197495038-4-13-2023-58-CC-MREN-CQUNNG-20230413103644

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 197495038
Report Date: 04/13/2023
Date Signed: 04/13/2023 10:37:39 AM

Document Has Been Signed on 04/13/2023 10:37 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
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME:	VALDEZ & RANJBAR FAMILY CHILD CARE		FACILITY NUMBER:	197495038
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY: 8	TOTAL ENROLLED CHILDREN: 8	CENSUS: 5	DATE:	04/13/2023
TYPE OF VISIT:	Case Management - Licensee Initiated	ANNOUNCED	TIME BEGAN:	08:05 AM
MET WITH:	Bahman Ranjbar and Anabel Valdez Rodriguez		TIME COMPLETED:	10:45 AM

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On 04/13/2023 Licensing Program Analysts (LPAs) Deborah Lowe and Maria Rendon met with Licensees Bahman Ranjbar and Anabel Valdez Rodriguez. The purpose of the visit is a case management licensee initiated visit inspection at the home located at 20142 Clark St to ensure that health, safety and personal rights as requires by Title 22 and Health and Safety Regulations governing California Child Care Homes will be met. Licensees are requesting an increase of capacity up to 14 children, ages 0 years to 6 years old. The Family Child Care Home will operate Monday – Friday 7:00 a.m. – 5:00 p.m. The fire clearance was approved on 03/14/2023.

Verification licensee owns property is on file reflecting licensee have control of property. Currently living in the home are the 2 licensees, 1 adult child and 2 minor children.

Description of Home:

On limit areas: Daycare room, Livingroom, bathroom #1, kitchen, and dining room.

Off limit areas: Garage, master bedroom, master bathroom, bedroom #2, and bedroom #3

Rooms identified matched facility sketch on file. Licensee will amend to show labels of Off Limit rooms.

LPAs Lowe and Rendon observed a working carbon monoxide detector in the home, LPA Lowe and Rendon were able to hear a successful test. Smoke detectors are located kitchen, hallway, living room and children’s playroom. Fire extinguisher 2A10BC was observed, located in the kitchen mounted on the wall. Electrical outlets were observed to be inaccessible to children in care with the use of plug covers. The home was observed to be clean and orderly with heating and ventilation. LPAs observed safe toys, play equipment, and materials.

LPAs observed cleaning compounds and detergents inaccessible to children with the use of child proof latches on cabinets. LPAs advised poisons shall be locked with a key or a combination lock. No poisons were observed.

SUPERVISORS NAME: Lisa Rios
LICENSING EVALUATOR NAME: Maria Rendon
LICENSING EVALUATOR SIGNATURE:	DATE: 04/13/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/13/2023

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
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME: VALDEZ & RANJBAR FAMILY CHILD CARE	FACILITY NUMBER: 197495038
	VISIT DATE: 04/13/2023

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LPAs observed 4 cots, and 3 play yards were observed for napping. LPAs reviewed and discussed Safe Sleep regulation with licensees. LPAs observed home to be in compliance with Safe Sleep Regulations.

Per licensee, there are no firearms located in the home. LPAs Lowe and Rendon observed a fireplace in the living room to be screened barricaded making it inaccessible to children in care.

Kitchen was observed with sharp utensils, matches, and open bottles of alcohol are inaccessible with the child proof latches. Kitchen was observed to be clean. Kitchen is not off limits however licensee has 2 child proof gates on each entrance to the kitchen. LPAs observed refrigerator to be clean and no children’s food from home was observed. Per licensee, licensee prepares food and children may bring food from home. Per licensee, food brought from home is labeled with child’s name.

Bathrooms were observed to be clean with toilet and faucet safe and operable. The On Limits bathroom was observed with a child proof latch on the shower door making shampoos and soaps in the shower inaccessible to children.

Outdoor area is located in the back yard. Outdoor play areas was observed to be fenced. Off Limit areas in the backyard was made inaccessible with a child’s gate. No pools and other bodies of water were observed.

Isolation area will be located in the living room. Home was observed with a first aid kit in the children’s play room.

LPAs advised smoking is prohibited on the premises of a family child care home as specified in Health and Safety Code Section 1596.795(a). A baby walker shall not be allowed on the premises of a family child care home in accordance with Health and Safety Code Sections 1596.846(b) and (c).

LPAs advised, fixtures, furniture, and equipment that have been banned or recalled by the United States Consumer Safety Commission shall not be used for children in care or accessible to children in care.

LPAs observed the following required postings: current facility license, LIC610A Emergency Disaster Plan, and PUB 394 Notification of Parents’ Rights Poster. LPAs reviewed facility’s current LIC 9040 Child Care Roster. LPAs reviewed a sample children’s file and found children’s file in compliance.

LPAs advised per CC Regulation 102417(a) Operation of A Family Child Care Home The licensee shall be

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SUPERVISORS NAME: Lisa Rios
LICENSING EVALUATOR NAME: Maria Rendon
LICENSING EVALUATOR SIGNATURE:	DATE: 04/13/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/13/2023

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
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME: VALDEZ & RANJBAR FAMILY CHILD CARE	FACILITY NUMBER: 197495038
	VISIT DATE: 04/13/2023

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present in the home and shall ensure that children in care are supervised at all times. When circumstances require the licensee to be temporarily absent from the home, the licensee shall arrange for a substitute adult to care for and supervise the children during his/her absence. Temporary absences shall not exceed 20 percent of the hours that the facility is providing care per day.

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.

LPAs 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. LPAs also informed licensees 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

LPAs reviewed with licensee the LIC 311D, Forms/Records To Keep In Your Family Child Care Homes, children’s forms/records, facility forms/records, and information to be posted.

Entrance Checklist was provided to the licensee.

Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other important information communication platform. pg 3 of 4

SUPERVISORS NAME: Lisa Rios
LICENSING EVALUATOR NAME: Maria Rendon
LICENSING EVALUATOR SIGNATURE:	DATE: 04/13/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/13/2023

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
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME: VALDEZ & RANJBAR FAMILY CHILD CARE	FACILITY NUMBER: 197495038
	VISIT DATE: 04/13/2023

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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 following corrections are needed before a capacity increase will be considered. Corrections are due by 04/17/2023:

· Facility Sketch with off limit areas identified

· A picture showing placement of child gate making bedrooms off limit.

A notice of site visit was given and must remain posted on, or immediately adjacent to, the interior side of the main door for 30 days.

An exit interview was conducted with the above items discussed and a copy of appeal rights and this report was provided to the Licensees Bahman Ranjbar and Anabel Valdez Rodriguez. Final license determination will be made upon review by the Licensing Program Manager and correction of the above issues.

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SUPERVISORS NAME: Lisa Rios
LICENSING EVALUATOR NAME: Maria Rendon
LICENSING EVALUATOR SIGNATURE:	DATE: 04/13/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/13/2023

LIC809 (FAS) - (06/04)

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