197495179-12-6-2022-58-CC-LSTN-CLUTKK-20221206134805

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 197495179
Report Date: 12/06/2022
Date Signed: 12/06/2022 01:48:18 PM

Document Has Been Signed on 12/06/2022 01:48 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
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME:	REZAEI FAMILY CHILD CARE		FACILITY NUMBER:	197495179
ADMINISTRATOR:	NEDA REZAEI		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(310) 970-2382
CITY:	WOODLAND HILLS	STATE: CA	ZIP CODE:	91367
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 14	CENSUS:	DATE:	12/06/2022
TYPE OF VISIT:	Prelicensing	UNANNOUNCED	TIME BEGAN:	09:45 AM
MET WITH:	Neda Rezaei		TIME COMPLETED:	02:07 PM

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	On 12/06/2022 at 9:45AM Licensing Program Analyst (LPA’s) Laticia Thompson arrived at the home of Neda Rezaei (Applicant) to conduct an Announced Pre-Licensing Inspection. Applicant guided the LPA on a tour of the home. The facility operation hours will be Monday – Friday 7:00am to 6:30pm. The applicant is applying for a large family child care to care for a capacity of 14 children ages 3 months-12 years. Family members residing in the home include a friend and applicant’s son, Applicant’s home is a one story home. LPA Laticia Thompson was greeted by Neda Rezaei and Majid Shakeri (husband). LPA entered though the front door. Applicant stated parents and children will enter and exit through the left side bar gate located on the side of the home. This bar gate will be used to reach the left back door that leads directly to children’s area. Through the front door of the home there is a room located on the left hand side (off limits) this bedroom has a closet and bathroom. There is a small hall between the front door and the bedroom. There is a second door in the hall that leads into the living room and dinning room area. To the right of the front door is a storage closet. To the left of the front door is a door that leads to a hall, with 2 additional bedrooms, bathroom and 2 closets (all off limits) this door has a safety knob. One of the bedrooms has a door that leads to the garage. Applicant will store medication and cleaning solutions in one of the closets located in the hall area, that has a security latch preventing access. The living room and dinning room area (off limits) has a set of patio doors that leads to a patio area and the swimming pool (off limits). To the lefts of the dining room area there is an opening that leads into the kitchen (off limits), there is a security gate barrier. The kitchen cabinets have safety latches on the bottom cabinets. Applicant will store all sharp items in the top cabinet located at the entrance. Cabinet will have a safety latch preventing access. The kitchen has a side door that leads to the side of the home.

SUPERVISORS NAME: Rita Ramos
LICENSING EVALUATOR NAME: Laticia S Thompson
LICENSING EVALUATOR SIGNATURE:	DATE: 12/06/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/06/2022

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

FACILITY NAME: REZAEI FAMILY CHILD CARE	FACILITY NUMBER: 197495179
	VISIT DATE: 12/06/2022

NARRATIVE

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Applicant will use shelves in the kitchen area next to the back door as cubies for children’s belongings. There is a safety gate between the kitchen and children area preventing access. The children has to large areas with a safety gate dividing the children area. There is a bathroom in the children area. The cabinet under the sink located in the bathroom has a safety latch. The children area has cabinets with magnetic safety locks and one of the cabinets has a metal handle lock. There is also a sink, the cabinet under the sink has a safety latch. Next to the cabinet area is a side door where parents and children will enter and exit. There is a sliding glass door that leads to the backyard play area. The backyard play area is completely fenced in. The backyard play area has safe, age appropriate toys, play equipment and materials. There is cushioning material all around the back yard play area. LPA observed pool area and found it not in compliance, the fence is not at least 5 feet, gate does not self latching and does not open outward.

Parent board is located in the children area on the left side wall. Applicant states there are no firearms or weapons of any kind in the facility at the time of the visit. LPA observed the Parent Board with the required documents according to Title 22 Regulations posted. Prior to visit a file review was conducted by LPA, applicant has an Emergency Disaster Plan, Property Landlord Notification, Child Abuse Statement (LIC9108), and an Earthquake Preparedness Checklist. The applicant has up-to-date Preventative Health and Safety/Childhood Nutrition, First Aid/CRP/AED, and Mandated Reporter Trainings.

LPA observed safe toys, play equipment. Applicant stated learning materials are located at other facility at this time.

LPA observed one play yard and 6 cots for napping. Applicant stated she has additional 4 play yards and 6 additional cots for sleeping located at current location.

The home is clean and orderly with central air/heating and ventilation for safety and comfort.

Applicant has a working cell phone and line land.

SUPERVISORS NAME: Rita Ramos
LICENSING EVALUATOR NAME: Laticia S Thompson
LICENSING EVALUATOR SIGNATURE:	DATE: 12/06/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/06/2022

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: REZAEI FAMILY CHILD CARE	FACILITY NUMBER: 197495179
	VISIT DATE: 12/06/2022

NARRATIVE

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There is carbon monoxide and smoke detector located in the children area. LPA tested detectors and found them to be operable condition.

The fire extinguisher is up to standards (2A10BC) and is fully charged, fire extinguisher has not been inspected. Applicant stated she will purchase another or have the extinguisher inspected prior to licensure.

Poisons, detergents, cleaning compounds and medicines are stored where they are inaccessible to children.

There are 2 first aid kits located in the children area.
LPA provided applicant with posting requirements, emergency disaster plan information, earthquake preparedness checklist, Lead flyer requirements, Forms and Records to Keep in FCCH (LIC311D), Liability Insurance regulation, all documents required for children files, pool requirements, parents rights posting, safe sleep documents, ratio documents and additional help information.

Applicant 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, licensee, or facility representative] 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. LPA also informed [applicant, licensee, or facility representative] 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

SUPERVISORS NAME: Rita Ramos
LICENSING EVALUATOR NAME: Laticia S Thompson
LICENSING EVALUATOR SIGNATURE:	DATE: 12/06/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/06/2022

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: REZAEI FAMILY CHILD CARE	FACILITY NUMBER: 197495179
	VISIT DATE: 12/06/2022

NARRATIVE

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APPLICANT WILL WAIT UNTIL FACILITY OPENS TO DETERMINE IMS NEEDS:

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

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.

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.

Applicant will make corrections to pool area and purchase or have fire extinguisher inspected by 12/19/2022.

An exit interview was conducted with the plan of corrections that were discussed. A copy of this report was provided to the applicant. Final license determination will be made upon review by the Licensing Program Manager and corrections made.

SUPERVISORS NAME: Rita Ramos
LICENSING EVALUATOR NAME: Laticia S Thompson
LICENSING EVALUATOR SIGNATURE:	DATE: 12/06/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/06/2022

LIC809 (FAS) - (06/04)

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