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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 015700107
Report Date: 12/20/2022
Date Signed: 12/20/2022 11:23:05 AM

Document Has Been Signed on 12/20/2022 11:23 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, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME:RAHIMI, MUNEZHANFACILITY NUMBER:
015700107
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 3DATE:
12/20/2022
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
09:15 AM
MET WITH:Munezhah RahimiTIME COMPLETED:
11:30 AM
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On Dec 20, 2022 Licensing Program Analyst (LPA) Cortez conducted a case management visit for a capacity increase inspection. Present in the home today was the licensee Munezhah Rahimi, and 2 infants,4 preschool age children and her fingerprint cleared staff Bibi Habibi. All requested documents were received for the increase of capacity application. The fire clearance for a capacity of 14 was received from the Hayward Fire Department. Ratios were discussed including proper ratio compliance in case an assistant is unavailable for a day and or does not come due to illness etc. The Licensee was reminded that whenever an assistant is not present, the licensee will comply with the capacity requirement. The home is neat and clean with adequate ventilation for safety and comfort. This is a one story home which consists of a living room, dining room, family room, 3 bedrooms, a hallway bathroom, master bath, kitchen, backyard, attached garage. The living room has a fireplace, blocked and inaccessible to children in care.
On-limit-areas include: Living room, dining room, family room, kitchen, childcare area, hall bathroom and the backyard.
Off-limit-areas include: Master bedroom, master bath, 2nd and 3rd bedrooms, garden, and front side yard. The Off-Limit areas will be inaccessible by child safety gates, closed and/or locked doors and visual supervision.
The garden and the opposite side yard are blocked making them inaccessible to children in care.The outdoor play area will be in the backyard area of the home, which is fenced in.
Isolation area will be the family room away from children in care. There are no pools, hot tubs or any other accessible bodies of water.


All hazardous materials and toxins are kept out of the reach of children and it was observed that there are no toxins or hazardous items accessible during today's inspection. The home has a fully charged 2A10BC fire extinguisher, working smoke detector, working carbon monoxide detector, working telephone. There are no deficiencies cited on this visit.The home is recommended for a Large Family Child Care Home License effective today, 12/20/2022. Exit interview conducted and report was reviewed with the Licensee.


SUPERVISORS NAME: Wynn Norona
LICENSING EVALUATOR NAME: Sidney Cortez
LICENSING EVALUATOR SIGNATURE: DATE: 12/20/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/20/2022
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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