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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 330908480
Report Date: 08/29/2023
Date Signed: 08/29/2023 05:18:21 PM

Document Has Been Signed on 08/29/2023 05:18 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
INLAND EMPIRE CHILD, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501
FACILITY NAME:ISLAMIC ACADEMY OF RIVERSIDEFACILITY NUMBER:
330908480
ADMINISTRATOR:KHALIDA ZIAULLAHFACILITY TYPE:
850
ADDRESS:1038 W. LINDEN STREETTELEPHONE:
(951) 682-1202
CITY:RIVERSIDESTATE: CAZIP CODE:
92507
CAPACITY: 24TOTAL ENROLLED CHILDREN: 17CENSUS: 0DATE:
08/29/2023
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
03:15 PM
MET WITH:Director Nadia SaberTIME COMPLETED:
05:25 PM
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On 08/29/2023 at 3:15 PM, Licensing Program Analyst (LPA) Susan Brewer, arrived unannounced for the purpose of conducting an Case Management Inspection at licensee's request. The licensee recently completed alterations to the facility by converting a utility storage room into an additional restroom designated to the preschool program. LPA was greeted by Administrator Josef Mohebi, granted entry to tour the facility and met with Director Nadia Saber. The following was observed and discussed: A census of 0 children were present at the facility. The licensee agrees to submit updated LIC999 facility sketches to reflect the new restroom added. The restroom is not being used at this time and is off limits to daycare children.

LPA S. Brewer, inspected the new restroom located at the Northwest Corner of the building along with paperwork received from the City of Riverside. On 08/10/2023 a Plan of Corrections from the City of Riverside, state the licensee is to weld the exterior door, provide grab bars, repair weather stripping and add a sign to identify the restroom. LPA observed the restroom to have 1 child sized toilet, 1 urinal and 1 sink. The door from the outside of the restroom is closed and blocked by an installed handrail. The director placed a sign on the restroom door, however LPA was unable to determine if the City of Riverside, approved of door welding or the weather stripping requested on 08/10/2023. LPA observed construction floor/wall tile, grout, paint, miscellaneous construction materials remaining on the floor of the restroom. The restroom is not supplied with soap, paper towels or toilet tissue at this time. Prior to utilizing the new restroom for the preschool, the licensee agrees to submit the following:
1. Verification of repairs requested by the city for weather stripping and door welding.
2. Updated LIC999 Facility Sketches to include the new restroom.
3. Remove construction materials, clean restroom and stock restroom with soap, paper towels and toilet paper.

No citations were issued on today's date. No civil penalties issued on today's date.
A notice of site visit was given and must remain posted for 30 days.
Exit interview conducted and report was reviewed with the licensee Director Nadia Saber.
SUPERVISORS NAME: Kimberly Williams
LICENSING EVALUATOR NAME: Susan Brewer
LICENSING EVALUATOR SIGNATURE: DATE: 08/29/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/29/2023
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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