304313998-3-24-2022-06-CC-KDEI-CCTVDP-20220324162105

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 304313998
Report Date: 03/24/2022
Date Signed: 03/24/2022 04:21:16 PM

Document Has Been Signed on 03/24/2022 04:21 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:	SOBHANI, MINOO		FACILITY NUMBER:	304313998
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY: 8	TOTAL ENROLLED CHILDREN: 8	CENSUS: 0	DATE:	03/24/2022
TYPE OF VISIT:	Prelicensing	ANNOUNCED	TIME BEGAN:	01:15 PM
MET WITH:	Applicant Ms. Sobhani, Minoo		TIME COMPLETED:	04:40 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) Desai, Ketki conducted an announced in-person Pre-Licensing inspection for a new Small Family Child Care home. LPA met with the applicant Ms. Sobhani, Minoo who provided a tour of the new home. It is a Relocation A review of the Facility Personnel Report Summary indicates adult residents, who require caregiver background check clearances, transfers, exemptions have been obtained and they are cleared. Applicant stated, she is in process of registering with Resource Foster Care agency, to obtain the license for a Resource foster parent. Applicant was reminded, to notify the licensing office when the License is received. The applicant is requesting a Small family childcare home license. Per applicant, operation hours will be Monday to Saturday, 6:00 AM to 9:00 PM, care and supervision shall be provided to children ages 2 months to 8 years only ( Infants to School age children ) All areas identified on the facility sketch were inspected, including but not limited to, off limit areas. This is a Single level family home with 3 bedrooms, 2 full bathrooms, living area, kitchen with dining area, Family room, attached garage, Front yard , open backyard with two side yards. Areas that will be used by children were inspected for safety, comfort, cleanliness, telephone service (cell phone is the primary contact phone. Ventilation and heating. Home has central Air and Heating system with the unit in the right hand side yard, which is inaccessible to children. There are ceiling fans in each room along with the vents for air circulation. There are no wall mounted heaters. Fire place is in the living area with a safe metal barrier installed. Detergents, cleaning compounds, medicines, sharp objects and hazardous items that can pose a danger to children are inaccessible in areas designated for children. The applicant states (that there are no poisons on the premises). Applicant was advised that any poisons must be locked with a key or combination lock. (1)

SUPERVISORS NAME: Thuy Ho
LICENSING EVALUATOR NAME: Ketki Desai
LICENSING EVALUATOR SIGNATURE:	DATE: 03/24/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/24/2022

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: SOBHANI, MINOO	FACILITY NUMBER: 304313998
	VISIT DATE: 03/24/2022

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Based on the Facility Sketch submitted, areas off limits to children and parents are: Applicant have designated following areas, one bedroom (End of the hallway on the left hand side) Master bathroom inside the Master bedroom/ kitchen, attached garage and right hand side yard. Applicant has made this area inaccessible by installing a child safety gate at the entrance of the kitchen area, making the kitchen and garage inaccessible to children. Bedroom on the left - end of the hallway, master bathroom door has safety latch stopper installed. Applicant needs to install a safety gate on the right side yard . There are additional drawer set in the bedrooms designated for Infant care and they have safety locks on it making them inaccessible to children.

During the Pre-licensing inspection, LPA observed the designated off limits area was closed and locked.

The applicant shall use the Cell phone for Day care activities and applicant was informed if a cell phone is used for child care, it must remain on the premises at all times during hours of operation. Applicant was informed and understands the home is to be free from smoking during hours of operation.

