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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 343625580
Report Date: 11/21/2024
Date Signed: 11/21/2024 03:12:55 PM

Document Has Been Signed on 11/21/2024 03:12 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:SAFI, FARIDAFACILITY NUMBER:
343625580
ADMINISTRATOR/
DIRECTOR:		FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 4DATE:
11/21/2024
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
02:15 PM
MET WITH:Farida SafiTIME VISIT/
INSPECTION COMPLETED:
03:20 PM
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Licensing Program Analyst (LPA) Gagandeep Singh met with the licensee, Farida Safi, for a case management inspection. The department received an application from licensee’s spouse listing himself as sole applicant or licensee and licensee’s spouse left voice message to LPA asking to be added as helper. Purpose of today’s inspection was to verify the licensee’s decision about her license.

During today’s inspection, LPA inspected the facility and interviewed licensee. LPA explained to licensee that as licensee’s spouse has criminal background clearance on file, he can be used as helper and if the spouse wishes to be co licensee, licensee needs to submit an application with licensee and her spouse as applicants. Licensee stated that licensee wish to add her spouse only has helper, as he has an outside job and will be helping only in the day care. Licensee has provided the copy of spouse’s valid CPR training and preventive health and safety course certificate. During today’s inspection, LPA obtained an updated application from licensee, which states licensee as applicant/licensee and spouse as helper.

During today’s inspection, no violation of any regulation was observed or cited. Copy of this report was reviewed and provided to the licensee. Notice of site visit is posted and shall remain posted for next 30 days.

SUPERVISORS NAME: Natalie Dunaway
LICENSING EVALUATOR NAME: Gagandeep Singh
LICENSING EVALUATOR SIGNATURE: DATE: 11/21/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/21/2024
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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