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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 343626358
Report Date: 12/10/2024
Date Signed: 12/10/2024 01:08:07 PM

Document Has Been Signed on 12/10/2024 01:08 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:NOORI, ATIAFACILITY NUMBER:
343626358
ADMINISTRATOR/
DIRECTOR:		FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 0DATE:
12/10/2024
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:50 PM
MET WITH:Atia NooriTIME VISIT/
INSPECTION COMPLETED:
01:45 PM
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On Tuesday, 12/10/2024, Licensing Program Analyst (LPA) Amanda Sutter met with Applicant Atia Noori for the purpose of an announced change of location inspection. All individuals subject to criminal background review have obtained a criminal record clearance. A health and safety inspection of the home was conducted on 12/4/2024. The purpose of today’s inspection is to observe the pool area and confirm that it is fenced according to regulation.

During the first change of location inspection, LPA observed a pond in the backyard. Since the inspection, Applicant's husband has constructed a wooden platform to cover the pond on the top and the sides. Due to the platform's weight, LPA observed the cover to be immovable. LPA observed gaps in the platform near some of the rocks and in the back near a plant. LPA advised Applicant to cover all the gaps so that a child could not crawl through these areas. The facility is still pending until proof that the pond is completely covered.

Exit interview conducted and report was reviewed with the applicant Atia Noori.

SUPERVISORS NAME: Seychelle De Luca
LICENSING EVALUATOR NAME: Amanda Sutter
LICENSING EVALUATOR SIGNATURE: DATE: 12/22/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/10/2024
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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