015700107-4-4-2023-52-CC-SCOZ-CQKNR2-20230404104050

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 015700107
Report Date: 04/04/2023
Date Signed: 04/04/2023 10:41:19 AM

Document Has Been Signed on 04/04/2023 10:41 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 EAST, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612

FACILITY NAME:	RAHIMI, MUNEZHAN		FACILITY NUMBER:	015700107
ADMINISTRATOR:	RAHIMI, MUNEZHAN		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(510) 585-8107
CITY:	HAYWARD	STATE: CA	ZIP CODE:	94544
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 14	CENSUS: 5	DATE:	04/04/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	08:08 AM
MET WITH:	MUNEZHAN RAHIMI		TIME COMPLETED:	10:23 AM

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	Licensing Program Analyst Sidney Cortez, met with licensee Rahimi Munezhan for an Unannounced Annual Random Inspection. Present for this visit was the licensee, her 2 fingerprint cleared assistants: Mahbooba Ahmadi, and Bibiaqila Habibi, and 5 children (3 infants, and 2 preschool age). The home was toured to conduct a Health and Safety Inspection. The facility currently operates from 9:00AM until 5PM, MONDAY-FRIDAY. 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, and garage. The living room has a fireplace, blocked and inaccessible to children in care. The home is neat and clean, with wall heaters. Isolation area will be the in the family room away from 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. The outdoor play area is free from defects. There are ample age appropriate toys that are safe and observed to be clean and in good repair. There are no pools, hot tubs or any other bodies of water. LPA Cortez did not observe any hazardous materials or toxins accessible to children today The home has a fully charged (2A10BC) fire extinguisher, working smoke detector, working carbon monoxide detector, working telephone. The licensee CPR and First Aid certificate is current and expires (April 2024). The licensee's mandated reporter certificate is current, and will expire in APRIL 2024. Per licensee, there are no firearms in the home. The licensee conducts and documents fire and disaster drills twice a year with the last one conducted on JAN 2023 .2 Children files were reviewed, facility roster reviewed and copy obtained. The licensee is in ratio today. All REQUIRED forms are posted and visible for public review. See 809-C for continuance

SUPERVISORS NAME: Wynn Norona
LICENSING EVALUATOR NAME: Sidney Cortez
LICENSING EVALUATOR SIGNATURE:	DATE: 04/04/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/04/2023

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 EAST, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612

FACILITY NAME: RAHIMI, MUNEZHAN	FACILITY NUMBER: 015700107
	VISIT DATE: 04/04/2023

NARRATIVE

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LPA Cortez provided a copy of Safe Sleep in Child Care brochure, a handout "What Does A Safe Sleep Environment Look Like?," and PIN 19-06-CCP to the licensee. LPA Cortez provided licensee with a copy of the CDSS handout on Effects of Lead Exposure and Never Shake a Baby Brochure (attached PUB 271). The licensee is reminded any structural changes to the home or additions to the child care facility must be reported to Community Care Licensing. Also, any adults moving into the home must be reported to Community Care Licensing prior to them moving in and all requirements must be met before the person lives in the facility. Licensee was reminded of Departments inspection authority, with our without any notice.California Law requires Family Child Care Home licensees to report unusual incidents or injuries to children in care to child's parents and to the Department of Social Services using the Unusual Incident/Injury form (LIC 624). Incidents must be reported within 24 hours by phone, fax, or electronic mail. Roster of the children must be properly maintained and fire/disaster drill every six months must be documented.

The licensee was also reminded that baby bouncers, exersaucers, johnny jumpers and similar items are not allowed in licensed day care. Licensee is reminded that ALL assistants, volunteers, frequent visitors, or adults living in the home, that are 18 years of age or older must be fingerprint cleared and associated to this facility prior to being in the presence of children in care or an immediate civil penalty will be assessed from $100 to $3000 per person, per incident. Licensee was reminded of the responsibility as a mandated reporter. All forms can be downloaded at www.ccld.ca.gov For licensing updates email childcareadvocatesprogram@dss.ca.gov and ask to be added to the email list. This entire report has been read to the Licensee by LPA Cortez. The licensee is aware the signature on this report confirm receipt of these documents. LPA asked the licensee if the licensee had any questions pertaining to any aspects including, but not limited to, any part of this report and of the documents given to the licensee, and per licensee, there are no further questions at this time. Licensee is aware at anytime she can reach out to LPA Cortez or CCLD.

There are no deficiencies cited. This report shall remain on file for 3 years. A notice of site visit was given and must remain posted for 30 days. Exit interview conducted

SUPERVISORS NAME: Wynn Norona
LICENSING EVALUATOR NAME: Sidney Cortez
LICENSING EVALUATOR SIGNATURE:	DATE: 04/04/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/04/2023

LIC809 (FAS) - (06/04)

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