Applicant understands that licensing staff may have access to off-limit areas during inspection visit if necessary.
Areas Designated for Day care activities: Applicant has designated the Family room ,living with dining area, two bedrooms and bathroom for Indoor Child Care activities. The children shall enter through the main door of the home, they shall enter into the small passage area leading into the Family room the designated Child Care room, where age appropriate toys for all ages to be served, arts and craft materials, books and educational items are arranged. Age appropriate furniture was also observed in this room. Older children shall nap in this area, soft mattresses shall be used, linens and blankets are provided and washed by the applicant. Younger infants shall nap in the Cribs/ playpens in the designated napping rooms ( Master bedroom and bedroom across it) Applicant shall use this 2 bedrooms during Infant nap time only. Children shall use the dining area for dining activities only and they shall walk through the living room to access the back yard for outdoor activities. Applicant also has a bassinet for younger infants if needed. Changing mat is placed on the carpeted area and all infant needs shall be provided by the parents.

The bathroom is located at the end of the hallway area, It was observed to be safe and free of hazardous items. There is no cabinet under the sink, there is storage cabinet on the side with a child safety latch installed. Applicant has a toddler potty chair / step stool, she plans to provide toilet training to the young toddlers. (2)

SUPERVISORS NAME: Thuy Ho
LICENSING EVALUATOR NAME: Ketki Desai
LICENSING EVALUATOR SIGNATURE:	DATE: 03/24/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/24/2022

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: SOBHANI, MINOO	FACILITY NUMBER: 304313998
	VISIT DATE: 03/24/2022

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Applicant shall provide Breakfast/ Lunch /Dinner along AM/PM snacks, if the food is brought from home, these containers shall be labelled with their names by the parents and stored accordingly.

Upon entrance through the designated main door of the home applicant shall receive the children here, upon entrance temperatures shall be checked, hands shall be sanitized, before children are guided

OUTDOOR PLAY AREA: Applicant shall use the front enclosed yard area and the back yard with covered patio area. Both the front yard and back yard are completed fenced with surrounding wall along the property. Front yard has concrete flooring and it has a green fence installed along the edge where plants are planted. Back yard has grass in the open area and shaded patio area has concrete flooring. Children shall walk through the living area to access the open back yard. Left side yard is open it has a wooden locked storage shed. Applicant has age appropriate outdoor activity toys and equipment's.

Per applicant there are no Pets, firearms, weapons or bodies of water in the home.

The value on the 2A10BC fire extinguisher indicates fully charged, as indicated on service tag observed. Smoke and carbon monoxide detectors were tested and are operable. The fire extinguisher is mounted on the wall in the day care room. A smoke detector and carbon monoxide units are installed in the ceiling area of the living room, garage and in each bedroom.

Applicant have completed the required Mandated Reporter Child Abuse training, Health and Safety with Nutrition and Lead Poisoning component training and Pediatric First Aid and CPR which is valid through 2/16/2024. There are first aid supplies available and is stored in the day care area with all the required items. The first aid kit was checked for proper items including tweezers, bandages and alcohol wipes. The kit is placed in the Day care area.

The following was discussed with the applicant: In the absence of the licensee a qualified adult must be present supervising the children; a qualified adult is an individual who has a valid and current Pediatric First Aid and CPR certification, TB clearance along with a valid criminal record clearance associated to the facility license.
Annual fees must be paid promptly and by the due date or a late fee shall be assessed and/or the License may be terminated.
The fire extinguisher type 2A-10BC must be serviced annually or as often as necessary. Smoke and carbon monoxide detectors should be checked, and batteries replaced as needed.

SUPERVISORS NAME: Thuy Ho
LICENSING EVALUATOR NAME: Ketki Desai
LICENSING EVALUATOR SIGNATURE:	DATE: 03/24/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/24/2022

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: SOBHANI, MINOO	FACILITY NUMBER: 304313998
	VISIT DATE: 03/24/2022

NARRATIVE

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Reporting Requirements: Changes should be reported to the Department as soon as they occur such as construction, remodeling, telephone number changes and/or if you move from your home.

Reporting Requirements: Any unusual incidents or injuries must be reported to the Department within 24 hours via telephone and within seven (7) days in writing.

Fire and safety drills must be performed every six months and documented for review by the Department. Children and Staff records must be maintained and updated as needed and must be available for review by the Department.

