376101565-1-7-2024-51-CC-KLAE-CZA7XN-20240107210323

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 376101565
Report Date: 01/05/2024
Date Signed: 01/07/2024 09:03:43 PM

Document Has Been Signed on 01/07/2024 09:03 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 N. CC RO, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108

FACILITY NAME:	HASHIMI, ZAHRA FAMILY CHILD CARE		FACILITY NUMBER:	376101565
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY: 8	TOTAL ENROLLED CHILDREN: 8	CENSUS: 3	DATE:	01/05/2024
TYPE OF VISIT:	Case Management - Licensee Initiated	UNANNOUNCED	TIME BEGAN:	09:10 AM
MET WITH:	Zahra Hashimi		TIME COMPLETED:	11:00 AM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	On 1/5/24 at 9:10 AM, Licensing Program Analyst (LPA) Keturah Lane conducted an unannounced inspection for a capacity increase with the Licensee. Upon arrival, LPA met with Licensee Zahra Hashimi. Also present was Licensee’s adult son Sayed Ali Hashimi (who helped with translation in Farsi) and Licensee’s minor children. The two-story home was toured and inspected to ensure an environment safe for the care and supervision of children. Approximately five minutes after LPA’s arrival, Licensee’s husband Sayed Hashimi arrived with 3 daycare children. At that point, the Licensee’s husband took over with translation in Farsi. The fire extinguisher, carbon monoxide detector, and smoke detector meet requirements and are operational. All hazardous items were latched/locked and secured out of reach of children. There are no bodies of water on the property. Licensee states that there are no weapons in the home. 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. Licensee will be using the following rooms for childcare: living room, kitchen and bathroom. The following areas will be off limits: entire second story which includes living area, 3 bedrooms and additional bathroom and are inaccessible through use of safety gate at the bottom of the stairs. There is a working phone at the facility. The Licensee has sufficient age appropriate and safe toys/equipment available. The home has a fully fenced backyard available for outdoor activities. LPA observed some tools on the side area of the yard (hoe, shovel, wrench and rake). Licensee’s son stated they block the area with a trash can. LPA requested the items be removed to the garage as the child could possibly move the trash can. Licensee’s son removed the items immediately and he put them in the garage and no other hazards were observed in the backyard. The garage is off-limits and is inaccessible by use of a door latch. (continued on LIC809-C...)

SUPERVISORS NAME: Tashima Daniel
LICENSING EVALUATOR NAME: Keturah Lane
LICENSING EVALUATOR SIGNATURE:	DATE: 12/08/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/08/2023

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 N. CC RO, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108

FACILITY NAME: HASHIMI, ZAHRA FAMILY CHILD CARE	FACILITY NUMBER: 376101565
	VISIT DATE: 01/05/2024

NARRATIVE

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Licensee owns the home. Verification of control of property are on file. The home appears to be large enough to comfortably accommodate 14 children. Fire clearance was received on 11/21/23. Licensee’s First Aid and CPR certifications expire on 9/2024. Licensee’s mandated reporter training expires 5/3/24, however she speaks mainly Farsi. Assistant did not have CPR/First Aid or mandated reporter completed, however LPA waived the mandated reporter requirement due to husband’s language barriers. He speaks some English but it is not his main language. Licensee maintains emergency records for children. Required documents are posted. Licensee stated last fire drill was conducted last week but didn’t have a log to show LPA. LPA advised Licensee to document fire/earthquake drills on the log once every 6 months. (See LIC9102TV).

Provider is hereby reminded of the following: Report suspected child abuse and neglect, maintain children’s records according to regulation, corporal punishment, smoking, exersaucers, bouncy seats, walkers, and jumpers 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 Lane directed Licensee to website: https://www.cdss.ca.gov/inforesources/community-care-licensing to receive important updates and information.

Licensee was reminded that all adults 18 and over living or working in the home, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, 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 for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.

(continued on LIC809-C...)

SUPERVISORS NAME: Tashima Daniel
LICENSING EVALUATOR NAME: Keturah Lane
LICENSING EVALUATOR SIGNATURE:	DATE: 01/05/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/05/2024

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 N. CC RO, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108

FACILITY NAME: HASHIMI, ZAHRA FAMILY CHILD CARE	FACILITY NUMBER: 376101565
	VISIT DATE: 01/05/2024

NARRATIVE

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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 informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

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: https://www.ada.gov/resources/child-care-centers/.

LPA initiated provisional license for 14 children to be granted upon final file review which expires in 90 days. Once CPR/First Aid has been completed by the assistant Sayed Hashimi and completed certificate e-mailed to LPA Lane, then the regular license will be issued. Applicant agreed to comply with all regulations and laws governing family child-care homes.

No deficiencies are cited.

Exit interview conducted and report was reviewed with the licensee Zahra Hashimi. Notice of Site Visit was provided and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100. Sayed Hashimi translated report in Farsi and Licensee verbally stated she understood the translation of the report.

SUPERVISORS NAME: Tashima Daniel
LICENSING EVALUATOR NAME: Keturah Lane
LICENSING EVALUATOR SIGNATURE:	DATE: 01/05/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/05/2024

LIC809 (FAS) - (06/04)

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