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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 304313998
Report Date: 08/10/2022
Date Signed: 08/10/2022 12:48:36 PM

Document Has Been Signed on 08/10/2022 12:48 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, MINOOFACILITY NUMBER:
304313998
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 3DATE:
08/10/2022
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
10:15 AM
MET WITH:Licensee Ms. Sobhani, Minoo TIME COMPLETED:
12:45 PM
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A Case Management (Licensee initiated) inspection for a change in capacity was conducted at the facility by Licensing Program Analyst (LPA), Desai, Ketki. LPA observed licensee Ms. Sobhani, Minoo caring for 2 Infants and 1 Preschool age children between the ages of 6 months and 2 and half years old. Licensee has been a care provider for a Small Family child care home since February 2017, qualifying her to be a Large Family child care provider.
Licensee was operating within the licensed 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 three adults residing in the home.

Licensee stated, she is not currently registered with any Resource Foster Care agency or holds a Resource foster parent license. She was reminded if changes to notify the licensing office.

Per Licensee, operation hours will be Monday to Saturday, 6.00 AM to 6.00 PM, care and supervision shall be provided to children ages 2 months to 8 years of age (Infants to School age children only).

During today’s inspection, LPA and licensee toured the inside and outside areas identified in the facility sketch as accessible to child care children.

Off Limit areas: One bedroom (End of the hallway on the left hand side) Master bathroom inside the Master bedroom/ kitchen, attached garage and two side yards. Licensee has made this areas 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. There is no stairway in the home. (1)

SUPERVISORS NAME: Thuy Ho
LICENSING EVALUATOR NAME: Ketki Desai
LICENSING EVALUATOR SIGNATURE: DATE: 08/10/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/10/2022
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: 08/10/2022
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Detergents, cleaning compounds, medicines, and other items which could pose a danger if readily available to children were stored inaccessible to children.

Designated Day care area: Parents and children shall enter the home, through the left side gate in the drive way leading into the front yard of the home, which is completed with concrete flooring with a shaded roof . A ring bell has been installed, on the side door, this door remains locked during operating hours. The side entrance gate is the official pick up and drop off area. Licensee has placed a child fencing across the side plants making it safe for children. Licensee continues to use Family room ,living with dining area, two bedrooms and bathroom for Indoor Child Care activities. The children enter through the main door of the home, entering 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 is observed in this room. There is a fire place in the living area with a safety lock on the door.

Older children shall nap in the day care room on a soft mattresses and cots are also used, linens and blankets are provided and washed by the Licensee.

Younger infants nap in the Cribs/ playpens in the designated napping rooms ( Master bedroom and bedroom across it) Licensee uses this 2 bedrooms during Infant nap time only and between herself and the assistant the infants are supervised every 15 minutes and the door is left open.

Now with the change in capacity , Licensee shall have older children nap in the living area on the cots. Older school age children only use the dining area for dining activities, while younger children have the meal activities in the day care room on the small table and chair. Infants use high chairs which are arranged in the day care room. Children walk through the living room to access the back yard for outdoor activities.

Infant room was observed to have napping items, including changing table/ high chair, Infant items: diapers / wipes/ lotions and milk shall be provided by the parents. Mother's milk shall be labeled and stored appropriately. Per Licensee infants shall not be left unattended while they are sleeping. Both the rooms were observed to be well lighted with proper ventilation and air flow. Licensee 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. (2)

SUPERVISORS NAME: Thuy Ho
LICENSING EVALUATOR NAME: Ketki Desai
LICENSING EVALUATOR SIGNATURE:

DATE: 08/10/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/10/2022
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: 08/10/2022
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The bathroom is located next to the infant bedroom, their is a small step stool and toddler toilet seat for the younger toddlers. There is a cabinet under the sink with a safety lock installed. The children's bathroom was observed to be safe and free of hazardous items.

