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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 304313904
Report Date: 05/22/2024
Date Signed: 05/22/2024 01:11:57 PM

Document Has Been Signed on 05/22/2024 01:11 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:YOUSEFI, P & SADAGHIANPOOR, SFACILITY NUMBER:
304313904
ADMINISTRATOR/
DIRECTOR:		YOUSEFI, P & SADAGHIANPOORFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(949) 315-6815
CITY:LAGUNA HILLSSTATE: CAZIP CODE:
92653
CAPACITY: 14TOTAL ENROLLED CHILDREN: 9CENSUS: 8DATE:
05/22/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:00 AM
MET WITH:Licensee, Yousefi ParvanehTIME VISIT/
INSPECTION COMPLETED:
01:30 PM
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An Annual Random inspection was conducted at the facility by Licensing Program Analyst (LPA) Mahnaz (Nancy) Malek. LPA met with licensee, Parvaneh Yousefi. The co-licensee Seyed Mania Sadaghianpoor was not present. LPA also met with assistant, Seyed Sadaghianpoor who were caring for 8 children of whom 2 were under 24 months old. Licensee was operating within the licensed large capacity as specified on license.
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.

Currently there are 4 adults including the licensee and no minor child living in the facility. Facility Day care hours of operation is Monday through Friday 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 locks. The childcare area consists of one childcare room, one bedroom for napping, children's bathroom, part of backyard. The licensee updated the sketch to add bedroom # 2 for additional napping room.
This is single story home with four bedrooms, two full baths, living room, kitchen/dining area, garage, Front yard, two side yards (Left side yard & right side yard are inaccessible) Backyard is divided into two sections. The entrance to day care is from the back yard gate. Children don't have access to the other side of the yard by a barricading it by a plastic fence.
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
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SUPERVISORS NAME: Thuy Ho
LICENSING EVALUATOR NAME: Mahnaz Malek
LICENSING EVALUATOR SIGNATURE: DATE: 05/22/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/22/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.

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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
ORANGE CO CHILD CARE, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
FACILITY NAME: YOUSEFI, P & SADAGHIANPOOR, S
FACILITY NUMBER: 304313904
VISIT DATE: 05/22/2024
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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 and there are not pets. LPA verified there is a working telephone service (cellular service). Backyard is all fenced with appropriate toys. There is a small height slide and a metal climbing structure on the cushioning surface (built in turf). There is a spa (Jacuzzi) located in the backyard where children play. The spa (Jacuzzi) was covered. However, The four corners of the cover were not locked. Three locks were not working and in disrepair, and one side lock was working but not locked. LPA could lift one corner up and observed water in it. The water was accessible to children by not four sides being locked strongly. There was a two step bench in front of the Jacuzzi. This section for accessibility of water was cited. A civil penalty of $500.00 was assessed. During the inspection the four sides were strapped by a rope for now until it is fixed permanently. The bench was removed from the side of the Jacuzzi during inspection.

The licensee does have a current roster of children in care. Fire Drill was not done and logged. Children’s records for children present during LPA’s inspection were reviewed for a copy of the emergency information card that contains all the information specified by regulation (LIC 700) and found to be in compliance. The log for every 15 minutes check on napping children under 24 months old was not available. (Total of 8 files were reviewed). The licensee and her assistants' Pediatric CPR/First Aid certification cards are current. (Expires 7/8/2025).

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 and assistant were 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. Licensee and her assistant are exempt from having mandated reporter training certificates because the course is not offered in their native language (Farsi) but it was recommended.
Incidental Medical Services (IMS) policy was discussed. For information see PIN 22-02-
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SUPERVISORS NAME: Thuy Ho
LICENSING EVALUATOR NAME: Mahnaz Malek
LICENSING EVALUATOR SIGNATURE:

DATE: 05/22/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/22/2024
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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
ORANGE CO CHILD CARE, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
FACILITY NAME: YOUSEFI, P & SADAGHIANPOOR, S
FACILITY NUMBER: 304313904
VISIT DATE: 05/22/2024
NARRATIVE
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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 she 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 Parvaneh Yousefi 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, Parvaneh Yousefi 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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SUPERVISORS NAME: Thuy Ho
LICENSING EVALUATOR NAME: Mahnaz Malek
LICENSING EVALUATOR SIGNATURE:

DATE: 05/22/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/22/2024
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
ORANGE CO CHILD CARE, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
FACILITY NAME: YOUSEFI, P & SADAGHIANPOOR, S
FACILITY NUMBER: 304313904
VISIT DATE: 05/22/2024
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Licensee, Parvaneh Yousefi 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, the following deficiencies were observed of the California Code of Regulations, Title 22, Division 12 on this inspection. Please refer to LIC 809D. Type A under California Title 22 Regulations Section 102417(g)(5) for accessibility of body of water is cited on 809D next page. Type B citations were issued. An immediate Civil Penalty of $500.00 was assessed until it is fixed.

