198017496-1-16-2025-33-CC-SSAN-DCYUPM-20250116144547

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198017496
Report Date: 01/16/2025
Date Signed: 01/16/2025 02:45:55 PM

Document Has Been Signed on 01/16/2025 02:45 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:	EBRAHIMI FAMILY CHILD CARE		FACILITY NUMBER:	198017496
ADMINISTRATOR/ DIRECTOR:	EBRAHIMI, GLADYS		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(818) 500-8983
CITY:	GLENDALE	STATE: CA	ZIP CODE:	91206
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 14	CENSUS: 10	DATE:	01/16/2025
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	01:00 PM
MET WITH:	Gladys Ebrahmi		TIME VISIT/ INSPECTION COMPLETED:	03:00 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	Annual Inspection was conducted in Armenian. On 01/16/2025 , at 1 pm, Licensing Program Analyst (LPA) Shushanik Safaryan conducted an annual random inspection to the above facility. LPA met with Licensee, Gladys Ebrahimi, to whom the reason for the visit was explained. Per Licensee, there are 11 children currently enrolled. There were 10 children , licensee, and licensee`s husband (assistant ) present upon arrival. The licensee was observed to be operating within the license capacity limitations. The licensee states that 2 adults and no children currently live in the home. All adults living in the home have obtained a criminal record clearance. This is a one story home located on the first level which consists of 3 bedrooms, 2 & 1/2 bathrooms, kitchen, childcare room, dining room, living room, laundry room, garage (storage), front yard, and backyard (fenced). The children use the bathroom in the hallway of bedrooms, childcare room, dining room, living room, kitchen, and backyard (fenced). Per licensee, areas off limits to children and parents include: 3 bedrooms, 1 & 1/2 bathrooms, laundry room, front yard, and garage (storage). During this visit, all areas identified that are accessible for children to use were inspected for the safety, comfort, and cleanliness. At 1 pm , Licensee guided LPA to the tour of the home. LPA was toured starting from the day care room and observed 10 napping children with licensee`s assistant . LPA observed door from the day care room to the other areas of the house . Per licensee , that door is always closed , since they don’t use areas behind the door ,only bathroom in the hallway .Next LPA toured the bathroom used for children and observed safety latches on the cabinets . LPA toured the living room , dinning room and observed fireplace . Fireplace was blocked to prevent children access. Next LPA toured the kitchen and observed licensee keeps sharp items high inaccessible to the children . Facility License, Emergency Disaster Plan, Parent’s Rights Poster, and Earthquake Preparedness Checklist were observed to be posted in the day care room on the wall .A current children’s roster was available for review. Page 1 of 4

SUPERVISORS NAME: Brandi VanOosten
LICENSING EVALUATOR NAME: Shushanik Safaryan
LICENSING EVALUATOR SIGNATURE:	DATE: 01/16/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/16/2025

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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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: EBRAHIMI FAMILY CHILD CARE	FACILITY NUMBER: 198017496
	VISIT DATE: 01/16/2025

NARRATIVE

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There is telephone service via a cellphone that stays at the facility during operation hours. Hours of operation are Monday – Friday, 08:00 am – 5:00 pm. There is central air and heating in the home.

Detergents, cleaning compounds, and medications were observed to be inaccessible to children. Per Licensee, there are no poisons in the home. LPA advised that any poisons should be locked under key or combination lock. Licensee states that there are no firearms or weapons stored in the home.

The valve on the required 2A 10BC fire extinguisher indicates fully charged and LPA observed receipt with a purchase date of March 2024. Smoke and carbon monoxide detectors were not tested since children were napping .

All homes shall conduct fire and disaster drills at least once every six months and document the date and time of each drill. Last drill documented was conducted on 01/07/2025.

The home is observed to be clean and orderly. There are first aid supplies available. There are age-appropriate toys available for children.

Per licensee, she provides food for children in care. Licensee was advised that if food is brought from the children’s homes, all containers must be labeled with child’s name and properly stored or refrigerated.
Currently, children are using the backyard for outdoor play time. The outdoor play area was observed to be fenced and gated. Per licensee , children only use turf area . LPA observed that the outdoor yard has toys and other materials for children to play with. LPA did not observe any objects that can pose danger to children. No bodies of water were observed on this day. Next LPA toured the bathroom that is located outside, did not observe any hazards .

At 11:00 am Licensee and assistant records were reviewed. The licensee has completed training on preventive health practices including Pediatric First Aid and CPR. The licensee's Pediatric First Aid and CPR expires on 6/5/23.
LPA observed that the Licensee does have proof of Mandated Reporter AB 1207 compliant Child Care Training Certificate on file with expiration on 4/12/24. www.mandatedreporterca.com
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SUPERVISORS NAME: Brandi VanOosten
LICENSING EVALUATOR NAME: Shushanik Safaryan
LICENSING EVALUATOR SIGNATURE:	DATE: 01/16/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/16/2025

LIC809 (FAS) - (06/04)

Page: 2 of 4

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: EBRAHIMI FAMILY CHILD CARE	FACILITY NUMBER: 198017496
	VISIT DATE: 01/16/2025

NARRATIVE

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Children’s records were reviewed, including emergency information and were observed to be complete. Licensee states she is currently not caring for any infants.

LPA created an LIC 857, Children’s Record Review, and LIC 811, Staff Record Review which documents staff and children’s files reviewed during this inspection.

During the visit LPA observed turtle and parrot in off limit bedrooms . Per licensee children don’t have access to the animals in the home. LPA discussed with licensee importance of keeping off limit areas closed and inaccessible to the children .Smoking is prohibited in a licensed Family Child Care Home. Per Licensee, no one smokes in the home.

Licensee stated no children enrolled need IMS services .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/.

To improve the quality and value of the new inspection process, a survey will 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 tools, please send them by email 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/process.

During the visit , licensee discussed with LPA if licensee`s son can reside in the home . Licensee stated that right now he is residing with grandmother and will move to her house when fingerprints cleared .

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.

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SUPERVISORS NAME: Brandi VanOosten
LICENSING EVALUATOR NAME: Shushanik Safaryan
LICENSING EVALUATOR SIGNATURE:	DATE: 01/16/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/16/2025

LIC809 (FAS) - (06/04)

Page: 3 of 4

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: EBRAHIMI FAMILY CHILD CARE	FACILITY NUMBER: 198017496
	VISIT DATE: 01/16/2025

NARRATIVE

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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.

LPA advised the licensee how to access forms, regulations and quarterly updates on the Child Care Licensing website at www.ccld.ca.gov.

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 Gladys Ebrahimi confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.

Currently, the licensee is in compliance with California Code of Regulations Title 22. No deficiencies cited.

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

Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

Exit interview conducted and report was reviewed with the licensee Gladys Ebrahimi on 01/16/2025.

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SUPERVISORS NAME: Brandi VanOosten
LICENSING EVALUATOR NAME: Shushanik Safaryan
LICENSING EVALUATOR SIGNATURE:	DATE: 01/16/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/16/2025

LIC809 (FAS) - (06/04)

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