376627395-4-11-2022-51-CC-JREG-CDDQA7-20220411115929

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 376627395
Report Date: 04/11/2022
Date Signed: 04/11/2022 11:59:38 AM

Document Has Been Signed on 04/11/2022 11:59 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
CCLD Regional Office, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108

FACILITY NAME:	VAZIRINIA, SAYENA & SHIRAZI, SAHRA FCC		FACILITY NUMBER:	376627395
ADMINISTRATOR:	SAYENA VAZIRINIA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(858) 254-9263
CITY:	CARLSBAD	STATE: CA	ZIP CODE:	92011
CAPACITY:	14	CENSUS: 11	DATE:	04/11/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	10:35 AM
MET WITH:	Licensee Sayena Vazirinia		TIME COMPLETED:	12:05 PM

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	On 4/11/2022 at 10:35 a.m., Licensing Program Analyst, Joelle Redding, made an unannounced visit for the purpose of an Annual Inspection. During this visit, there were 11 children in care, four under the age of 2 years. The facility is within ratio and capacity. Licensee operates Monday thru Friday from 7 a.m to 5:30 p.m. LPA toured the home. Primary child care areas are spare bedroom, living room, family room, bathroom by the front door and the fully fenced backyard and the facility sketch on file is accurate. Off limits areas have been made inaccessible with the use of safety gates and latches. There are no weapons stored in the home or on the property and there are no bodies of water present. The fireplaces have been secured The fire extinguisher is full and of adequate size and located under the kitchen sink. The smoke alarm (located in the each room used per fire marshal) and carbon monoxide detector (located in back hallway) are operational. Emergency drills are being conducted and logged at least every six months and there is a written Disaster Plan on file. The home is clean, orderly with adequate ventilation and heating. Licensee has provided enough space for the children to eat, sleep and play within the home. Licensee provides all meals. The furniture, to include napping materials and children’s toys, books and activities are safe and age appropriate and in good repair. Licensee has checked for recalled items. There is a working telephone and all required forms are posted. Outdoor play space is fully fenced with age appropriate play equipment and activities in good repair. No hazards were noted. Licensee understands there is no smoking in or around day care areas. Children’s files were reviewed and found to be complete. The facility roster was current and complete and is being stored for 3 years. Licensee Sayena's pediatric CPR/FA certificate with A-B-Cpr is valid through 5/23. Licensee is reminded that Mandated Reporter Training certificates are to be renewed every two years at the following website: www.mandatedreporterca.com. Both Licensees certificates are valid thru 5/23. LPA discussed the safe sleep regulations with licensee [or facility representative] and discussed the Child Care Licensing Safe Sleep webpage at

SUPERVISOR'S NAME: Renesha Pack	TELEPHONE: (619) 767-2155
LICENSING EVALUATOR NAME: Joelle Redding	TELEPHONE: (619) 767-2222
LICENSING EVALUATOR SIGNATURE:	DATE: 04/11/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/11/2022

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: VAZIRINIA, SAYENA & SHIRAZI, SAHRA FCC	FACILITY NUMBER: 376627395
	VISIT DATE: 04/11/2022

NARRATIVE

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https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as anadditional resource. LPA also informed licensee [facility representative] 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 the CPSC to be notified of any recalls on their purchased equipment. . Licensee is reminded that infants may not be swaddled while in care and walkers, exersaucers, jumpers, bouncy seats, napping portables and drop sided cribs are not permitted for use.

With regard to Covid 19 precautions, Licensee is reminded that although the Department of Public Health is not currently requiring facial coverings, they are strongly recommended while indoors for children over 2 and adults, regardless of vaccination status.

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

Licensee was reminded that all adults 18 and over living or working in the home, 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 $500.00 maximum per day/per person will be assessed if this regulation is violated.

Licensee is to be present in the home to ensure children are supervised and reminded that no children are to be left in parked vehicles and car seats are not to use used for sleeping. . Capacity limitations were reviewed. LPA discussed California Megan's Law and the website was provided as follows: www.meganslaw.ca.gov

Licensee is advised to sign up for Quarterly Updates and Provider Information Notices (PINs) for one or more programs on our website: www.ccld.ca.gov. Select “Child Care” then “Quick Links” and Quarterly Updates. Select “Receive Important Updates” then put the email address in and choose which program(s) you would like to subscribe to and select “subscribe.”

SUPERVISOR'S NAME: Renesha Pack	TELEPHONE: (619) 767-2155
LICENSING EVALUATOR NAME: Joelle Redding	TELEPHONE: (619) 767-2222
LICENSING EVALUATOR SIGNATURE:	DATE: 04/11/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/11/2022

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: VAZIRINIA, SAYENA & SHIRAZI, SAHRA FCC	FACILITY NUMBER: 376627395
	VISIT DATE: 04/11/2022

NARRATIVE

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To improve the quality and value of the new inspection process, a survey will be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or tools, please send them by email to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/process.

LPA conducted child care quality management interview with Licensee Sayena Vazirinia. Exit interview conducted and report was reviewed with the Licensees Sayena VAzirinia and Sahra Shirazi.

No deficiencies are cited.

NOTICE OF SITE VISIT WAS GIVEN AND MUST REMAIN POSTED FOR 30 DAYS. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

SUPERVISOR'S NAME: Renesha Pack	TELEPHONE: (619) 767-2155
LICENSING EVALUATOR NAME: Joelle Redding	TELEPHONE: (619) 767-2222
LICENSING EVALUATOR SIGNATURE:	DATE: 04/11/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/11/2022

LIC809 (FAS) - (06/04)

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