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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 304311796
Report Date: 10/17/2024
Date Signed: 10/18/2024 01:21:58 PM


Document Has Been Signed on 10/18/2024 01:21 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
ORANGE CO CHILD CARE, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868



FACILITY NAME:MOGHBEL, NASRINFACILITY NUMBER:
304311796
ADMINISTRATOR:MOGHBEL, NASRINFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(949) 333-2927
CITY:IRVINESTATE: CAZIP CODE:
92614
CAPACITY:14CENSUS: 5DATE:
10/17/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
12:45 PM
MET WITH:Licensee TIME COMPLETED:
03:15 PM
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An Annual Random inspection was conducted at the facility by Licensing Program Analyst (LPA) Mahnaz (Nancy) Malek. LPA met with licensee, Nasrin Moghbel and her spouse, Mohsen Djoourabchi. LPA toured the home. LPA observed 5 children of whom 4 were under 24 months old under supervision of two adults. Licensee was operating within the licensed capacity as specified on license for Large Family Childcare Home.

A review of the Facility Personnel Report Summary on this date indicates all facility residents, staff, or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions.

According to the updated information received, currently there are two adults including the licensee, and no minors living in the house. Day care hours of operation is Monday through Friday from 7:30 am-6:00 pm.

During today’s inspection, LPA toured the inside and outside areas identified in the facility sketch as accessible to childcare children. Off limits areas are made inaccessible by means of baby gates. The childcare area consists of family room, one bedroom, children's bathroom and backyard. The main day care area is family room. There is a baby gate installed between the family room and the bedroom. There is also another gate installed in front of the kitchen to make the kitchen inaccessible to children. The children's bathroom was inspected and was free of any hazardous items. The bathroom is located in the hallway where the bedrooms are located.

There are age appropriate toys and equipment for children to play in indoor space. LPA observed 3 cribs for children's napping in the bedroom and mats for older children. There is no body of water observed.
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SUPERVISOR'S NAME: Thuy HoTELEPHONE: (714) 703-2741
LICENSING EVALUATOR NAME: Mahnaz MalekTELEPHONE: (714) 292-9851
LICENSING EVALUATOR SIGNATURE:
DATE: 10/17/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/17/2024
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE CO CHILD CARE, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
FACILITY NAME: MOGHBEL, NASRIN
FACILITY NUMBER: 304311796
VISIT DATE: 10/17/2024
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The garage is not for children's use and is inaccessible to children by the garage door being locked.
Backyard was inspected. It is all fenced. There were no hazardous items in the back yard. The licensee stated she barely uses the backyard for children.

There are working carbon monoxide, smoke detector, and fire extinguishers in the home that meet statutory and State Fire Marshall standards.

Detergents, cleaning compounds, medicines, and other items which could pose a danger to children were not readily available to children they were stored inaccessible to children, none were observed during inspection.

According to licensee, there is no firearm in the facility. There is no pets living in the house. LPA verified there is a working telephone service (cellular service).

The licensee does have a current roster of children in care. Fire Drill was available. The last fire drill was conducted 6/11/2024. Children’s records for children present during LPA’s inspection were reviewed. Five files were reviewed. They were all in compliance. The log for every 15 minutes check on napping children under 24 months old were available. LIC 9227 (Individual Infant Sleeping Plan) for infants under 12 months old were available on their files. The licensee and the assistant's CPR/First Aid certification are current. (Expires 2/4//2026).

Beginning September 1, 2016, Health and Safety (H&S) 1597.622 states, a person shall not be employed or volunteer at a family childcare home if he or she has not been immunized against influenza, pertussis, and measles. Proof of immunization against pertussis, measles for licensee and her assistant were 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.
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SUPERVISOR'S NAME: Thuy HoTELEPHONE: (714) 703-2741
LICENSING EVALUATOR NAME: Mahnaz MalekTELEPHONE: (714) 292-9851
LICENSING EVALUATOR SIGNATURE:

DATE: 10/17/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/17/2024
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
ORANGE CO CHILD CARE, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
FACILITY NAME: MOGHBEL, NASRIN
FACILITY NUMBER: 304311796
VISIT DATE: 10/17/2024
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Mandated Reporter Training Certificate for the licensee and here assistant were exempt because the training course is not offered in the licensee and her assistant's native language.

Incidental Medical Services (IMS) policy was discussed. For information see PIN 22-02-CCP. 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: https://www.ada.gov/resources/child-care-centers/.

The licensee understands they must be present in the facility and must ensure children in care are always supervised. Children are not to be left alone 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, immunization, Pediatric CPR/First Aid, and mandated reporter training.

Licensee, Nasrin Moghbel 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 clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a volunteers, except as specified in Health and Safety Code section 1596.871, must obtain a criminal record clearance before working in a licensed Family Child Care Home. A civil penalty of $100.00 minimum/day for a maximum of 5-days or, if the penalty is for a repeat violation, for a maximum of 30-days per person will be assessed if this regulation is violated.

LPA discussed the safe sleep regulations with Licensee, Nasrin Moghbel 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,

LPA also informed Licensee, Nasrin Moghbel of the importance of checking for recalled as infant devices on the United States Consumer Product Safety Commission (CPSC) website at: https://www.cpsc.gov/, and

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SUPERVISOR'S NAME: Thuy HoTELEPHONE: (714) 703-2741
LICENSING EVALUATOR NAME: Mahnaz MalekTELEPHONE: (714) 292-9851
LICENSING EVALUATOR SIGNATURE:

DATE: 10/17/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/17/2024
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
ORANGE CO CHILD CARE, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
FACILITY NAME: MOGHBEL, NASRIN
FACILITY NUMBER: 304311796
VISIT DATE: 10/17/2024
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recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

Licensee, Nasrin Moghbel was informed of the MyChildCarePlan.org site, a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California. Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other important information communication platforms.

To receive important licensed related information to licensed facilities, visit the CCLD Important Information website athttps://www.cdss.ca.gov/inforesources/community-care- licensing/subscribe and select the Child Care option to receive email communication.

In the areas that were evaluated, no deficiency was observed of the California Code of Regulations, Title 22, Division 12 on this inspection.

A notice of site visit was given to Licensee, Nasrin Moghbel and must remain posted on, or immediately adjacent to, the interior side of the main door for 30 days. Failure to post will result in Civil Penalties of $100.00.

Exit interview conducted and report was reviewed with the Licensee, Nasrin Moghbel..

End of report

SUPERVISOR'S NAME: Thuy HoTELEPHONE: (714) 703-2741
LICENSING EVALUATOR NAME: Mahnaz MalekTELEPHONE: (714) 292-9851
LICENSING EVALUATOR SIGNATURE:

DATE: 10/17/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/17/2024
LIC809 (FAS) - (06/04)
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