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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198000148
Report Date: 05/30/2025
Date Signed: 05/30/2025 01:19:53 PM

Document Has Been Signed on 05/30/2025 01:19 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
MONTEREY PARK CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME:FAOURI FAMILY DAY CAREFACILITY NUMBER:
198000148
ADMINISTRATOR/
DIRECTOR:		FAOURI, FERYALFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(909) 625-5808
CITY:CLAREMONTSTATE: CAZIP CODE:
91711
CAPACITY: 14TOTAL ENROLLED CHILDREN: 11CENSUS: 4DATE:
05/30/2025
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:00 AM
MET WITH:Feryal FaouriTIME VISIT/
INSPECTION COMPLETED:
01:30 PM
NARRATIVE
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On 05/30/2025 at 09:00 am, Licensing Program Analyst (LPA), Carolyn Tuba conducted an unannounced inspection visit for the above facility. LPA entered home through the front door. The facility is a large family childcare. LPA met with Licensee, Feryal Faouri. LPA observed 4 children in care during this visit. Licensee stated that she currently has 11 children enrolled.

Family members residing in the home are 4 adults (criminal record clearances on file) and there are no minor children. This is a one-story home which consists of 3 bedrooms, 2 bathrooms, kitchen, dining room, living room, converted garage with permit, front yard and backyard (fenced). The children use the bathroom in the hallway. LPA observed cleaning products that are kept locked under the bathroom sink.

A facility roster was available. Per Licensee, operating hours are from Sunday-Saturday 6:00 am – 7:00 pm and cares for children ages Birth to 13 years of age. The licensee provides Breakfast, PM snack, lunch, and dinner for the children in care and is currently part of a food program.

Areas used by children were inspected include: Playroom (Permitted Garage), kitchen, 1 bathroom in hallway and enclosed back yard.

Per Licensee areas off limits include: 3 bedrooms, 1-bathroom inside of bedroom, living room, dining area are off-limits and need to be made inaccessible during operating hours. LPA observed that doors are kept closed and locked.
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NAME OF LICENSING PROGRAM MANAGER: Katrina Chicote
NAME OF LICENSING PROGRAM ANALYST: Carolyn Tuba
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 05/30/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/30/2025
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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California Health & Human Services Agency
California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:
  • Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.
  • Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)
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Document Has Been Signed on 05/30/2025 01:19 PM - It Cannot Be Edited


Created By: Carolyn Tuba On 05/30/2025 at 12:26 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: FAOURI FAMILY DAY CARE
FACILITY NUMBER: 198000148

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/30/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102417(d)
Operation of A Family Child Care Home
(d) The home shall provide safe toys, play equipment and materials.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on (observation), the licensee did not comply with the section cited above in 3 bikes were missing the rubber handlebars and broken scooter which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 06/13/2025
Plan of Correction
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Licensee will replace the outside bike equipment.
Type B
Section Cited
CCR
102425(a)(3)
Infant Safe Sleep
(a) There shall be one crib or play yard for each infant who is unable to climb out of the crib or play yard. (3) Mattresses shall be firm and covered with a fitted sheet that is appropriate to the mattress size, fits tightly on the mattress, and overlaps the underside of the mattress so it cannot be dislodged.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on (observation), the licensee did not comply with the section cited above in a fitted sheet was not observed and a blanket was being used instead which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 05/30/2025
Plan of Correction
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During the visit Licensee's daughter purchased a new fitted sheet and it was replaced.
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
Katrina Chicote
NAME OF LICENSING PROGRAM MANAGER:
Carolyn Tuba
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 05/30/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/30/2025


LIC809 (FAS) - (06/04)
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Document Has Been Signed on 05/30/2025 01:19 PM - It Cannot Be Edited


Created By: Carolyn Tuba On 05/30/2025 at 12:26 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: FAOURI FAMILY DAY CARE
FACILITY NUMBER: 198000148

