376100948-1-13-2022-51-CC-JLOT-CAN2AM-20220113161345

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 376100948
Report Date: 01/13/2022
Date Signed: 01/13/2022 04:13:51 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108

FACILITY NAME:	RAZIQI, SHABANA & JAMAL FAMILY CHILD CARE		FACILITY NUMBER:	376100948
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY:	8	CENSUS: 0	DATE:	01/13/2022
TYPE OF VISIT:	Prelicensing	UNANNOUNCED	TIME BEGAN:	10:35 AM
MET WITH:	Applicant, Jamal Raziqi		TIME COMPLETED:	11:35 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	Licensing Program Analysts(LPAs), Jennifer Lott and Saraliz Velando conducted an announced Pre-Licensing Inspection. LPAs were greeted at the front door by applicant, Jamal Raziqi and granted entry after identifying themselves and disclosing the purpose of their visit. The applicant has applied for a capacity of eight (8). The home consists of five (5) bedrooms and three (3) bathrooms. The applicant will be using the following areas for daycare: Living room/hall, kitchen and dining room. Off limit areas include: All upstairs, front yard, back yard and garage. Outdoor play area will take place at the local park with constant supervision. Business Hours are Sunday through Saturday, 6am to 11pm. The home has a functioning carbon monoxide / smoke detector and fire extinguisher that meet statutory requirements. There are no fireplaces or open faced heaters in the home. Storage areas for poisons, detergents, cleaning solutions, medications and items which state keep out of reach of children have been locked and are inaccessible to children. There are no bodies of water at the unit. Applicant, Raziqi advised there are no firearms or ammunition stored on the premises. The home is kept clean with heating and ventilation for safety and comfort. Where children less than 5 years old are in care, stairs are fenced and/or barricaded. The home provides safe toys, play equipment and materials. The licensee has completed training on preventive health practices including pediatric CPR and First Aid. Staff immunizations were reviewed and are in compliance. There is a working telephone and email address. LPA reviewed with applicant the 311D, Forms/Records To Keep In Your Family Child Care Homes; children’s forms/records, facility forms/records, and information to be posted.

SUPERVISOR'S NAME: Tashima Daniel	TELEPHONE: (619) 629-8413
LICENSING EVALUATOR NAME: Jennifer Lott	TELEPHONE: 619-782-8300
LICENSING EVALUATOR SIGNATURE:	DATE: 01/13/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/13/2022

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, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108

FACILITY NAME: RAZIQI, SHABANA & JAMAL FAMILY CHILD CARE	FACILITY NUMBER: 376100948
	VISIT DATE: 01/13/2022

NARRATIVE

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The new provider packet was reviewed with the applicant including information on children’s records, immunizations, child abuse reporting, car seat laws, shaken baby syndrome, SIDS, safe sleep and the effects of lead poisoning.
Applicant was also reminded that corporal punishment, smoking, walkers, exersaucers, jumpers and bouncy seats shall not be permitted during daycare operation. All equipment that is used should be used only as intended by the manufacturer. Applicant Raziqi states they are aware that interference with a child’s daily functions, physical or mental abuse and corporal punishment is not permitted. LPA and applicant discussed California Megan’s Law and LPA provided the link www.meganslaw.ca.gov.

LPA discussed safe sleep regulations with the applicant, 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 as an additional resource. LPA also informed the applicant of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with CPSC to be notified of any recalls on their purchased equipment.

LPA discussed the following with the applicant: Maximum capacity for a small family child care home; 4 infants only (infants defined as children under 24 months) or 6 children with no more than 3 infants; or with landlord consent, 8 children with no more than 2 infants – 1 child in kindergarten or elementary school and 1 child at least age 6 including children under the age of 10 who reside in the applicant’s home.

Applicant 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 volunteers, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a licensed Family Child Care Home. A civil penalty of $100.00 minimum/day up to $500 maximum per day/per person will be assessed if there is regulation is violated.

SUPERVISOR'S NAME: Tashima Daniel	TELEPHONE: (619) 629-8413
LICENSING EVALUATOR NAME: Jennifer Lott	TELEPHONE: 619-782-8300
LICENSING EVALUATOR SIGNATURE:	DATE: 01/13/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/13/2022

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, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108

FACILITY NAME: RAZIQI, SHABANA & JAMAL FAMILY CHILD CARE	FACILITY NUMBER: 376100948
	VISIT DATE: 01/13/2022

NARRATIVE

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LPA provided the applicant with the following: Child Care Advocates email address of childcareadvocatesprogram@dss.ca.gov.

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.

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 platform.

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

No corrections are needed at this time. A license for eight (8) children will be granted upon final file review. Applicant understands they must obtain landlord consent to care for more than eight (8) children. Applicant agrees to comply with all regulations and laws governing Family Child Care Homes. Additional Technical Assistance was provided and noted on the attached Advisory Note – Technical Assistance (LIC 9102). Exit interview conducted and report was reviewed with applicant, Raziqi.

SUPERVISOR'S NAME: Tashima Daniel	TELEPHONE: (619) 629-8413
LICENSING EVALUATOR NAME: Jennifer Lott	TELEPHONE: 619-782-8300
LICENSING EVALUATOR SIGNATURE:	DATE: 01/13/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/13/2022

LIC809 (FAS) - (06/04)

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