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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 073409320
Report Date: 08/31/2022
Date Signed: 08/31/2022 11:03:59 AM

Document Has Been Signed on 08/31/2022 11:03 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, SUITE 1102
OAKLAND, CA 94612
FACILITY NAME:SARTIP, NAEEMEHFACILITY NUMBER:
073409320
ADMINISTRATOR:SARTIP, NAEEMEHFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(925) 448-6537
CITY:PLEASANT HILLSTATE: CAZIP CODE:
94523
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 0DATE:
08/31/2022
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME BEGAN:
09:24 AM
MET WITH:Naeemeh SartipTIME COMPLETED:
11:15 AM
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On 08/31/2022, at 9:24am, Licensing Program Analyst (LPA) Catherine Fernandes conducted an announced increase and change of location inspection. Present for the inspection was the Licensee and her finger print cleared adult daughter. Residing in the home is the Licensee, her fingerprint cleared husband and adult daughter. The home was toured for a health and safety inspection. Operating hours will 7:00am- 5:30pm, Monday through Friday.

The house is two-story home that consists of four bedrooms and two bathrooms, which is neat and clean with heating and ventilation for the children. The entrance to the day care is the front door. The inside and outside of the home were observed to be neat, clean with age appropriate materials and toys for the children. All toxins, cleaning products, medications, and hazardous materials were observed to be in inaccessible areas. During today’s inspection, LPA observed the following precautions, there is a fireplace in the main room of the day care that has been covered and blocked, the stairs leading upstairs has a safety gate and the outlet in the home have been covered. Licensee has stated that there are no firearms. Both outdoor areas are fully fenced in with a age appropriate toys.

ON LIMIT AREAS: The living room (main area of day care), dining room (another area of day care), the downstairs bathroom, the kitchen, the family room, and both areas of the fenced in backyard.
OFF LIMIT AREAS: The entire second floor, the downstairs master bedroom, the laundry room, the shed in the backyard and the garage, which will be inaccessible by closed and/or locked doors or visual supervision.
ISOLATION AREA: the family room.
The home has a fully charged 3A40BC fire extinguisher located in the garage, a working smoke/carbon monoxide detector in the hallway next to the kitchen. The home has a pull down fire alarm located in the closet. The Licensee has a working telephone and complete First Aid Kit. All required forms are posted and visible for public view at the entrance of the day care. The Licensee's CPR and First Aid certificate is
Report continues on 809C
SUPERVISORS NAME: Mayla Mendoza
LICENSING EVALUATOR NAME: Catherine Fernandes
LICENSING EVALUATOR SIGNATURE: DATE: 08/31/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/31/2022
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612
FACILITY NAME: SARTIP, NAEEMEH
FACILITY NUMBER: 073409320
VISIT DATE: 08/31/2022
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current and expires on 5/23. The Licensee was reminded of the responsibility as a mandated reporter and has provided proof of the required training for which was conducted on 5/10/22. LPA did not observe any bodies of water in or around the home.
Licensee was reminded that all adults 18 and over living in the home, persons who provide care and supervision to children, and staff who have contact with children, 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 applicant and discussed the Child Care Licensing Safe Sleep web page at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed applicant 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.

Incidental Medical Services (IMS) policy was discussed. For IMS information , see PIN 22-02-CCP. 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


To receive important licensed related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-care-licensing/subscribe and select the Child Care option to receive email communication.

The home has been granted a fire clearance by the Contra Costa County Fire Protection Department on 8/25/22.

The home and Licensee has been approved for a Large family child care home.

Exit interview conducted.

Report and Appeal Rights provided

SUPERVISORS NAME: Mayla Mendoza
LICENSING EVALUATOR NAME: Catherine Fernandes
LICENSING EVALUATOR SIGNATURE:

DATE: 08/31/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/31/2022
LIC809 (FAS) - (06/04)
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