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/30/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102425(c)
Infant Safe Sleep
An Individual Infant Sleeping Plan [LIC 9227 (3/20)] shall be completed for each infant up to 12 months of age the provider has in care and included in the infant's file at the facility.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on interview, the licensee did not comply with the section cited above in missing the Infant Sleeping Plan which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 06/06/2025
Plan of Correction
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Licensee will have the parent fill out the form and provide a copy to the LPA.
Type B
Section Cited
CCR
102425(j)(2)(D)(c)
Infant Safe Sleep
Documentation shall be maintained in the infant’s file and be available to the Department for review. Documentation shall include the following: Time of each 15-minute check

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on (interview), the licensee did not comply with the section cited above in documentation was not available for the infant present in the daycare which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 06/06/2025
Plan of Correction
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Licensee will fill out every 15 minute sleep log for any current infants under the age of 24 months and provide a copy to the LPA.
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
Katrina Chicote
NAME OF LICENSING PROGRAM MANAGER:
Carolyn Tuba
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 05/30/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/30/2025


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
MONTEREY PARK CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: FAOURI FAMILY DAY CARE
FACILITY NUMBER: 198000148
VISIT DATE: 05/30/2025
NARRATIVE
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Licensee states that there are no bodies of water and LPA did not observe any around the property of the home.

Licensee states that there are no firearms stored in the home. The home was inspected for safety, comfort, cleanliness, ventilation, and telephone service. LPA verified the phone number which was found to be correct. Fire and safety drills must be performed every 6 months and documented for review by the Department. Licensee conducted an Emergency Drill and documented in May 2025. No one smokes at the family childcare home. Parent Board was available. LPA advised that the Earthquake Preparedness needs to be completed and posted on the board.

During the visit LPA observed that the pack-n-play did not have a fitted sheet but instead Licensee was using a blanket to cover the mattress, and the blanket had moved off the mattress while an infant was observed inside and getting ready to take a nap. While the LPA was conducting the visit the Licensee's daughter went to the store and purchased a new fitted sheet and Licensee replaced it. LPA advised the Licensee that part of safe sleep regulations is to always have a fitted sheet that does not move around when the infant is sleeping. LPA printed the Child Care Regulations 102425 Infant Safe Sleep for the Licensee to review.

In the absence of the licensee a qualified adult must be present supervising the children; a qualified adult is an individual who has a valid and current Pediatric First Aid and CPR training EMSA approved, Immunization's (TDAP, MMR, TB, Influenza (or a waiver for the influenza may be in writing), mandated reporter training and a valid criminal record clearance associated to the facility license.

Detergents, cleaning compounds, medications, and other items, which could pose a danger, were determined to be inaccessible to children in care during this inspection. Knives are kept in the kitchen cabinet, out of the reach of children with a child safety latch. Medication/vitamins are kept in the kitchen cabinet with a child safety latch and made inaccessible to children in care. Cleaning supplies are kept in a kitchen cabinet with a child-proof lock.

LPA observed the required 2:A-10:B-C fire extinguisher and observed it was last serviced in June 2024. State Fire Marshall standards, state that fire extinguisher shall be service annually. The smoke and carbon
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NAME OF LICENSING PROGRAM MANAGER: Katrina Chicote
NAME OF LICENSING PROGRAM ANALYST: Carolyn Tuba
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 05/30/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/30/2025
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
MONTEREY PARK CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: FAOURI FAMILY DAY CARE
FACILITY NUMBER: 198000148
VISIT DATE: 05/30/2025
NARRATIVE
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monoxide detector were tested and is working properly during today’s visit. Currently the facility has no pets, and none were observed.

Safe sleep was discussed during this visit and during the prior visit on September 24, 2024. LPA consulted with Licensee regarding the 15-minute safe sleep log that requires to be completed for any child under the age of 2 years. LPA observed and interviewed Licensee who currently cares for a child under 2 years old and was present during the visit. Licensee stated that she observes while the child is napping but has not been documenting when the infant sleeps. Licensee also disclosed that the infant’s parents/guardians have not filled the Infant Sleeping Plan. LPA stated that any child being cared for who is under the age of (1) one-year olds, parents/guardians are required to fill this out prior to attending the daycare. During the prior annual visit Licensee disclosed that she was not caring for children under 24 months however LPA provided safe sleep documentation and advised of PIN 20-24 CCP Safe Sleep, as well as a sample of the 15-minute safe sleep log for children under 24 months and Individualized Infant Sleeping Plan for children under 12 months.

