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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 343625126
Report Date: 10/17/2024
Date Signed: 10/17/2024 01:41:55 PM

Document Has Been Signed on 10/17/2024 01:41 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
SACRAMENTO CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME:SALARZAI, ZAINABFACILITY NUMBER:
343625126
ADMINISTRATOR/
DIRECTOR:
FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 2DATE:
10/17/2024
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:30 PM
MET WITH:Zainab SalarzaiTIME VISIT/
INSPECTION COMPLETED:
02:00 PM
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Licensing Program Analyst (LPA) Jennifer Velasco met with Licensee, Zainab Salarzai, for the purpose of an unannounced case management inspection. Licensee has requested to increase from a small family childcare to a large family childcare. Fire clearance STD 850 was granted on 10/14/2024. All individuals subject to criminal background review have obtained a criminal record clearance. Licensee 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, 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. LPA verified with Licensee that her associations are current. LPA observed that the annual facility fees are current. Facility hours of operation are Monday through Friday, 7:00 AM – 10:00 PM. Weekend care may be possible by arrangement.

A health and safety inspection were conducted in the areas accessible to children. The backyard is fenced and the backyard is ready for daycare use. Off-limit areas will consist of: Left and right side yards kitchen, pantry, utility closets, garage, stairs to second story, entire second story, and outdoor storage area. Licensee acknowledged that children may never enter these off-limit areas. LPA discussed ratios for a large capacity and personnel records. Licensee understands that her own children under the age of 10 count towards the total ratio and capacity. Licensee understands that when there is no assistant present, the facility reverts back to the ratios of a small capacity. LPA provided a copy of CCR Regulation 102416.5 which discusses Ratio and Capacity. LPA discussed required documentation for adult and minor assistants.

Effective today, 10/17/24, the Facility is approved for a Large Family Child Care Licensed to serve 12 children (when there is an assistant present) with no more than 4 infants, or maximum capacity of 14 children when 1 child is enrolled in Transitional Kindergarten or above and 1 child at least age 6 with a maximum of 3 infants. In the areas that were evaluated, no deficiencies were observed. Exit Interview was conducted, a Notice of Site Visit was provided, and must remain posted for 30 days for parental review.
SUPERVISORS NAME: Natalie Dunaway
LICENSING EVALUATOR NAME: Jennifer Velasco
LICENSING EVALUATOR SIGNATURE: DATE: 10/17/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/17/2024
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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