304314152-12-12-2023-06-CC-MMAK-CYG2PB-20231212163403

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 304314152
Report Date: 12/12/2023
Date Signed: 12/12/2023 04:34:18 PM

Document Has Been Signed on 12/12/2023 04:34 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:	MALEKNEJAD, ELHAM		FACILITY NUMBER:	304314152
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY: 8	TOTAL ENROLLED CHILDREN: 8	CENSUS: 4	DATE:	12/12/2023
TYPE OF VISIT:	Case Management - Licensee Initiated	UNANNOUNCED	TIME BEGAN:	01:15 PM
MET WITH:	Licensee		TIME COMPLETED:	05:00 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 3 Licensing Program Analyst (LPA) Mahnaz (Nancy) Malek conducted a case management inspection of this facility for the purpose of increasing the capacity to Large Family Child Care home. LPA met with licensee Elham Maleknejad who provided a tour of the home. LPA also met with the licensee's assistant, Vafa Ganji. Per the licensee, there are no minors living in the home. LPA took census. There were 4 children napping in the napping room. One child was under 24 months old and the rest of the children were over 2 years old. The log for every 15 minutes check on infants were reviewed and the facility was in compliance. A review of the Facility Personnel Report Summary indicates on 12/12/2023 two adults live in the home. The adult resident received caregiver background check clearances or exemptions as required by the Department. There was no transfer criminal record clearance for the assistant Vafa Ganji to this facility. The staff has been working at this facility since 11/1/2023. Civil penalty of 500.00 was assessed today. The licensee obtained the clearance ID number for the assistant, and filled out the appropriate form to transfer the assistant's clearance ID number, and emailed it to the office to correct the deficiency during LPA's visit. The licensee's operation hours are Monday through Friday, 7:30 AM- 5:30 PM. Care and supervision will be provided to children ages infants to 12 years old. For the purposes of licensing, an infant is defined as any child 0 to 24 months of age. All areas identified on the facility sketch were inspected, including but not limited to, off limit areas. This is a three story home with 4 bedrooms, 3.5 bathrooms, living room, kitchen, dining room, sport room, laundry room, 1 small patio on the first floor, 1 small patio on the second floor, and 1 large patio on the third floor, outdoor area, and garage. There is no fireplace in the home. A child proof gate is located at the bottom of the stairs of the first floor. The day care area for children is one bedroom, living room, family room/dinning room, and children's bathroom, and the patio as outdoor space. Kitchen area and all the upstairs are off limit. The garage is not Continued on page 2

SUPERVISORS NAME: Thuy Ho
LICENSING EVALUATOR NAME: Mahnaz Malek
LICENSING EVALUATOR SIGNATURE:	DATE: 12/12/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/12/2023

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

FACILITY NAME: MALEKNEJAD, ELHAM	FACILITY NUMBER: 304314152
	VISIT DATE: 12/12/2023

NARRATIVE

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accessible to children and is locked by two locks. The storage room has two locks on it. The kitchen area is off limit and two gates have been installed on two sides of the kitchen. Areas that will be used by children were inspected for safety, comfort, cleanliness, telephone service (cell phone), ventilation and heating.
Detergents, cleaning compounds, medicines, sharp objects, and hazardous items that can pose a danger to children are inaccessible in areas designated for children. The licensee stated that there are no poisons on the premises and LPA did not observe any.The licensee was advised that any poisons must be locked with a key or combination lock. Per licensee, there were no weapons or firearms on the premises. There are no body of water and no pets living in the house.
Smoke and carbon monoxide detectors were working. The pressure gauge on the 2A-10BC fire extinguisher indicates fully charged, as indicated on the service tag observed (mounted on the wall by the entrance door).
A records review indicates the licensee completed the required Health and Safety Training with Nutrition and Lead Poisoning components. The licensee has a current (EMSA approved) Pediatric First Aid and Pediatric CPR certification that expires on 8/2024. The licensee's mandated reporter training certificate expires 9/1/2024. Commencing September 1, 2016, a person shall not be employed or volunteer at a family day care home if he or she has not been immunized against influenza, pertussis, and measles. The applicant has submitted proof of immunizations. Immunization for the licensee and assistant was complete.

The Child Advocacy Program was discussed with the licensee. The licensee was advised to register for the program to receive quarterly reports and other information in a timely manner. To register email ChildCareAdvocatesProgram@dss.ca.gov.

The LPA advised the applicant on how to access forms, regulations, and quarterly updates on the Child Care Licensing website at: www.cdss.ca.gov/inforesources/community-care-licensing. LPA reviewed and issued the LIC311D “Forms/Records to Keep in Your Family Child Care Home” and provided to licensee.
Children's files were reviewed and they were all in compliance.

Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02-CCP. When any IMS is provided, an updated Plan of Operation that includes IMS must be submitted to the Department. The
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SUPERVISORS NAME: Thuy Ho
LICENSING EVALUATOR NAME: Mahnaz Malek
LICENSING EVALUATOR SIGNATURE:	DATE: 12/12/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/12/2023

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

FACILITY NAME: MALEKNEJAD, ELHAM	FACILITY NUMBER: 304314152
	VISIT DATE: 12/12/2023

NARRATIVE

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following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice) or (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 Incidental Medical Services (IMS) - Family Child Care Homes
The licensee, Elham Maleknejad 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 volunteers, except as specified in Health and Safety Code section 1596.871, 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 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 the applicant 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. LPAs also informed the licensee 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.

Licensee, Elham Maleknejad 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. The licensee has been signed up for this.

The Small Family Child Care Home was not in compliance with Title 22 Regulations at the time of inspection. Type B citation was issued for the assistant not being associated to the facility. The request for Large Family Child Care Home will be discussed with the management in the office. In the event additional requirements are needed, the licensee will be notified. Appeal rights were provided.

Exit interview conducted and report was reviewed with the licensee, Elham Maleknejad.

End of report

SUPERVISORS NAME: Thuy Ho
LICENSING EVALUATOR NAME: Mahnaz Malek
LICENSING EVALUATOR SIGNATURE:	DATE: 12/12/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/12/2023

LIC809 (FAS) - (06/04)

Page: 3 of 4

Document Has Been Signed on 12/12/2023 04:34 PM - It Cannot Be Edited

Created By: Mahnaz Malek On 12/12/2023 at 03:43 PM

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: MALEKNEJAD, ELHAM	FACILITY NUMBER: 304314152
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 12/12/2023

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 12/12/2023 Section Cited CCR 102370(d)(2)	1 2 3 4 5 6 7	102370(d)(2) All individuals subject to a criminal record review pursuant to Health and Safety Code Section 1596.871 shall prior to working, residing, or volunteering in a licensed facility: Request a transfer of a criminal record clearance as specified	1 2 3 4 5 6 7	During LPA's presence, the licensee obtained the clearance ID number for the assistant and filled out the transfer request form (LIC 9182) and emailed it to the office. LPA will check the computer system to make sure the assistant is associated to the facility.
	8 9 10 11 12 13 14	in Section 102370(j). The above requirement was not met as evidenced by the licensee failed to transfer criminal record clearance for the assistant, Vafa Gangi to her facility. The assistant has been working since 11/1/2023. This is a potential hazard to the safety of children.	8 9 10 11 12 13 14	An immediate civil penalty of 500.00 was assessed today.
	1 2 3 4 5 6 7		1 2 3 4 5 6 7
	1 2 3 4 5 6 7		1 2 3 4 5 6 7

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: 12/12/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/12/2023

LIC809 (FAS) - (06/04)

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