304312043-3-12-2024-06-CC-MMAK-D3APFD-20240312111630

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 304312043
Report Date: 03/12/2024
Date Signed: 03/12/2024 11:16:44 AM

Document Has Been Signed on 03/12/2024 11:16 AM - 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:	RASTA, MAHJAN		FACILITY NUMBER:	304312043
ADMINISTRATOR:	RATSA, MAHJAN		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(949) 481-6748
CITY:	SAN CLEMENTE	STATE: CA	ZIP CODE:	92673
CAPACITY:	14	CENSUS: 0	DATE:	03/12/2024
TYPE OF VISIT:	Office	UNANNOUNCED	TIME BEGAN:	10:30 AM
MET WITH:	Licensee		TIME COMPLETED:	11:30 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	Page 1 of 3 An informal office meeting was conducted on this date, 3/12/2024, in the Orange County Regional Office. In attendance was Licensing Program Manager (LPM), Thuy Ho, Licensing Program Analyst (LPA), Mahnaz (Nancy) Malek, and the Licensee, Rasta Mahjan. The purpose of the informal meeting was to discuss the following citations that were issued on: 4/7/2023- 102425(j)(2) Infant Safe Sleep- The provider shall supervise infants while they are sleeping and adhere to the following requirements: The licensee did not comply with the section cited above due to not having sleep logs (stating she checks for labor breathing, distress and infants position) available for review. The licensee will begin documentation for children under 24 months as of today. Since issuance of the citation, the Licensee has provided documents and information required pursuant to the plans of correction. Licensee stated she has been complying since the last violation. A sample log for every 15 minutes check on napping children was provided and discussed. 4/7/2023- 102425(c) Infant Safe Sleep- An Individual Infant Sleeping Plan [LIC 9227 (3/20)] shall be completed for each infant up to 12 months of age the provider has in care and included in the infant's file at the facility. The licensee did not comply with the section cited above in by means of not having this document completed and filed which poses an immediate health, safety risk to persons in care. Since issuance of the citation, the Licensee has provided documents and information required pursuant to the plans of correction. Licensee stated she has been complying since the last violation. Continued on page 2

SUPERVISOR'S NAME: Thuy Ho	TELEPHONE: (714) 703-2741
LICENSING EVALUATOR NAME: Mahnaz Malek	TELEPHONE: (714) 292-9851
LICENSING EVALUATOR SIGNATURE:	DATE: 03/12/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/12/2024

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: RASTA, MAHJAN	FACILITY NUMBER: 304312043
	VISIT DATE: 03/12/2024

NARRATIVE

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4/7/2023- 102425(j)(2)(D) Infant Safe Sleep The licensee did not comply with the section cited above by means of having infant safe sleep logs and LIC 9227 to verify what position each infant can sleep in available for review and completed which poses an immediate health and safety risk to persons in care. The licensee will begin infant safe sleep logs and include the name, date, initials of who is checking, and 15 minutes check. Licensee will check for labor breathing, signs of distress, and log infants position.
Since issuance of the citation, the Licensee has provided documents and information required pursuant to the plans of correction.
Licensee stated she has been complying since the last violation.
A copy of LIC 9227 was provided to licensee and the form was discussed.

4/7/2023- 1596.8662(b)(1) Administration of child day care Licensing- (1) On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child day care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training provided pursuant to paragraphs (2) and (3) of subdivision (a), and shall complete renewal mandated reporter training every two years following the date on which he or she completed the initial mandated reporter training. Based on observation, interview, record review the licensee did not comply with the section cited above due to training not being completed every two years (last completed 2018) which poses a potential health and safety risk to persons in care.
Since issuance of the citations, the Licensee has provided documents and information required pursuant to the plans of correction.Licensee stated she has been complying since the last violation. She understands the certificate expires every two years from the date of the completion. The licensee was advised that increased unannounced visits to the facility will be conducted by Community Care Licensing for the next 2 years to monitor compliance. The purpose of these increased inspections is to ensure the Department is working with the licensee for continued compliance with applicable regulations and code.
The following was discussed with the licensee:
1. The facility must be in compliance at all times.
2. The licensee was advised the facility will be placed on increased required visits for the next two years.
Continued on page 3

SUPERVISOR'S NAME: Thuy Ho	TELEPHONE: (714) 703-2741
LICENSING EVALUATOR NAME: Mahnaz Malek	TELEPHONE: (714) 292-9851
LICENSING EVALUATOR SIGNATURE:	DATE: 03/12/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/12/2024

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: RASTA, MAHJAN	FACILITY NUMBER: 304312043
	VISIT DATE: 03/12/2024

NARRATIVE

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3. The licensee was advised that subsequent citations within the next 12 months may result in civil penalties.
4. The licensee shall visit the CDSS website and review the Safe Sleep page at: https://cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep.
Resources provided: The licensee has been enrolled to receive important updates. PINs may be accessed at: https://www.cdss.ca.gov/inforesources/community-care-licensing/policy/provider-information-notices/child-care. Quarterly Updates may be accessed at: https://www.cdss.ca.gov/inforesources/community-care/self-assessment-guides-and-key-indicator-tools/qurterly-updates

Provider's Webinar: https://www.cdss.ca.gov/inforesources/child-care-licensing/resources-for-providers
In today’s office meeting, Technical Support Program (TSP) was discussed, and licensee stated she would think about it for the future. TSP referral flyer was provided to licensee.
A flyer of items banned for children in the childcare facilities were provided to licensee.

Upon receipt of this report pertaining to a meeting conducted by a local Licensing Agency in which issues of were discussed, the licensee must: 1) Provide a copy of this report to the parent/guardian of children currently enrolled by the next business day or immediately upon return. 2) A copy of this report shall also be provided to the parent/guardian of any newly enrolled children for the next 12 months (1 year). 3) Obtain signature and date from the child's parent/guardian on the Acknowledgement of Receipt of Licensing Reports LIC 9224. 4) Keep a record immediately upon receipt of the completed and signed LIC 9224 acknowledging receipt of this report in the child's file.
The licensee was informed to provide a copy of this report and LIC 9224 (Acknowledgement form) to the parents/guardian of children in care. A copy of LIC 9224 was provided to licensee.

Exit interview conducted with Licensee, Rasta Mahjan who is in agreement with the above. A copy of this report was provided to Licensee, Rasta Mahja

End of report

SUPERVISOR'S NAME: Thuy Ho	TELEPHONE: (714) 703-2741
LICENSING EVALUATOR NAME: Mahnaz Malek	TELEPHONE: (714) 292-9851
LICENSING EVALUATOR SIGNATURE:	DATE: 03/12/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/12/2024

LIC809 (FAS) - (06/04)

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