Licensee provides Breakfast, AM/PM snacks, lunch if food is brought from home and these containers shall be labelled with their names by the parents and stored accordingly. Licensee has been enrolled in the food program. (City of La Habra food program)

LPA's discussed the Safe Sleep practice with the Licensee Ms. Sobhani, Minoo



Safe to Sleep Campaign: https://safetosleep.nichd.nih.gov/materials
LPA reviewed with applicant 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 if 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.
Licensee shall maintain LIC 9227 form in the infant file. ( Printed and given to the Licensee)

Hard copy and link of Child Care Providers Guide to Safe Sleep provided to licensee on this day: https://www.cdph.ca.gov/programs/SIDS/Documents/SIDSchildcaresafesleep.pdf

Outdoor activity area: Licensee continues to use the open back yard and front yard for outdoor activities. It is fenced with concrete and grass flooring. It is safe for outdoor activities. Licensee has installed two safety gates on each end of the back yard making the side yards inaccessible to children. LPA observed several age appropriate activities arranged in the both front and back yard.

There are no pets, firearms, weapons, bodies of water in the home. (3)
SUPERVISORS NAME: Thuy Ho
LICENSING EVALUATOR NAME: Ketki Desai
LICENSING EVALUATOR SIGNATURE:

DATE: 08/10/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/10/2022
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: 08/10/2022
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The value on the 2A10 BC fire extinguisher indicates fully charged, as indicated on service tag observed. Smoke and carbon monoxide detectors were tested and are operable. Licensee has mounted the Fire extinguisher on the side wall of the day care room. Smoke & Carbon Monoxide detectors are mounted on the ceiling of the passage area and a new Fire Alarm system has been installed as per the Fire Statutory requirements.

LPA verified there is a working telephone service (cellular service) in the home.

The licensee does have a current roster of children in care and the 3 records were reviewed on today's inspection, LPA reviewed the emergency information card that contains all the information specified by regulation (LIC 700) and found to be in compliance.

The licensee holds a valid Pediatric CPR/First Aid certification is valid through May 2024 and have completed the required Mandated Reporter Child Abuse training.
Licensee also has conducted Emergency fire and earthquake drills, last drill conducted in June 2022.

LPA verified the Control of Property : Licensee is the owner of the home ( Documents on file)

The licensee understands she must be present in the facility, must ensure children in care are supervised at all times, and children are not to be left 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's, Pediatric CPR/First Aid, and mandated reporter training.

A copy of the California Department of Social Services Lead Information Brochure was explained and provided to the licensee.

OTHER INFORMATION AND FORMS PROVIDED:
Capacity Handout for a Large Family Child Care Home was provided and LIC 9150 was reviewed with the Licensee (4)
SUPERVISORS NAME: Thuy Ho
LICENSING EVALUATOR NAME: Ketki Desai
LICENSING EVALUATOR SIGNATURE:

DATE: 08/10/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/10/2022
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: 08/10/2022
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Fire inspection from Orange County Fire Authority Fire inspection services have granted the fire clearance with specific instruction where garage is not permitted for Day care.

LPA discussed the following items with the Licensee Ms. Sobhani, Minoo during the Exit interview:

Criminal Record statement: Licensee 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 Licensee Ms. Shobani, 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 Licensee Ms.Shobani, 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.Shobani, 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: 08/10/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/10/2022
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: 08/10/2022
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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 license- 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

LPA discussed the ratio for the Large Family Child Care home with the Licensee: Large Family Child Care Home, and with an assistant provider, may provide care for more than 12 and up to 14 children when one child is enrolled in and attending kindergarten (including transitional kindergarten) or elementary school, and another child is at least six years old, and no more than three infants are in care.

( Poster given to the Provider)

An advisory issued to the Licensee on today's inspection.



On today’s inspection each child was observed to have a safe, healthful and comfortable accommodation furnishing and equipment’s.

A license with the change in capacity for 14 children (Large Family Child care home) will be issued after final review, in the event additional requirements are needed, Licensee will be notified.


A notice of site visit was given and must remain posted on, or immediately adjacent to, the interior side of the main door for 30 days.

A copy of this report and Appeal rights were presented to the Licensee.

SUPERVISORS NAME: Thuy Ho
LICENSING EVALUATOR NAME: Ketki Desai
LICENSING EVALUATOR SIGNATURE:

DATE: 08/10/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/10/2022
LIC809 (FAS) - (06/04)
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