No smoking, No Johnny jumpers, No Baby walkers, No saucer chairs, No trampolines and any other item that falls into that category are not permitted in the facility.

Licensees shall reveal each facility license number in all advertisements, publications or announcements with the intent to attract clients.

LPA provided Guardian Information and website info: https://www.cdss.ca.gov/inforesources/cdss-programs/community-care-licensing/caregiver-background-check/guardian

Applicant Ms. Sobhani, Minoo shall provide Infant care. A copy of the 2016 “A Child Care Providers Guide to Safe Sleep” was provided to the licensee. The following electronic links were also provided:
English: https//www.cdph.ca.gov/programs/SIDS/Documents/SIDSchildcaresafesleep.pdf

LPA reviewed with the following safe sleep best practices:
*Always place infants on their backs for sleeping
*Use only a tight-fitting sheet on the crib or play yard mattress
*Do not hang any items from the crib or above the crib
*Keep all items, including blankets, out of the crib or play yard
*Pacifiers may be used as long as they do not have items attached to them
*Infants should not be swaddled or have any items covering them while sleeping
*The temperature of the room should be comfortable enough for an adult to wear a T-shirt and not be too hot or too cold. (4)

SUPERVISORS NAME: Thuy Ho
LICENSING EVALUATOR NAME: Ketki Desai
LICENSING EVALUATOR SIGNATURE:	DATE: 03/24/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/24/2022

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: SOBHANI, MINOO	FACILITY NUMBER: 304313998
	VISIT DATE: 03/24/2022

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Per Licensee, all infants shall nap in the Napping rooms ( 2 bedrooms) in the cribs, she along with her assistant will check on them and the doors shall remain open and they are not left unattended in this room. LPA discussed the new form LIC 9227 to be maintained in Infant's file and to be updated every quarter or as needed.

LPA discussed the following items with the applicant Ms. Sobhani, Minoo during the Exit interview:
Criminal Record statement: Applicant Ms. Sobhani, Minoo 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.

Safe Sleep : LPA discussed the safe sleep regulations with applicant Ms.Sobhani, Minoo & 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 of the applicant Ms. Sobhani, Minoo 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.

APPLICANT WILL WAIT UNTIL FACILITY OPENS TO DETERMINE IMS NEEDS: 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: http://www.ada.gov/childqanda.htm.

Review of records to be maintained : LPA reviewed with applicant Ms.Sobhani, Minoo, 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.

SUPERVISORS NAME: Thuy Ho
LICENSING EVALUATOR NAME: Ketki Desai
LICENSING EVALUATOR SIGNATURE:	DATE: 03/24/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/24/2022

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: SOBHANI, MINOO	FACILITY NUMBER: 304313998
	VISIT DATE: 03/24/2022

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Subscribe to CCLD important information
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 platform. 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.

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.

Exit interview conducted with the Applicant Ms. Sobhani, Minoo this report was read to the applicant.

OTHER INFORMATION AND FORMS PROVIDED: Capacity Handout for a Small Family Child Care Home. LPA explained the age requirements for the enrolled children ensuring that when there are 8 children, at least one child is enrolled in Kindergarten or 6 years old, to be in compliance with Title 22 requirements.

LPA reviewed Title 22 Regulation Section 102423 Personal Rights including but not limited to: no intimidation, no humiliation, and no corporal punishment.

The facility at the time of Pre-licensing inspection, Applicant is not in compliance for a (Small Family Child Care Home) with Title 22 Regulations.

Applicant needs to install a safe barrier on the right hand side yard, making it inaccessible to children to be in compliance. Applicant shall submit a proof of correction to the LPA. Once received, file shall be submitted for Management approval.

SUPERVISORS NAME: Thuy Ho
LICENSING EVALUATOR NAME: Ketki Desai
LICENSING EVALUATOR SIGNATURE:	DATE: 03/24/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/24/2022

LIC809 (FAS) - (06/04)

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