE: 01/21/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/21/2021

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: SARTIP, NAEEMEH	FACILITY NUMBER: 073409070
	VISIT DATE: 01/21/2021

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A fire clearance was granted to facility. All documents have been reviewed for the increase of capacity application. The Licensee was reminded that an assistant is needed with a large family child care home license, and whenever an assistant is not present, the licensee will comply with the capacity requirements for a small family child care home.

Licensee submitted COVID-19 Self-Assessment Guide. LPA reviewed responses with licensee and provided technical assistance and postings were posted during todays inspection.

The Licensee is reminded any structural changes to the home or additions to the child care facility must be reported to Community Care Licensing. Licensee is reminded that ALL assistants, volunteers, frequent visitors, or adults living in the home, that are 18 years of age or older must be fingerprint cleared and associated to this facility prior to being in the presence of children in care or an immediate civil penalty will be assessed from $100 to $3000 per person, per incident.

California Law requires Family Child Care Home licensees to report unusual incidents or injuries to children in care to child's parents and to the Department of Social Services using the Unusual Incident/Injury form (LIC 624). Incidents must be reported within 24 hours by phone, fax, or electronic mail.

For licensing updates email childcareadvocatesprogram@dss.ca.gov and ask to be added to the email list.

The following needs to be completed prior to getting an increase of capacity license.
- gate to block off the air conditioning unit in the backyard
- gate to block off the stairs or block the hallway from the family room
- Lead poison training certificate

There are no deficiencies cited today.
The report will remain on file for three years.
An exit interview was conducted with Licensee.
Report will be mailed and emailed.

SUPERVISOR'S NAME: Mayla Mendoza	TELEPHONE: (510) 873-6408
LICENSING EVALUATOR NAME: Catherine Fernandes	TELEPHONE: (510) 725-7002
LICENSING EVALUATOR SIGNATURE:	DATE: 01/21/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/21/2021

LIC809 (FAS) - (06/04)

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