376101616-9-14-2023-51-CC-PMAA-CVNPBM-20230914111033

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 376101616
Report Date: 09/14/2023
Date Signed: 09/14/2023 11:11:09 AM

Document Has Been Signed on 09/14/2023 11:11 AM - 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:	ZAREI, MARYAM FAMILY CHILD CARE		FACILITY NUMBER:	376101616
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY: 8	TOTAL ENROLLED CHILDREN: 0	CENSUS: 0	DATE:	09/14/2023
TYPE OF VISIT:	Prelicensing	ANNOUNCED	TIME BEGAN:	08:30 AM
MET WITH:	Maryam Zarei		TIME COMPLETED:	11:40 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 9/14/23 at 8:30am, Licensing Program Analyst (LPA) Patrick Ma conducted an announced Pre-Licensing inspection with the applicant Maryam Zarei. Also present in the home were Licensee's spouse Farhad Hassani. The 3-bedroom, 3 bathrooms, 2 story home was toured and inspected to ensure an environment safe for the care and supervision of children. Applicant will be using the upstairs daycare room, upstairs hallway bathroom, and backyard for childcare. Off limit areas are entire downstairs, all 3 bedrooms, and garage. Some areas have been made inaccessible by gate, but other areas still need to be inaccessible prior to licensure. Gate at the bottom of the stairs inside the home was not required since applicant will not use the first level. Kitchen is on a different level than the licensed child care area and will be discussed with a Licensing Program Manager for possible adjustments that will be required prior to licensure. Roof is accessible by the second level patio, used for the entrance of the daycare and will be reviewed with management as well. The applicant has sufficient toys and equipment available. Applicant will use fully fenced back yard for outdoor activities. Licensee was advised to provide visual supervision at all times when children are outdoors. The fire extinguisher, carbon monoxide detector, and smoke detector meet requirements and are operational. Hazardous items need to be made inaccessible or out of reach of children prior to licensure. There is a pool in the back yard which is properly fenced and made inaccessible. Applicant states that there are no weapons in the home. 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. First Aid and CPR expire on 6/14/24 and preventative health practices course was completed on 1/29/23. Applicant completed Mandated Reporter Training and expires on 1/26/25. Licensee immunization requirements per SB792 were met. The applicant owns the home and provided proof of control of property.

SUPERVISORS NAME: Renesha Askew
LICENSING EVALUATOR NAME: Patrick Ma
LICENSING EVALUATOR SIGNATURE:	DATE: 09/14/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/14/2023

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
CCLD Regional Office, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108

FACILITY NAME: ZAREI, MARYAM FAMILY CHILD CARE	FACILITY NUMBER: 376101616
	VISIT DATE: 09/14/2023

NARRATIVE

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LPA reviewed with applicant 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.

The new provider packet was reviewed with the applicant 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, effects of lead poisoning, COVID safety guidance, and the YMCA Resource Center. Applicant was 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.

On this date, 9/12/23, the California Attorney General - Megan’s Law website was searched for information on sex offenders required to register with local law enforcement under California's Megan's Law. No registered sex offenders were found at the facility addresses. Under state law, some registered sex offenders are not subject to public disclosure; therefore,
they may not have been included in this search. However, the Department conducts a monthly cross reference of each address on record for all registered sex offenders against all CCLD facility addresses pursuant to information shared by California DOJ.

Applicant was 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, 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.

SUPERVISORS NAME: Renesha Askew
LICENSING EVALUATOR NAME: Patrick Ma
LICENSING EVALUATOR SIGNATURE:	DATE: 09/14/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/14/2023

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
CCLD Regional Office, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108

FACILITY NAME: ZAREI, MARYAM FAMILY CHILD CARE	FACILITY NUMBER: 376101616
	VISIT DATE: 09/14/2023

NARRATIVE

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LPA discussed the safe sleep regulations with applicant and discussed the Child Care Licensing Safe Sleep webpage at: https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-andresources/safe-sleep, as an additional resource. LPA also informed applicant 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.

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.
• To report COVID-19 cases contact the Health & Human Services Agency Epidemiology Department at 619-692-8636.

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) or (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.
Applicant was informed of the MyChildCarePlan.org site, 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.

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 platforms.

To receive important licensed related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-carelicensing/subscribe and select the Child Care option to receive email communication.

SUPERVISORS NAME: Renesha Askew
LICENSING EVALUATOR NAME: Patrick Ma
LICENSING EVALUATOR SIGNATURE:	DATE: 09/14/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/14/2023

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
CCLD Regional Office, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108

FACILITY NAME: ZAREI, MARYAM FAMILY CHILD CARE	FACILITY NUMBER: 376101616
	VISIT DATE: 09/14/2023

NARRATIVE

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Applicant was reminded that annual fees are due on the date they are licensee every year. Licensee is reminded that the license is NOT transferable and should she relocate, without proper notice, this license will be null and void.

The following corrections are needed.
• Gate at bottom of outdoor stair entrance
• A/C unit needs to be made inaccessible
• Crawl space under cement outdoor island needs to be made inaccessible
• Off-Limit bedrooms needs mechanism to be made inaccessible
• Hazards in the upstairs bathroom and hallway need to be made inaccessible or out-of-reach for children

Applicant understands that corrections must be submitted to the Department within 30 days, or the application may be denied.

Title 22 Regulations, Section 102417(a) Operation of a Family Child Care Home was provided (below) due to applicant’s statement that she plans to leave the country for a couple of months.

“The licensee shall be present in the home and shall ensure that children in care are supervised at all times. When circumstances require the licensee to be temporarily absent from the home, the licensee shall arrange for a substitute adult to care for and supervise the children during his/her absence. Temporary absences shall not exceed 20 percent of the hours that the facility is providing care per day.”

Exit interview conducted and report was reviewed with the applicant Maryam Zarei.

SUPERVISORS NAME: Renesha Askew
LICENSING EVALUATOR NAME: Patrick Ma
LICENSING EVALUATOR SIGNATURE:	DATE: 09/14/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/14/2023

LIC809 (FAS) - (06/04)

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