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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 274417334
Report Date: 07/07/2023
Date Signed: 07/07/2023 11:21:33 AM

Document Has Been Signed on 07/07/2023 11:21 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
SAN JOSE-DAY CARE, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME:AZAR, FARHANAFACILITY NUMBER:
274417334
ADMINISTRATOR:AZAR, FARHANAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(831) 917-4263
CITY:MARINASTATE: CAZIP CODE:
93933
CAPACITY: 14TOTAL ENROLLED CHILDREN: 0CENSUS: 0DATE:
07/07/2023
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME BEGAN:
08:25 AM
MET WITH:Farhana AzarTIME COMPLETED:
11:35 AM
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Licensing Program Analyst (LPA) Joe Macias conducted an announced Prelicensing Inspection. The LPA met with the Applicant Farhana Azar and disused the nature of today's inspection. The purpose of today’s inspection is to ensure the home is in compliance with Title 22 California Code of Regulations. The Applicant, her husband Amanullah Azar, and adult son Mustafa Azar are the only adults who reside in the home. The Applicant has two children under the age of 18 who also reside in the home, son age 13, and daughter age 16 years old. The hours of operation are Monday - Friday, 6am - 6pm. The Applicant's CPR and First Aid are current, and expire May 2025. The Applicant has completed the Lead Poisoning Prevention Training. Applicant may obtain liability insurance upon receiving her license.

LPA reviewed with the Applicant 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 applicant.

LPA toured the indoor and outdoor areas of the home during today's inspection. The Applicant has a working telephone in the home. LPA observed sufficient materials, toys, and play equipment for the children in care. The home is orderly, and safe for the day care children. LPA Macias did not observe a wall heater in the home, as the home has central heat. LPA observed a securely gated/ barricaded staircase in the home. The off limit areas inside the home are: entire second floor, all bedrooms, and detached garage.

The Applicant provided proof of control of property. Prior to today's inspection LPA Macias received an approved fire clearance from Monterey County Regional Fire District. LPA observed a fully charged 2A10BC fire extinguisher, working smoke, and carbon monoxide detectors. LPA did not observe a body of water. The Applicant states that she does not have weapons in the home. All detergents, cleaning compounds, poisons, medications, and other similar items are out of reach and inaccessible to children. Applicant states that she does not plan on administering medications.

SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Joseph Macias
LICENSING EVALUATOR SIGNATURE: DATE: 07/07/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/07/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 3
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN JOSE-DAY CARE, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME: AZAR, FARHANA
FACILITY NUMBER: 274417334
VISIT DATE: 07/07/2023
NARRATIVE
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Applicant will be using positive reinforcement, redirection, effective communication (proactive, not reactive) as forms of discipline. Applicant understands that children's personal rights should not be violated; including no corporal punishment. Discussed isolation of sick children, supervision of children, capacity options, transportation of children, requirements for reporting suspected child abuse, unusual incidents/injuries, heat related illnesses, and requirements for assistant/substitute. LPA informed applicant that fire/disaster drills must be practiced at least once every 6 months and documented.

LPA discussed the safe sleep regulations with the Applicant 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 [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.

A review of staff records on July 7, 2023 indicates that all Facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions. The Applicant Farhana Azar was reminded that all adults 18 and over living or working in the home, 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.

On this date, 07/07/2023, the California Attorney General - Megan’s Law website was searched for information on sex offenders required to register with local law enforcement under California's Megan's Law. No registered sex offenders were found at the facility addresses. Under state law, some registered sex offenders are not subject to public disclosure; therefore, they may not have been included in this search. However, the Department conducts a monthly cross reference of each address on record for all registered sex offenders against all CCLD facility addresses pursuant to information shared by California DOJ.

SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Joseph Macias
LICENSING EVALUATOR SIGNATURE:

DATE: 07/07/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/07/2023
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
SAN JOSE-DAY CARE, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME: AZAR, FARHANA
FACILITY NUMBER: 274417334
VISIT DATE: 07/07/2023
NARRATIVE
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Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. 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

The Applicant Farhana Azar was informed of the MyChildCarePlan.org site, a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

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 platforms.
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 Applicant has completed the Mandated Reporter Training.

Exit interview conducted and report was reviewed with the Applicant Farhana Azar. The Applicant was advised that a large family child care license will be issued pending management approval.

SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Joseph Macias
LICENSING EVALUATOR SIGNATURE:

DATE: 07/07/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/07/2023
LIC809 (FAS) - (06/04)
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