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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 343625169
Report Date: 09/24/2024
Date Signed: 09/25/2024 08:11:14 AM

Document Has Been Signed on 09/25/2024 08:11 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
SACRAMENTO CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME:SAFI, RABYA & ABDUL BASIRFACILITY NUMBER:
343625169
ADMINISTRATOR/
DIRECTOR:		FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 0DATE:
09/24/2024
TYPE OF VISIT:POCUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
02:35 PM
MET WITH:Abdul Basir SafiTIME VISIT/
INSPECTION COMPLETED:
03:35 PM
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On September 24, 2024, Licensing Program Analyst (LPA) Stephanie Piring, met with licensee, Abdul Basir Safi, for the purpose of conducting a plan of correction inspection.

Licensee was cited on 08/26/2024 for being out of compliance with Title 22 Regulation, CCR 102421 Children's records. At the time, all children's records for children enrolled were missing. During today's inspection, LPA observed all required forms filled out and signed by authorized representatives for all children currently enrolled.

LPA has cleared the citation after observing the licensee in compliance with children's records requirements.

Exit interview and report reviewed with Licensee, Abdul Basir Safi. Notice of Site provided and must remain posted for 30 days.
SUPERVISORS NAME: Natalie Dunaway
LICENSING EVALUATOR NAME: Stephanie Piring
LICENSING EVALUATOR SIGNATURE: DATE: 09/24/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/24/2024
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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