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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197494425
Report Date: 12/16/2019
Date Signed: 12/17/2019 08:22:47 AM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME:AMBREEN FAMILY CHILD CAREFACILITY NUMBER:
197494425
ADMINISTRATOR:AMBREEN, AYESHAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(818) 687-2408
CITY:WEST HILLSSTATE: CAZIP CODE:
91307
CAPACITY:14CENSUS: 0DATE:
12/16/2019
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME BEGAN:
08:30 AM
MET WITH:Licensee-Ayesha and Danish AmbreenTIME COMPLETED:
10:00 AM
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On December 16th, 2019 at 8:30 am, Licensing Program Analyst Lisa Rios, went to the Family Child Care Home of Ayesha and Danish Ambreen to continue the Pre-licensing inspection for change of location. Upon arrival, LPA Rios saw that the licensee had completely finished the set up of the child care both in the main living and dining room area. The dining area consists of age appropriate toys, games, children's table and chairs and stuffed animals. There's a large colorful children's carpet laid in both areas. In the living room area there is a single crib, stacked cots, a playpen, changing table, a single high chair and more age appropriate toys. The roster shows that they currently have 6 children enrolled: 1 infant, 2 toddlers 2 years old, and 3 children ages 3-4 years old.

LPA Rios has also seen with pictures submitted and a visual walk-thru all of the following items have been corrected:
1. In entrance of home there are two outlets that need covers and inaccessibility to children.
2. Potty seat needed in bathroom downstairs that children use.
3. Downstairs need carbon monoxide detectors and smoke detectors.
4. Notification of video cameras is in each parents contract.
5. Necessary postings as stated in the body of the report (809).
6. Kitchen: drawer's with sharp scissors, knives, lighters and other sharp and dangerous items need to have latches.
7. Fire extinguisher needs to be serviced. Picture of tag for service or receipt of purchase with date.
8. Complete First Aid Kit with thermometer.
9. Yard: remove lantern from children's play area. Bricks, wood and electrical cords on the ground and within reach of the children need to be removed. Storage chest will be removed and made inaccessible. Gate making side of house inaccessible is needed and a lock on the gate leading to the front of the house is needed as well.
Licensee has stated that the area will be properly swept and maintained with small items off the ground. The slide needs a mat with cushion under it and area will have proper supervision at all times.
10. Licensee will complete both the 4 hour general and the 3 hour child care mandated reporter training and send copies of certificates to LPA Rios.
SUPERVISOR'S NAME: Jennie FerreiraTELEPHONE: (424) 301-3067
LICENSING EVALUATOR NAME: Lisa RiosTELEPHONE: (424) 301-3072
LICENSING EVALUATOR SIGNATURE:

DATE: 12/16/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/16/2019
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, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: AMBREEN FAMILY CHILD CARE
FACILITY NUMBER: 197494425
VISIT DATE: 12/16/2019
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Licensee was reminded that the following are guidelines and recommendations for best practices only. When the regulation is approved providers will be notified through Provider Information Notice (PIN).

*Always place infants on their backs for sleeping
*Use a tight-fitting sheet on the crib or play yard mattress
*Do not hang any items from the crib or above the crib
*Keep all items out of the crib or play yard
*Pacifiers may be used as long as they do not have items attached to them
*Infants should not be swaddled or have any items covering them while sleeping
*The temperature of the room should be comfortable enough for an adult to wear a
t-shirt and not be too hot or too cold.

Licensee was reminded it is the licensee’s responsibility to know the regulations as well as anyone who assists in providing care. Licensee was advised on how to access quarterly reports, forms, and regulations for Child Care online at www.ccld.ca.gov. Licensee was also encouraged to read the Child Care quarterly updates every season as the come out to stay informed of any changes or updates to the regulations.

There were no deficiencies cited during the visit. The facility is in substantial compliance and ready for licensor. Exit interview was conducted and a copy of this report was given to the licensee.
SUPERVISOR'S NAME: Jennie FerreiraTELEPHONE: (424) 301-3067
LICENSING EVALUATOR NAME: Lisa RiosTELEPHONE: (424) 301-3072
LICENSING EVALUATOR SIGNATURE:

DATE: 12/16/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/16/2019
LIC809 (FAS) - (06/04)
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