343624302-6-9-2022-03-CC-JGAG-CF8PW6-20220609114012

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 343624302
Report Date: 06/09/2022
Date Signed: 06/09/2022 11:40:19 AM

Document Has Been Signed on 06/09/2022 11:40 AM - 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, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833

FACILITY NAME:	HANIFI, BIBI GUL		FACILITY NUMBER:	343624302
ADMINISTRATOR:	HANIFI, BIBI GUL		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(916) 582-1423
CITY:	SACRAMENTO	STATE: CA	ZIP CODE:	95821
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 0	CENSUS: 1	DATE:	06/09/2022
TYPE OF VISIT:	Prelicensing	ANNOUNCED	TIME BEGAN:	10:25 AM
MET WITH:	Bibi Gul Hanifi		TIME COMPLETED:	11:50 AM

NARRATIVE

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On Thursday, June 9 2022, at approximately 10:25 AM, Licensing Program Analyst (LPA) Josiah Gathing met with Applicant Bibi Gul Hanifi for the purpose of conducting an announced change of location pre-licensing inspection for a large Family Child Care Home. During today's inspection, the applicant, her husband, and minor child were present in the home. All adults living in the home have received criminal record background clearance. Applicant’s first language is Pashto and her husband provided translation during today’s inspection. Applicant plans to operate Monday – Friday from 6:00 AM to 11:00 PM.

A health and safety inspection was conducted inside and out of the home. The first floor of the home includes 2 bedrooms, bathroom, living room, kitchen, garage and fenced back yard. The second floor includes the master bedroom #3 and bathroom #2. Off-limits areas: Garage and entire second floor.

Cleaning supplies are stored in the hall closet, inaccessible to children and out of children's reach. Sharp knives are stored in the kitchen out of children's reach. Multiple smoke detectors, a carbon monoxide detector, and a full 2A10BC fire extinguisher were observed in the home. A pull alarm was also observed in the home. Per applicant the first aid kit is still at the previous location. Required documents were posted near the facility entrance. In the back yard, LPA observed that the playground was still in the process of being constructed. LPA also observed a hole in the ground where a plant had been removed.

Applicant completed the Preventative Health and Safety course including the Lead Poisoning Prevention training on 08/24/2020. Applicant has a current EMSA certified CPR and First Aid certificate which expires 08/22/2022. Applicant stated there are no weapons in the home and there are no bodies of water on the premises. Applicant understands that prior to making alterations or additions to the home or grounds, she shall notify the Department of the proposed changes.

CONT. ON LIC809-C...

SUPERVISORS NAME: Seychelle De Luca
LICENSING EVALUATOR NAME: Josiah Gathing
LICENSING EVALUATOR SIGNATURE:	DATE: 06/09/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/09/2022

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, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833

FACILITY NAME: HANIFI, BIBI GUL	FACILITY NUMBER: 343624302
	VISIT DATE: 06/09/2022

NARRATIVE

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Applicant was encouraged to visit the Department’s website at www.cdss.ca.gov for more information regarding child care updates, forms, regulations and legislation.

LPA discussed open door policy, supervision, fire drills, reporting requirements, and the smoking prohibition with the applicant. A current roster of children enrolled must be available and maintained for a period of three years, even after children are no longer in care.

Annual fees must be paid promptly and by the due date or late fees will be assessed. Applicant understands that the license is non-transferable, and once licensed, licensee must live in the home and be present for 80% of the operating hours. LPA explained to applicant that if she relocates and wants to continue to provide care, she must submit a change of location application and have the new home inspected.

Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual – Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. When any IMS is provided, a Plan for Providing IMS must be submitting 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

LPA discussed the safe sleep regulations with 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. LPA also informed Director 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.

CONT. ON LIC809-C...

SUPERVISORS NAME: Seychelle De Luca
LICENSING EVALUATOR NAME: Josiah Gathing
LICENSING EVALUATOR SIGNATURE:	DATE: 06/09/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/09/2022

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, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833

FACILITY NAME: HANIFI, BIBI GUL	FACILITY NUMBER: 343624302
	VISIT DATE: 06/09/2022

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An exit interview was conducted with Applicant and Covid-19 protocols were discussed. LIC311D, records, postings, and reporting requirements were discussed. LPA discussed personal rights, criminal record clearances, ratios and capacity, and maintaining buildings and grounds. Applicant was encouraged to visit the Department's website at WWW.CCLD.CA.GOV for information regarding child care updates, forms, regulations and legislation pertaining to family child care homes.

Prior to licensing, applicant must provide LPA with the following:

- Proof of a first aid kit in the home.

- Proof that the back yard playground has been completed.

- Proof that the hole in the back yard has been filled in.

LPA reviewed this report with the applicant and provided a copy to keep with applicant’s records

SUPERVISORS NAME: Seychelle De Luca
LICENSING EVALUATOR NAME: Josiah Gathing
LICENSING EVALUATOR SIGNATURE:	DATE: 06/09/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/09/2022

LIC809 (FAS) - (06/04)

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