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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376101526
Report Date: 03/22/2024
Date Signed: 03/22/2024 02:45:37 PM

Document Has Been Signed on 03/22/2024 02:45 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
SAN DIEGO NORTH, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108
FACILITY NAME:KOHISTANI, MUHAMMAD ZAMAN FAMILY CHILD CAREFACILITY NUMBER:
376101526
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 19CENSUS: 0DATE:
03/22/2024
TYPE OF VISIT:Case Management - Licensee InitiatedANNOUNCEDTIME BEGAN:
01:25 PM
MET WITH:Muhanmmad Zaman KohistaniTIME COMPLETED:
03:00 PM
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Licensing Program Analyst, Sherlynn Banas conducted an announced Case Management visit for an increase in capacity from eight (8) to fourteen (14) children. LPA was greeted at the front door by Muhammad Zaman Kohistani and granted entry after identifying herself and disclosing the purpose of the visit. Zakirullah Kohistani (son) translated for licensee and Lima Kohistani (daughter-in-law) were present upon entry to the facility. Licensee stated that there were no children at this time. They have 19 children enrolled in the facility.

The Fire Safety Inspection Request (STD 850) was approved by the local fire marshal and GRANTED the capacity increase to fourteen (14) children on 03/12/2024.

LPA conducted an inspection of home which includes # 4 bedrooms and 2 1/2 bathrooms. Licensee will be using living room, dining room, kitchen, and backyard for child care. Off limit areas include garage, all bedrooms upstairs, and the front yard. There was a safety gate to prevent children from going upstairs. Smoke alarms and carbon monoxide detector are functional and meet statutory requirements. Fire extinguisher is installed in the kitchen and is operational.

Licensee was reminded of requirements for children’s records, child abuse, and unusual incident reporting, immunizations, adults living or working in the home and associated civil penalties, licensee was also reminded that corporal punishment, smoking, walkers, exersaucers, bouncy seats and jumpers are not allowed in day care. All equipment that is used should be used only as intended by the manufacturer. LPA discussed Shaken Baby Syndrome and current COVID Child Care Guidance. LPA and Licensee discussed California Megan's Law and LPA provided: www.meganslaw.ca.gov.
SUPERVISORS NAME: Tashima Daniel
LICENSING EVALUATOR NAME: Sherlynn Banas
LICENSING EVALUATOR SIGNATURE: DATE: 03/22/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/22/2024
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN DIEGO NORTH, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108
FACILITY NAME: KOHISTANI, MUHAMMAD ZAMAN FAMILY CHILD CARE
FACILITY NUMBER: 376101526
VISIT DATE: 03/22/2024
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LPA discussed the safe sleep regulations with licensee 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 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.

Licensee was reminded of the staffing/capacity ratios for Large Family Child Care Homes. Twelve (12) children, no more than 4 infants (birth to 24 months) and 8 older children over the age of 2. A qualified assistant (age 14 or older) is required. For fourteen (14) children, no more than 3 infants (birth to 24 months) and 11 older children; at least 2 school age, 1 child at least age 6, 1 child enrolled in and attending kindergarten or elementary school. When there isn't a qualified assistant, licensee must follow Small Family Home Child Care Regulations.

No deficiencies were cited during today’s visit. A license for a capacity of fourteen (14) will be issued after final file review. An exit interview was conducted the report was reviewed with Licensee, Muhammad Zaman Kohistani. An Appeal Rights was also provided. A notice of site visit was given and most remain posted for 30 days.
SUPERVISORS NAME: Tashima Daniel
LICENSING EVALUATOR NAME: Sherlynn Banas
LICENSING EVALUATOR SIGNATURE:

DATE: 03/22/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/22/2024
LIC809 (FAS) - (06/04)
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