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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 015700227
Report Date: 04/30/2024
Date Signed: 04/30/2024 01:28:30 PM

Document Has Been Signed on 04/30/2024 01:28 PM - 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:ELDEEB, SAHARFACILITY NUMBER:
015700227
ADMINISTRATOR/
DIRECTOR:		ELDEEB, SAHARFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(510) 335-9712
CITY:FREMONTSTATE: CAZIP CODE:
94538
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 3DATE:
04/30/2024
TYPE OF VISIT:POCUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:10 PM
MET WITH:Tamana RahimiTIME VISIT/
INSPECTION COMPLETED:
01:35 PM
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On 04/30/2024 at 1:1oPM, Licensing Program Analyst (LPA) Jaleesa Jackson conducted an unannounced Plan of Correction Visit. LPA met with Licensee's assistant Tamana Rahimi. Licensee was away at an appointment. Also present in the home were 2 preschool aged children and 1 infant.

On 04/09/2024, LPA conducted a case management visit. The Family Child Care Home (FCCH) was cited 1 Type A citations for Criminal Background Check.

The Licensee and LPA developed a Plan of Correction (POC) with submission due date of 04/10/2024 and LPA conducted a POC visit.

LPA generated a Letter of Deficiency Citations Cleared and provided a copy to the Facility Representative.

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

Exit interview conducted and report was reviewed with the Facility Representative Tamana Rahimi.
SUPERVISORS NAME: Jason Jang
LICENSING EVALUATOR NAME: Jaleesa Jackson
LICENSING EVALUATOR SIGNATURE: DATE: 04/30/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/30/2024
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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