013422627-9-27-2024-52-CC-RMIA-D9G233-20240925170140

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 013422627
Report Date: 09/25/2024
Date Signed: 09/27/2024 10:24:52 AM

Document Has Been Signed on 09/27/2024 10:24 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
OAKLAND SOUTH CC RO, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612

FACILITY NAME:	JABEEN, ZAHIDA		FACILITY NUMBER:	013422627
ADMINISTRATOR/ DIRECTOR:	JABEEN, ZAHIDA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(510) 857-4606
CITY:	FREMONT	STATE: CA	ZIP CODE:	94536
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 14	CENSUS: 3	DATE:	09/25/2024
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	02:55 PM
MET WITH:	Zahida Jabeen		TIME VISIT/ INSPECTION COMPLETED:	05:01 PM

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On September 25, 2024 2:55pm Licensing Program Analyst (LPA) Randy Miranda arrived unannounced for the purpose of conducting an annual inspection for health and safety. Living in the home is the licensee, her fingerprint cleared and TB tested husband, adult daughter, and 17-year-old son. Present for the inspection today is the licensee, licensee’s husband, adult daughter, and 3 children in care (2 infants and 1 toddler age). The hours of operation are Monday – Friday 7:00am to 7:00pm.

The facility is a single story 3-bedroom, 2 bath with a living room; dining room; kitchen; family room, attached 2-car garage, side and back yard areas. The outdoor play area is a raised wooden deck surrounded by a fence and is free from defects and dangerous conditions. Per the licensee, there are no firearms in the home. Licensee rents the property and lease agreement is on file.

Toxins, medicines, and hazardous items were inaccessible during today's inspection. Per the licensee, the ISOLATION AREA will be in the living room, by the front door away from the other children in care.

On-limit-areas include: Living room; family room (child care room); dining room; hallway leading to the house bathroom; outside raised wooden patio deck. There are child safety gates installed preventing child access to the kitchen and another to separate the dining room from the living room. There are no accessible hazardous cleaning chemicals or other liquids in the on-limits area

Off-limit-areas include: Kitchen; all bedrooms in the home; master bathroom; all outside areas except for the raised wooden patio deck; and attached 2-car garage. The off-limit areas will be inaccessible by child gates, closed and/or locked doors, and/or by child supervision.

SUPERVISORS NAME: Wynn Norona
LICENSING EVALUATOR NAME: Randy Miranda
LICENSING EVALUATOR SIGNATURE:	DATE: 09/25/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/25/2024

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
OAKLAND SOUTH CC RO, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612

FACILITY NAME: JABEEN, ZAHIDA	FACILITY NUMBER: 013422627
	VISIT DATE: 09/25/2024

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The home has a fully charged 2A10BC fire extinguisher wall mounted, between the living room and family room (child day care area), a combined smoke alarm and a carbon monoxide detector (all tested and functioning), and a working telephone. Fire clearance was granted on 3/18//2024 from the Fremont Fire Department with the condition of having no children present in the garage.

There is a fireplace in the on-limits living room with a zip-tied glass screen and blocked by a large couch. Fire and earthquake drills are conducted every 6 months, the last drill was completed on 6/10/2024. The home has heating and ventilation for safety and comfort. There were ample age appropriate toys observed to be in safe and good condition.

The licensee's CPR and First Aid certificate are current and expire on 2/23/2025; Mandated Reporter has been completed and will expire 12/23/2025. All adults living in the home were in compliance with all immunization laws which pertains to day care providers.

LPA reminded licensee of the following: CPR/1st Aid and Mandated Reporter training must be renewed every two years. Baby bouncers & drop-down cribs are not allowed at the day-care facility. LPA did not observe any bodies of wate,r hazardous materials, or toxins accessible to children on the premises during the inspection.

Children's files were reviewed, a roster was reviewed and a copy taken by the LPA. All files were complete and in good order. Sleep logs were present for infants, reviewed and complete. The licensee does not carry liability insurance. All LIC 282 forms Notice of no Liability Insurance signed and dated in each child’s file.

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.

SUPERVISORS NAME: Wynn Norona
LICENSING EVALUATOR NAME: Randy Miranda
LICENSING EVALUATOR SIGNATURE:	DATE: 09/25/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/25/2024

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
OAKLAND SOUTH CC RO, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612

FACILITY NAME: JABEEN, ZAHIDA	FACILITY NUMBER: 013422627
	VISIT DATE: 09/25/2024

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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

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.

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/inspection-process.

There were no deficiencies issued today. A copy of this report will remain on file for three years.

A notice of site visit was given and must remain posted for 30 days. Appeal Rights provided.

Exit interview conducted and report was reviewed with the licensee Zahida Jabeen.

SUPERVISORS NAME: Wynn Norona
LICENSING EVALUATOR NAME: Randy Miranda
LICENSING EVALUATOR SIGNATURE:	DATE: 09/25/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/25/2024

LIC809 (FAS) - (06/04)

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