Parvaneh Yousefi was informed that the “Notice of Site Visit” must be posted for 30 consecutive days. The “Notice of Site Visit” must be posted on or adjacent to the door. Failure to post will result in Civil Penalties of $100.00. LPA Malek informed the licensee, Parvaneh Yousefi that this report dated 5/22/2024 documents type A citation shall be posted for 30 consecutive days as there is immediate risks to the health, safety, or personal rights of children in care. Also, LPA Malek informed the licensee, Parvaneh Yousefi to provide a copy of this licensing report dated 5/22/2024 that documents any Type A citation to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification. The licensee, Parvaneh Yousefi, was provided with a copy of their appeal rights (LIC 9058) 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. LPA provided some resources to the director. The exit interview was conducted with licensee, Parvaneh Yousefi in her native language (Farsi).

End of report

SUPERVISORS NAME: Thuy Ho
LICENSING EVALUATOR NAME: Mahnaz Malek
LICENSING EVALUATOR SIGNATURE:

DATE: 05/22/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/22/2024
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 05/22/2024 01:11 PM - It Cannot Be Edited


Created By: Mahnaz Malek On 05/22/2024 at 11:39 AM
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
, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME: YOUSEFI, P & SADAGHIANPOOR, S
FACILITY NUMBER: 304313904

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/22/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type A
Section Cited
CCR
102417(g)(5)
Operation of A Family Child Care Home
(g) The home shall be free from defects or conditions which might endanger a child. Safety precautions shall include but not limited to: (5) All licensees shall ensure the inaccessibility of pools (in-ground and above-ground), fixed-in-place wading pools, hot tubs, spas, fish ponds and similar bodies of water through a pool cover or by surrounding the pool with a fence.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation today, the licensee did not comply with the section cited above in one count out of one count, the spa (jacuzzi) in the back yard were not locked on four sides which poses an immediate health, safety risk to persons in care. 3 locks were in disrepair and one lock not in place. Immediate Civil Penalty of 500.00 for accessibility of body of water was assessed until is fixed.
POC Due Date: 05/23/2024
Plan of Correction
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The licensee stated they would fix the locks permanently. During inspection the four corners were strapped by rope temporarily until it is fixed permanently. Licensee will send proof of fixing by the due date of 5/23/2024
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Thuy Ho
LICENSING EVALUATOR NAME:Mahnaz Malek
LICENSING EVALUATOR SIGNATURE:
DATE: 05/22/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/22/2024


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Document Has Been Signed on 05/22/2024 01:11 PM - It Cannot Be Edited


Created By: Mahnaz Malek On 05/22/2024 at 11:39 AM
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
, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME: YOUSEFI, P & SADAGHIANPOOR, S
FACILITY NUMBER: 304313904

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/22/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102417(g)(9)(A)
Operation of A Family Child Care Home
(g) The home shall be free from defects or conditions which might endanger a child. Safety precautions shall include but not limited to: (9) Each family child care home shall have a written disaster plan of action prepared on a form approved by the Department. All children, age and ability permitting, and the provider, the assistant provider, and other members of the household, shall be instructed in their duties under the disaster plan. As their age and ability permit, newly enrolled children shall be informed promptly of their duties as required in the plan. (A) Each family child care home shall conduct fire drills and disaster drills at least once every six months.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on record review, the licensee did not comply with the section cited above in one count out of one count not conducting fire drill with children every 6 months which poses a potential health, safety risk to persons in care.
POC Due Date: 05/28/2024
Plan of Correction
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The licensee agreed to conduct a fire drill log with children and sent the proof to LPA's email address by the due date.
Type B
Section Cited
CCR
102425(j)(1)
Infant Safe Sleep
The provider shall supervise infants while they are sleeping and adhere to the following requirements: The provider shall physically check on the infant every 15 minutes.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on record review, the licensee did not comply with the section cited above in two counts out of eight counts not having a log for every 15 minutes on napping children for child # 1, 2, and 3 which poses a potential health, safety risk to persons in care.
POC Due Date: 05/28/2024
Plan of Correction
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The licensee agreed to send the log for child # 1 , 2, and 3 to LPA's email address by the due date.
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Thuy Ho
LICENSING EVALUATOR NAME:Mahnaz Malek
LICENSING EVALUATOR SIGNATURE:
DATE: 05/22/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/22/2024


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Document Has Been Signed on 05/22/2024 01:11 PM - It Cannot Be Edited


Created By: Mahnaz Malek On 05/22/2024 at 11:39 AM
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
, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME: YOUSEFI, P & SADAGHIANPOOR, S
FACILITY NUMBER: 304313904

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/22/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102418(g)
Immunizations
(g) The licensee shall document each child's immunizations as required by the California Code of Regulations, Title 17, Section 6070, and shall maintain such documentation for as long as the child is enrolled.

This requirement is not met as evidenced by:
Deficient Practice Statement
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4
Based on record review, the licensee did not comply with the section cited above in one count out of eight counts not having immunization for child # 1 on file which poses a potential health, safety risk to persons in care.
POC Due Date: 05/28/2024
Plan of Correction
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The licensee agreed to sent the child's immunization to LPA's email address by the due date.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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4
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Thuy Ho
LICENSING EVALUATOR NAME:Mahnaz Malek
LICENSING EVALUATOR SIGNATURE:
DATE: 05/22/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/22/2024


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