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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 414004619
Report Date: 09/15/2021
Date Signed: 09/15/2021 02:33:34 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME:BETERGESHFA, ZARIMA M.FACILITY NUMBER:
414004619
ADMINISTRATOR:BETERGESHFA, ZARIMA M.FACILITY TYPE:
810
ADDRESS:TELEPHONE:
(510) 423-2640
CITY:DALY CITY,STATE: CAZIP CODE:
94015
CAPACITY:14CENSUS: 6DATE:
09/15/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
12:10 PM
MET WITH:Betergeshfa ZarimaTIME COMPLETED:
02:30 PM
NARRATIVE
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On September 15, 2021, Licensing Program Analyst (LPA), Kaur, conducted an unannounced annual inspection and met with Licensee Betergeshfa Zarima and her daughter Darwish Dalia. The purpose of the inspection was explained and granted entry to the home by the Licensee. At present, there are 6 children in care. Licensee rents this double story house. Daycare areas downstairs – 2 Bedrooms, bathroom, living area and backyard. Off limit upstairs Days and operation hours are 7:30 am – 6:00 pm, Monday - Friday. Per Licensees, sick children will be separated from the group and waiting in the office area.

LPA, along with the Licensee, inspected the daycare areas for health and safety hazards. During the inspection, LPA observed the following: The daycare area is clean, orderly, and equipped with age-appropriate toys and equipment for the children. The home has adequate lighting and ventilation. The house has a working telephone, smoke alarm, carbon monoxide detector, and a fully charged fire extinguisher. First aid supplies are available for children. Per Licensee, there are no firearms, weapons, or pets in the home. LPA observed no pools, spas, or other bodies of water on the premises. The Licensee had posted all the required forms (i.e., License, Notification of Parent's Rights, and Notification of Personal Rights). Per Licensee, fire drills are conducted every six months, and a record of the drill was documented accordingly, and the last fire drill was performed on 06/20/21
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SUPERVISOR'S NAME: Ali ZebilaTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Harsimran KaurTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:

DATE: 09/15/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/15/2021
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, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME: BETERGESHFA, ZARIMA M.
FACILITY NUMBER: 414004619
VISIT DATE: 09/15/2021
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LPA reviewed the children's records and Licensee's records. LPA observed that the Licensee maintained records of each child accordingly; identification and emergency information, consent for medical treatment, and parent's rights are completed properly. The Licensee has maintained a record of immunization and CPR First Aid training is valid until 07/2022.

The Following were discussed with the Licensee; The Licensee was reminded about the Provider Information Notices (PINs) on the CCLD website. Licensee was informed that as of September 1, 2016, a person may not be employed or volunteer at a child care facility unless he or she has been immunized against influenza, pertussis, and measles or qualifies for an exemption pursuant to Health and Safety code 1596.7995 and 1597.662. LPA reviewed AB 1207 with the Licensee. As of January 1, 2018, all staff is required to complete Mandated Reporter Training every two years. The training can be obtained online at www.mandatedreporterca.com. Also, Licensee was given information regarding the new Safe Sleep regulation and infant sleep plan.
LPA encouraged the Licensee to frequently visit our website at www.ccld.ca.gov for licensing regulations and new updates. The facility can also email at childcareadvocatesprogram@dss.ca.gov and ask to be added to the email list for the updates.

No deficiencies were observed in today's inspection. The report was reviewed and signed by the Licensee, Darwish Dailia. Today's report, 09/15/2021, and notice of site visit will be sent to the Licensee at dalianabil446@gmail.com by the close of business on 09/15/21. Confirmation of receipt is required.

SUPERVISOR'S NAME: Ali ZebilaTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Harsimran KaurTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:

DATE: 09/15/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/15/2021
LIC809 (FAS) - (06/04)
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