304310673-12-10-2019-06-CC-GMAI-BJQPVS-20191210103936

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 304310673
Report Date: 12/10/2019
Date Signed: 12/10/2019 10:39:54 AM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME:	AKMAL, NADIA		FACILITY NUMBER:	304310673
ADMINISTRATOR:	AKMAL, NADIA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(714) 991-8438
CITY:	ANAHEIM	STATE: CA	ZIP CODE:	92805
CAPACITY:	14	CENSUS: 2	DATE:	12/10/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	08:30 AM
MET WITH:	Nadia Akmal - Licensee		TIME COMPLETED:	11:15 AM

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	An Annual Random inspection was conducted at the facility by Licensing Program Analyst (LPA), Mai. LPA observed licensee, Nadia Akmal, caring for 2 children; which included 1 infant and 1 preschool age. Licensee was operating within the licensed capacity as specified on license. A review of the Facility Personnel Report Summary on 12/09/2019 indicates all facility residents, staff, or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions. Currently there are 2 adults (including licensee) living in the facility. Operating hours are 6:00 AM to 6:00 PM, Monday through Friday. During today’s inspection, LPA and licensee toured the inside and outside areas identified in the facility sketch as accessible to child care children. The main day care areas are the living room, family room, dining area, kitchen and bathroom near laundry room. Off limits areas are all bedrooms, pool, backyard and garage; off limit areas are made inaccessible by means of baby gates and locks. The facility has an in-ground pool in the backyard area with mesh fencing and a self-latching gate that meets regulations. Licensee acknowledges that children are never to enter an off-limit area of the home. The fireplace is barricaded at the facility. There are working carbon monoxide, smoke detector, and fire extinguisher in the home that meet statutory and State Fire Marshall standards. Licensee stated she does conduct fire and disaster drills but did not keep a fire drill log. Detergents, cleaning compounds, medicines, and other items which could pose a danger if readily available to children were stored inaccessible to children. Licensee stated there are no firearms and/or other dangerous weapons in the facility and none were observed during today's inspections. The home has age appropriate toys for the ages served. Licensee stated there is a working land line service. There were no poisons or other items observed which could pose a danger to children. Page 1 of 3

SUPERVISOR'S NAME: Judy Hanson	TELEPHONE: (714) 703-2807
LICENSING EVALUATOR NAME: Gigi Mai	TELEPHONE: (714) 743-8565
LICENSING EVALUATOR SIGNATURE:	DATE: 12/10/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/10/2019

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, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME: AKMAL, NADIA	FACILITY NUMBER: 304310673
	VISIT DATE: 12/10/2019

NARRATIVE

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The licensee does not have a current roster of children in care. Children’s records for children present during LPA’s inspection were reviewed for a copy of Parents Rights LIC995A and Immunizations Records PM286 specified by regulation and found to be in compliance. The licensee’s Pediatric CPR/First Aid certification expires on 05/29/2021.

Beginning September 1, 2016, Health and Safety (H&S) 1597.622 states, a person shall not be employed or volunteer at a family day care home if he or she has not been immunized against influenza, pertussis, and measles. Proof of immunization against pertussis, measles and influenza for licensee were reviewed and within compliance.

Beginning March 31, 2018, H&S Code 1596.8662 requires all licensed providers and employees to complete mandated reporting training, and to renew the training every two years. The licensee has taken the required mandated reporter training on 10/21/2018.

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

The licensee understands she must be present in the facility and must ensure children in care are supervised at all times and children are not to be left in parked vehicles. When the licensee is temporarily absent from the facility, arrangements must be made for a qualified substitute adult to care and supervise children while absent. The substitute adult must have the required criminal record, child abuse index clearances, immunizations, Pediatric CPR/First Aid, and mandated reporter training.

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SUPERVISOR'S NAME: Judy Hanson	TELEPHONE: (714) 703-2807
LICENSING EVALUATOR NAME: Gigi Mai	TELEPHONE: (714) 743-8565
LICENSING EVALUATOR SIGNATURE:	DATE: 12/10/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/10/2019

LIC809 (FAS) - (06/04)

Page: 2 of 4

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME: AKMAL, NADIA	FACILITY NUMBER: 304310673
	VISIT DATE: 12/10/2019

NARRATIVE

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CCLD website www.ccld.ca.gov was provided to licensee to access regulations, updates, and licensing forms. Licensee was advised to register through childcareadvocatesprogram@dss.ca.gov in order to receive quarterly updates. Licensee was advised of their responsibility to review the Provider Information Notices (PIN) found on the CCLD website.

A copy of the California Department of Social Services Lead Information Brochure was explained and provided to the licensee. A copy of the 2016 “A Child Care Providers Guide to Safe Sleep” was provided to the licensee. The following electronic links were also provided:

English: https//www.cdph.ca.gov/programs/SIDS/Documents/SIDSchildcaresafesleep.pdf
AAP:https://www.healthychildren.org/English/ages-stages/baby/sleep/Pages/A-Parents-Guide-to-Safe-Sleep.aspx
NIH: https://safetosleep.nichd.nih.gov/safesleepbasics/environment/room/text_alternative
Safe to Sleep Campaign: https://safetosleep.nichd.nih.gov/materials

The following violations of the California Code of Regulations, Title 22; Division 12, were observed and cited today: Operation of a Family Child Care Home 102417(g)(9) and 102417(g)(9)(A)(1).

Inspection, report reviewed and exit interview was conducted in English. Appeal Rights were explained. The Licensee was provided a copy of appeal rights (LIC 9058 01/16) and their signature on this form acknowledges receipt of these rights. All appeals must be in writing and received by the Regional Office within 15 business days. First level appeals should be sent to the regional manager to the address listed above.

The Notice of Site Visit was posted and discussed as required by H&S Code Sec. 1596.817. Notice of Site Visit must be posted for 30 consecutive days. Failure to post will result in civil penalties of $100.00. The Notice of Site Visit must be posted on or adjacent to the door.

Page 3 of 3 - End or Report.

SUPERVISOR'S NAME: Judy Hanson	TELEPHONE: (714) 703-2807
LICENSING EVALUATOR NAME: Gigi Mai	TELEPHONE: (714) 743-8565
LICENSING EVALUATOR SIGNATURE:	DATE: 12/10/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/10/2019

LIC809 (FAS) - (06/04)

Page: 3 of 4

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME: AKMAL, NADIA	FACILITY NUMBER: 304310673
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 12/10/2019

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 12/11/2019 Section Cited	1 2 3 4 5 6 7	102417(g)(8) Operation of a Family Child Care Home. Each family child care home shall have a current roster of children as specified in Health and Safety Code Section 1596.841. This requirement was not met as evidenced by:
	8 9 10 11 12 13 14	Based on record review, the licensee failed to have a current roster of children in care. This poses a potential safety risk to children in care.	8 9 10 11 12 13 14
Type B 12/11/2019 Section Cited	1 2 3 4 5 6 7	102417(g)(9)(A)(1) Operation of a Family Child Care Home. All homes shall conduct fire and disaster drills at least once every six months and document the date and time of each drill. This requirement was not met as evidenced by:
	8 9 10 11 12 13 14	Based on interview and record review, the licensee failed to maintain a log and document the fire and disaster drills at least once every 6 months. This poses a potential safety risk to children in care.	8 9 10 11 12 13 14

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: Judy Hanson	TELEPHONE: (714) 703-2807
LICENSING EVALUATOR NAME: Gigi Mai	TELEPHONE: (714) 743-8565
LICENSING EVALUATOR SIGNATURE:	DATE: 12/10/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/10/2019

LIC809 (FAS) - (06/04)

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