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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 304313187
Report Date: 07/23/2019
Date Signed: 07/23/2019 02:47:50 PM

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:GHANBARZADEH, DONYAFACILITY NUMBER:
304313187
ADMINISTRATOR:GHANBARZADEH, DONYAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(818) 963-2323
CITY:IRVINESTATE: CAZIP CODE:
92604
CAPACITY:14CENSUS: 4DATE:
07/23/2019
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
01:45 PM
MET WITH:LicenseeTIME COMPLETED:
03:15 PM
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Licensing Program Analyst (LPA) Mahnaz (Nancy) Malek conducted a plan of correction inspection. LPA met with licensee, Donya Ghanbarzadeh. Licensee's two minor children over ten years old were present too. Licensee was caring for 4 children of whom all were under two years old. LPA observed a total of four children today. The children were napping in their cribs separately. The licensee was advised of safe sleep regulations. The facility had been cited under section 102416.5(a) for being over capacity by having 6 children including all under two years old on the day of 7/16/2019. On today's inspection, LPA observed that the deficiency section 102416.5(a) staffing ratio and capacity which was cited on 7/16/2019 is cleared. The written plan of correction was sent to our office on 7/17/2019. The licensee stated she made arrangements with parents in order to keep her capacity to four children under two years old to meet the licensing regulations. The licensee stated she understands the staffing ratio and capacity for running a large family childcare home. A review of staff records on this date indicates that all facility staff or other individuals who required caregiver background checks have received criminal record and child abuse index clearances or exemptions. The Notice of Site Visit was posted. Facility representative was informed that the Notice of Site Visit must be posted for 30 consecutive days. Failure to post will result in civil penalties of $100. Appeal Rights was explained. A copy of appeal rights (LIC 9058 1/16) was provided and their signatures on this form acknowledges receipt of these rights. First level appeal is to Regional Manager, address is above on the report. Facility was advised on how to receive notifications for quarterly updates and provided with Child Care Advocate contact information: childcareadvocatesprogram@dss.ca.gov
Also provided was information about the E-Learning Modules available at https://ccld.childcarevideos.org
Copies of provider's guide to safe sleep and Never Ever Shake a Baby pamphlets were given to the facility representative on the previous inspection date. An updated pamphlet regarding safe sleep regulations in childcare and a pamphlet for lead poisoning facts were given to the licensee today.
The facility representative was informed that they can refer to our Department website at www.ccld.ca.gov for obtaining the quarterly updates. In the areas that were evaluated, the facility was in compliance of the California Code of Regulations, Title 22, Division 12. No deficiencies were cited on today's inspection.
Report ends here.
SUPERVISOR'S NAME: Rina LopezTELEPHONE: (714) 703-2808
LICENSING EVALUATOR NAME: Mahnaz MalekTELEPHONE: (714) 703-2810
LICENSING EVALUATOR SIGNATURE:

DATE: 07/23/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/23/2019
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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