304312043-8-7-2024-06-CC-MMAK-D7WSW9-20240807141247

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 304312043
Report Date: 08/07/2024
Date Signed: 08/07/2024 02:12:53 PM

Document Has Been Signed on 08/07/2024 02:12 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
ORANGE CO CHILD CARE, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME:	RASTA, MAHJAN		FACILITY NUMBER:	304312043
ADMINISTRATOR:	RATSA, MAHJAN		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(949) 481-6748
CITY:	SAN CLEMENTE	STATE: CA	ZIP CODE:	92673
CAPACITY:	14	CENSUS: 12	DATE:	08/07/2024
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	12:15 PM
MET WITH:	Licensee and her assistant		TIME COMPLETED:	02:45 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	Page 1 of 4 An Annual Random inspection was conducted at the facility by Licensing Program Analyst (LPA) Mahnaz (Nancy) Malek. LPA met with licensee, Mahjan Rasta and her assistant Ahmad Shah Rasta who were taking care of 12 children of whom 4 were under 24 months old. Children were napping when LPA arrived except for one infant. Licensee was operating within the licensed capacity as specified on license for Large Family Childcare Home. A review of the Facility Personnel Report Summary on this date indicates all facility residents, staff, or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions. According to licensee, currently there are two adults including the licensee, and no minors living in the house. Day care hours of operation is Monday through Thursday from 7:30 am-5:00 pm. During today’s inspection, LPA and licensee toured the inside and outside areas identified in the facility sketch as accessible to childcare children. Off limits areas are made inaccessible by means of baby gates. The childcare area consists of family room/dinning room. There are two gates installed on both sides of the kitchen make it inaccessible to children. There is a baby gate installed between the children's area and hallway to make it inaccessible for children to the front entrance. There is a baby gate installed in front of the stairs to make upstairs inaccessible to children. There are two closets in the entrance way behind the baby gate. Part of back yard is for children's use. There is a fountain on the other side of the gate in the back yard in the off limit area which was dry and free of water. The gate on the children's area in the side yard make it Continued on page 2

SUPERVISOR'S NAME: Thuy Ho	TELEPHONE: (714) 703-2741
LICENSING EVALUATOR NAME: Mahnaz Malek	TELEPHONE: (714) 292-9851
LICENSING EVALUATOR SIGNATURE:	DATE: 08/07/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/07/2024

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 4

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE CO CHILD CARE, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME: RASTA, MAHJAN	FACILITY NUMBER: 304312043
	VISIT DATE: 08/07/2024

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
26
27
28
29
30
31
32

Page 2 of 4

inaccessible to children from going to the off limit area of back yard. There is a fire pit in the off limit area behind the baby gate which was not in operation. The side yard is covered with carpet for children's use. There are age appropriate toys and equipment for children to play outside. There are 4 cribs available for infants and sleeping bags are available for older children for napping.
The garage is not for children's use and is inaccessible to children by the garage door being locked.

There are working carbon monoxide, smoke detector, and fire extinguishers in the home that meet statutory and State Fire Marshall standards.

Detergents, cleaning compounds, medicines, and other items which could pose a danger to children were not readily available to children they were stored inaccessible to children, none were observed during inspection.

According to licensee, there is no firearm in the facility. There is no pet living in the home. LPA verified there is a working telephone service (cellular service).

The licensee does have a current roster of children in care. Fire Drill was available. The last fire drill was conducted 1/2/2024. Children’s records for children present during LPA’s inspection were reviewed. Twelve files were reviewed. They were all in compliance. The log for every 15 minutes check on napping children under 24 months old were available. (for four present infants). LIC 9227 (Individual Infant Sleeping Plan) for infants under 12 months old were available on their files. The licensee's and assistant's Pediatric CPR/First Aid certifications are current. (Expires 3/18/2025).

Beginning September 1, 2016, Health and Safety (H&S) 1597.622 states, a person shall not be employed or volunteer at a family childcare home if he or she has not been immunized against influenza, pertussis, and measles. Proof of immunization against pertussis, measles for the licensee was within compliance.
Beginning March 31, 2018, H&S Code 1596.8662 requires all licensed providers and employees to complete mandated reporting training, and to renew the training every two years.
Continued on page 3

SUPERVISOR'S NAME: Thuy Ho	TELEPHONE: (714) 703-2741
LICENSING EVALUATOR NAME: Mahnaz Malek	TELEPHONE: (714) 292-9851
LICENSING EVALUATOR SIGNATURE:	DATE: 08/07/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/07/2024

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
ORANGE CO CHILD CARE, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME: RASTA, MAHJAN	FACILITY NUMBER: 304312043
	VISIT DATE: 08/07/2024

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
26
27
28
29
30
31
32

Page 3 of 4

Mandated Reporter Training Certificate for the licensee and her assistant expires 4/7/2025.

Incidental Medical Services (IMS) policy was discussed. For 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/.

The licensee understands they must be present in the facility and must ensure children in care are always supervised. Children are not to be left alone in parked vehicles. When the licensee is temporarily absent from the facility, arrangements must be made for a qualified substitute adult to care and supervise children while absent. The substitute adult must have the required criminal record, child abuse index clearances, immunization, Pediatric CPR/First Aid, and mandated reporter training.

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 clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a volunteers, except as specified in Health and Safety Code section 1596.871, must obtain a criminal record clearance before working 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 discussed the safe sleep regulations with Licensee Mahjan Rastai 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

LPA also informed Licensee, Mahjan Rasta of the importance of checking for recalled

Continued on page 4

SUPERVISOR'S NAME: Thuy Ho	TELEPHONE: (714) 703-2741
LICENSING EVALUATOR NAME: Mahnaz Malek	TELEPHONE: (714) 292-9851
LICENSING EVALUATOR SIGNATURE:	DATE: 08/07/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/07/2024

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
ORANGE CO CHILD CARE, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME: RASTA, MAHJAN	FACILITY NUMBER: 304312043
	VISIT DATE: 08/07/2024

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
26
27
28
29
30
31
32

Page 4 of 4

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.

Licensee, Mahjan Rastai 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 athttps://www.cdss.ca.gov/inforesources/community-care- licensing/subscribe and select the Child Care option to receive email communication. (The licensee is already signed up for this purpose).

In the areas that were evaluated, no deficiencies were observed of the California Code of Regulations, Title 22, Division 12 on this inspection.

A notice of site visit was given to licensee, Mahjan Rasta and must remain posted on, or immediately adjacent to, the interior side of the main door for 30 days. Failure to post will result in Civil Penalties of $100.00.

Exit interview conducted and report was reviewed with the licensee, Mahjan Rasta.

End of report

SUPERVISOR'S NAME: Thuy Ho	TELEPHONE: (714) 703-2741
LICENSING EVALUATOR NAME: Mahnaz Malek	TELEPHONE: (714) 292-9851
LICENSING EVALUATOR SIGNATURE:	DATE: 08/07/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/07/2024

LIC809 (FAS) - (06/04)

Page: 4 of 4