304313834-3-17-2023-06-CC-STOE-CPZTL7-20230317144903

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 304313834
Report Date: 03/17/2023
Date Signed: 03/17/2023 02:49:12 PM

Document Has Been Signed on 03/17/2023 02:49 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
CCLD Regional Office, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME:	MARASHINIA, MAHSA		FACILITY NUMBER:	304313834
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY: 8	TOTAL ENROLLED CHILDREN: 5	CENSUS: 5	DATE:	03/17/2023
TYPE OF VISIT:	Case Management - Licensee Initiated	UNANNOUNCED	TIME BEGAN:	12:30 PM
MET WITH:	Mahsa Marashinia, Licensee		TIME COMPLETED:	03:15 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	Licensing Program Analyst (LPA) Stacy Torrence conducted a case management inspection, in response to licensee’s request for a capacity increase. LPA met with licensee Mahsa Marashinia, who guided analyst on a tour of the facility. During today’s inspection, Licensee’s Assistant Hossein Ali Mansoubi was also present. LPA Torrence observed five children in the designated daycare area. The facility was within licensed capacity and the required ratio. Licensee stated there are currently two adults and two minor children living in the home. Licensee stated she is not currently registered with any Foster Care agency or holds a foster parent license. Licensee was reminded if changes to notify the licensing office. A review of staff records on this date 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 facility is a 2-story home with 3 bedrooms, 2.5 bathrooms, a loft, living room, family room, kitchen, dining room, laundry room, front yard (not fenced), back yard (fenced), and garage. Applicant has designated the living room, family room, kitchen, dining room, .5 bathroom, and a portion of the back yard, as part of her day-care. Licensee has designated the entire 2^nd floor, garage, front yard, and portion of backyard, as the off-limit areas. Licensee has a child proof safety gate at the bottom of the stairs leading to the 2^nd floor, ensuring the areas are inaccessible to children in care. The licensee acknowledged the children may never enter the off-limit areas, during operation hours. Control of property was verified by LPA during today’s inspection. The licensee has a cell phone that is used for childcare. The licensee was informed if a cell phone is used for childcare, it must remain on the premises at all times during hours of operation. Licensee was informed and understands the home is to be free from smoking during hours of operation.

SUPERVISORS NAME: Thuy Ho
LICENSING EVALUATOR NAME: Stacy Torrence
LICENSING EVALUATOR SIGNATURE:	DATE: 03/17/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/17/2023

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
CCLD Regional Office, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME: MARASHINIA, MAHSA	FACILITY NUMBER: 304313834
	VISIT DATE: 03/17/2023

NARRATIVE

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The facility does have a fireplace, in the living room; barricaded by a metal screen and glass cover. Cleaning solutions/chemicals, utensils, and sharp knives located in the kitchen are all inaccessible by means of being in cabinets with child proof safety locks on them. Poisons/Hazardous items are not stored on site, and none were observed. There is a swimming pool, located in the back yard, which meets Title 22 regulation 102417. Mesh style fencing meets the regulatory standards for swimming pool fencing, and the licensee has agreed that the fence will remain in place whenever licensed care is provided. Licensee has an alarm on the sliding door facing the pool. The toys are age appropriate and in good condition for the potential ages served. Baby walkers, bouncers, jumpers, and similar items will not be used for children in care. The licensee stated there are no weapons or firearms on the premises. When firearms are present, they must be locked and stored separately from the ammunition. During today's inspection, the smoke detector and carbon monoxide were operable, and the fire extinguisher was charged.

Licensee will use a portion of the back yard and the community park for children's outdoor activities. The back yard is appropriately fenced. LPA observed play equipment to be safe and free of hazards.

Per licensee, she provides breakfast, lunch, and AM/PM snacks for the children. LPA reminded licensee, that if food is not provided and food is brought from the children’s homes; container shall be labeled with child’s name and properly stored or refrigerated.

Licensee and assistant’s Mandated Reporter Training is current. EMSA approved Pediatric CPR and Pediatric First Aide are current for the licensee and assistant and both expires on 08/24.

LPA advised the licensee how to access forms, regulations and quarterly updates online at: www.ccld.ca.gov.

LPA consulted and explained Child Abuse Reporting, Updated Parent’s Rights Poster with Complaint Hotline information, Never Shake a Baby, Sudden Infant Death Syndrome (SIDS), and Safe Sleeping practices.

SUPERVISORS NAME: Thuy Ho
LICENSING EVALUATOR NAME: Stacy Torrence
LICENSING EVALUATOR SIGNATURE:	DATE: 03/17/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/17/2023

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
CCLD Regional Office, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME: MARASHINIA, MAHSA	FACILITY NUMBER: 304313834
	VISIT DATE: 03/17/2023

NARRATIVE

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Fire clearance granted on 03/01/2023.

During todays’ inspection, there were no deficiency cited and licensee was in compliance with California Code of Regulations Title 22 for operating a Family Child Care home.

A new license for operating a Large Family Child Care Home shall be issued upon final review and if additional information is needed, licensee shall be contacted.

An exit interview was conducted. The report was reviewed and discussed with licensee. Appeal Rights were explained. The Licensee was provided a copy of appeal rights (LIC 9058 01/16) and their signature on this form acknowledges receipt of these rights. All appeals must be in writing and received by the Regional Office within 15 business days. First level appeals should be sent to the regional manager to the address listed above. The Notice of Site Visit was posted and discussed as required by H&S Code Sec. 1596.817. The Notice of Site Visit must be posted on or adjacent to the door. Notice of Site Visit must be posted for 30 consecutive days. Failure to post will result in civil penalties of $100.00.

SUPERVISORS NAME: Thuy Ho
LICENSING EVALUATOR NAME: Stacy Torrence
LICENSING EVALUATOR SIGNATURE:	DATE: 03/17/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/17/2023

LIC809 (FAS) - (06/04)

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