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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 566214337
Report Date: 12/28/2021
Date Signed: 12/28/2021 11:32:40 AM

Document Has Been Signed on 12/28/2021 11:32 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, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117
FACILITY NAME:MIRZADEH FCC AKA MINI STEPS ACADEMYFACILITY NUMBER:
566214337
ADMINISTRATOR:MIRZADEH, JALEHFACILITY TYPE:
810
ADDRESS:TELEPHONE:
8183550535
CITY:WESTLAKE VILLAGESTATE: CAZIP CODE:
91362
CAPACITY: 14TOTAL ENROLLED CHILDREN: 9CENSUS: 0DATE:
12/28/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:28 AM
MET WITH:Jaleh MirzadehTIME COMPLETED:
11:50 AM
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On December 28, 2021 at 9:38 AM, Licensing Program Analysts (LPA) Dean Thompson conducted an unannounced Annual/Random inspection. LPA conducted the Covid-19 screening questions prior to entering the facility. LPA met with licensees Jaleh Mirzadehi and advised the purpose of the inspection. Licensee provided LPA a tour of the home inside and out. There were no children in care at the time of the inspection.

LPAs observed required licensing documents mounted on the wall near the family room.

Children in care have access to the family room, bathroom, and backyard. During the tour, LPA did not observe any hazards/toxins items that would be accessible to children when in care. Licensee stated there are no firearms or ammunition inside the home. There are no bodies of water present at the time of inspection. Fire and carbon monoxide alarms were observed. Fire extinguisher 2A10BC is fully charged. Fire and earthquake drills are being logged and viewable. Fireplace in the family room is covered by a screen preventing children from access. Children have access to toys that are age-appropriate inside and outside of the home. Back yard is enclosed by a brick wall and shaded.

LPA reviewed children files. Licensee advised there were no children in care that required Incidental Medical Services.

Licensee CPR certification is due for renewal as of 12/17/21. Licensee has not completed the mandated reporter training and stated she was unaware of such certification.


Continued on 809-C
SUPERVISORS NAME: George Mingle
LICENSING EVALUATOR NAME: Dean Thompson
LICENSING EVALUATOR SIGNATURE: DATE: 12/28/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/28/2021
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, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117
FACILITY NAME: MIRZADEH FCC AKA MINI STEPS ACADEMY
FACILITY NUMBER: 566214337
VISIT DATE: 12/28/2021
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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.

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.

LPA discussed the safe sleep regulations with licensee 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 licensee 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.

LPA discussed mandated reporter training with licensee and advised licensee to visitwww.mandatedreporterca.com to complete the training.

Technical Advisory were given at the time of inspection.

A 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.

Exit interview conducted and report was reviewed with Licensee Jaleh Mirzadeh

SUPERVISORS NAME: George Mingle
LICENSING EVALUATOR NAME: Dean Thompson
LICENSING EVALUATOR SIGNATURE:

DATE: 12/28/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/28/2021
LIC809 (FAS) - (06/04)
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