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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376101057
Report Date: 04/08/2022
Date Signed: 04/08/2022 03:15:50 PM

Document Has Been Signed on 04/08/2022 03:15 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
CCLD Regional Office, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108
FACILITY NAME:NURISTANI, AKHTAR & ZAHIR FAMILY CHILD CAREFACILITY NUMBER:
376101057
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 2DATE:
04/08/2022
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME BEGAN:
01:10 PM
MET WITH:Akhtar and Zahir NuristaniTIME COMPLETED:
03:30 PM
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On 4/8/22 at 1:10 PM Licensing Program Analyst (LPA) Adrian Mangina conducted an announced change of location Pre-Licensing inspection with the Licensees Akhtar and Zahir Nuristani. Also present in the home during the inspection were 2 minor children. There were no children in care. The 4 bedroom, 3 bathroom 2 story home was toured and inspected to ensure an environment safe for the care and supervision of children. A copy of the grant deed was provided as proof of control of property.

Applicant states that they have sufficient financial resources to sustain the license. A review of staff records on this date indicates that all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse clearances or exemptions. Licensees were 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.

Licensees own the home and have provided Mortgage deed as proof of control of property. Licensee Akhtar Nuristani First Aid and CPR expire on 2/19/2024 and Licensee Zahir Nuristani First Aid and CPR expire on 2/23/2022. Licensee Akhtar Nuristani completed preventative health practices supplemental lead course on 3/30/2022. Licensee Zahir Nuristani has not completed preventative health practices supplemental lead course and must complete prior to licensure. Licensee Zahir Nuristani completed Mandated Reporter training 9/24/2022. Licensee Akhtar Nuristani must complete Mandated Reporter Training AB 1207 prior to licensure. Staff immunization requirements per SB792 were met. Applicant has the required immunizations. Applicant states that there are no weapons in the home.
(continued on LIC809 page 2)
SUPERVISORS NAME: Renesha Pack
LICENSING EVALUATOR NAME: Adrian L Mangina
LICENSING EVALUATOR SIGNATURE: DATE: 04/08/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/08/2022
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 3
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108
FACILITY NAME: NURISTANI, AKHTAR & ZAHIR FAMILY CHILD CARE
FACILITY NUMBER: 376101057
VISIT DATE: 04/08/2022
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(LIC809 page 2)

Applicant will be using the following rooms for childcare kitchen, living room, dining room, sitting room, and downstairs bathroom. The following areas will be off limits: front hall closet, entire second floor, and side yard. The off-limit areas either have safety latches, locks, doorknob covers or gates to prevent access. The fireplace located in living room is screened to prevent access. The attached garage will also be off limits and is kept inaccessible through the use of a door knob cover. There are no bodies of water on the property. There is a fountain in the back yard that has been filled with rocks for safety. The applicant has sufficient toys and equipment available. Outdoor play area is the fully fenced back yard.

The 2A10BC fire extinguisher located in the front hall closet and the smoke detector located in the hallway and carbon monoxide detector located in dining room meet requirements and are all operational. All hazardous items were latched/locked and secured out of reach of children.

The new provider packet was reviewed with the applicants including information on ratios and capacity, child abuse reporting, children’s records, immunizations, adults living or working in the home, car seat law, shaken baby syndrome, SIDS, safe sleep practices, effects of lead poisoning, and the YMCA Resource Center. Applicants were reminded that corporal punishment, smoking, walkers, exersaucers, jumpers, and bouncy seats are not allowed in day care. All equipment that is used should be used only as intended by the manufacturer. LPA and Licensee discussed California Megan's Law and LPA provided: www.meganslaw.ca.gov.

LPA discussed and provided applicant with the following information:
· Child Care Advocates - email address childcareadvocatesprogram@dss.ca.gov.
· For common questions or questions regarding licensing requirements to contact the Child Care Licensing duty line at 619-767-2248.

LPA discussed the safe sleep regulations with Licensees 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
(continued on LIC809 page 3)
SUPERVISORS NAME: Renesha Pack
LICENSING EVALUATOR NAME: Adrian L Mangina
LICENSING EVALUATOR SIGNATURE:

DATE: 04/08/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/08/2022
LIC809 (FAS) - (06/04)
Page: 2 of 3
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108
FACILITY NAME: NURISTANI, AKHTAR & ZAHIR FAMILY CHILD CARE
FACILITY NUMBER: 376101057
VISIT DATE: 04/08/2022
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(LIC809 page 3)

additional resource. LPA also informed Licensee 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.

Incidental Medical Services (IMS) policy was discussed. For IMS information , see PIN 22-02-CCP. When any IMS is provided, a Plan for Providing IMS must be submitted 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 reviewed with Licensees the LIC 311D, Forms/Records To Keep In Your Family Child Care Homes, children’s forms/records, facility forms/records, and information to be posted
Entrance Checklist was provided to the applicant.
Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other important information communication platform.
To receive important licensed-related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-care-licensing/subscribe and select the Child Care option to receive email communication.

The following corrections are needed prior to the issuance of the license:

1) Licensee Zahir to complete lead training supplement
2) Licensee Akhtar to complete Mandated Reporter training

Applicants understand that corrections must be submitted to the Department within 30 days, no later than 5/7/22 or the application may be denied. Exit interview conducted and report was reviewed with the Licensees Akhtar and Zahir Nuristani and signature acknowledges receipt.
SUPERVISORS NAME: Renesha Pack
LICENSING EVALUATOR NAME: Adrian L Mangina
LICENSING EVALUATOR SIGNATURE:

DATE: 04/08/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/08/2022
LIC809 (FAS) - (06/04)
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