The licensee and the assistant (not present during the time of the visit) have completed training on preventive health practices including Pediatric First Aid and CPR, which includes the EMSA Sticker, expires on 11/2025. There are first aid supplies available. Licensee and Assistant have the Mandated Reporting Training Certificate which expires 7/2026. LPA advised that all persons working with children require the AB 1207 Mandated Reporting training every 2 years. The following link http://www.mandatedreporterca.com/ was provided.

While LPA was conducting the visit the Licensee’s spouse was present in the daycare room. LPA asked if the Licensee’s spouse has the immunizations needed (MMR, Tdap, TB, Flu or Flu wavier) as well as the mandated reporter training certificate. Licensee stated that he does not typically care for the children but was there due to her answering the door to the LPA, however the LPA stated that even if volunteering or any person who is assisting directly with the children is required to have Immunizations and the Mandated Reporter Training. CPR/1st aid is optional if the Licensee is present. LPA printed the Health and Safety codes 1597.622 and 1596.8662 for the Licensee to review.

Currently, children are using the back yard which is enclosed with a cement wall. There is a side yard which is separated by an iron gate. LPA advised that children should have daily outdoor playtime weather
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NAME OF LICENSING PROGRAM MANAGER: Katrina Chicote
NAME OF LICENSING PROGRAM ANALYST: Carolyn Tuba
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 05/30/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/30/2025
LIC809 (FAS) - (06/04)
Page: 6 of 8
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: FAOURI FAMILY DAY CARE
FACILITY NUMBER: 198000148
VISIT DATE: 05/30/2025
NARRATIVE
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permitting due to heat advisories. LPA observed that there were 3 bikes that either did not have the rubber handle bars or missing pedals. The scooter had a missing wheel. Licensee removed immediately and stated she will be replacing the bikes. (Photos taken)

Children and Staff files must be maintained and updated as needed and must be available for review by the Department. If Children and Staff leave the day care all records must be maintained for 3 years after leaving. LPA observed that children’s files were complete. LPA advised that the following documents of the LIC 700, LIC 627 and LIC 995A are required, as well as the immunizations. LIC 282 is also needed if liability insurance is not available.

To improve the quality and value of the new inspection process, a survey may be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or CARE tools, please send email inquiries to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/inspection-process.

Licensee was reminded that all adults 18 and over living or working in the home, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, 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 for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated. LPA reviewed clearance list and will be removing persons that no longer live or work in the home.

LPA 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. LPA also informed licensee 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.
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NAME OF LICENSING PROGRAM MANAGER: Katrina Chicote
NAME OF LICENSING PROGRAM ANALYST: Carolyn Tuba
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 05/30/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/30/2025
LIC809 (FAS) - (06/04)
Page: 7 of 8
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: FAOURI FAMILY DAY CARE
FACILITY NUMBER: 198000148
VISIT DATE: 05/30/2025
NARRATIVE
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According to the Licensee there are no children currently on medication. 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: https://www.ada.gov/resources/child-care-centers/. There are no children currently taking medication.

Licensee was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain childcare by connecting them to childcare providers and Resource and Referral Agencies (R&Rs) throughout California.

During the exit interview, the Licensee, confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.

The deficiency listed on the following page were observed by the LPA and is being cited in accordance with California Code of Regulations Title 22. Please see attached LIC 809-D. The deficiency that is being cited needs to be cleared to protect the children’s health & safety.

A notice of site visit was given and must remain posted for 30 days. An exit interview was conducted, and report was reviewed with the Licensee, Feryal Faouri.
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NAME OF LICENSING PROGRAM MANAGER: Katrina Chicote
NAME OF LICENSING PROGRAM ANALYST: Carolyn Tuba
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 05/30/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/30/2025
LIC809 (FAS) - (06/04)
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