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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376101676
Report Date: 12/19/2024
Date Signed: 12/19/2024 12:06:34 PM

Document Has Been Signed on 12/19/2024 12:06 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:FAZLY, RAZIA FAMILY CHILD CAREFACILITY NUMBER:
376101676
ADMINISTRATOR/
DIRECTOR:		FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 5CENSUS: 2DATE:
12/19/2024
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:00 AM
MET WITH:Razia FazlyTIME VISIT/
INSPECTION COMPLETED:
12:30 PM
NARRATIVE
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On 12/19/24 at 9 am, Licensing Program Analyst (LPA) Gerald Poindexter conducted an unannounced inspection for an Increase in Capacity application. LPA met with licensee Razia Fazly. Licensee submitted application to the Department on 10/31/24. Fire clearance report was provided to the Department on 12/5/24. Also, in the home was the licensee’s adult brothers Rafiqullah Arhimzad and Shoaib Fazli, who both who both provided translation from Pashto to English. The two-bedroom, one-bath, one-story home was toured and inspected to ensure an environment safe for the care and supervision of children. Present in the home were 2 daycare children, 1 of whom were under 24 months.

The following areas will be used for child care: Living room, kitchen, bathroom, bedroom 1, and front yard. Off-limits areas include bedroom # 2, outside living room, and storage building area in front of the home. These areas are made inaccessible to day care children using doorknob covers and locks. There are latches on all cabinets in the kitchen and bathroom. Bedroom 1 will be used to separate sick children. There is no garage. There is no fire place. The licensee has sufficient toys and equipment available.

The home has a fenced/gated front yard area available for outdoor activities. Licensee understands that supervision is required at all times during outdoor activities. The fire extinguisher, smoke detector, and carbon monoxide detector meet requirements and are operational. All hazardous items were latched/locked and secured out of reach of children. There is no body of water on the property. Licensee states that there are no weapons in the home. Pediatric First Aid and CPR certifications for licensee expire 8/2026. Licensee has required immunizations. Licensees Mandated Reporter Training certificate expires on 12/10/26. LPA reminded licensee that Mandated Reporter training must be renewed every 2 years.

LPA observed all required postings were not posted. Children’s records were reviewed and found to be missing information. Staff records were reviewed. Licensee does not maintain a current roster of the children. Emergency drills were not conducted and documented. LPA verified that all adults living or working in the

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SUPERVISORS NAME: Joelle Redding
LICENSING EVALUATOR NAME: Gerald Poindexter
LICENSING EVALUATOR SIGNATURE: DATE: 12/19/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/19/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.

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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: FAZLY, RAZIA FAMILY CHILD CARE
FACILITY NUMBER: 376101676
VISIT DATE: 12/19/2024
NARRATIVE
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home have been fingerprint cleared and associated. LPA reminded Licensee that all unusual incident reports shall be submitted to Licensing office via email at SDIncidentReports@dss.ca.gov or via fax at (619)767-2203. Duty officer number is (619) 767-2248.

Provider is hereby reminded of the following: Report suspected child abuse and neglect, maintain children’s records according to regulation, post all required forms; 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 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.



Licensee was reminded that all adults 18 and over living or working in the home, 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.

The Licensee rents the home and provided proof of control of property. The applicant obtained a signed Property Owner/Landlord Consent form (LIC 9149). If capacity increase is approved, they can operate with a maximum capacity of 14 children.

Capacity limitations were reviewed. LPA advised licensee that a helper/assistant is required to care for 12 to 14 children and LPA provided helper requirements. Licensee is to be present in the home to ensure children are supervised and is reminded that the license is NOT transferable and should she relocate, this license will be null and void.

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SUPERVISORS NAME: Joelle Redding
LICENSING EVALUATOR NAME: Gerald Poindexter
LICENSING EVALUATOR SIGNATURE:

DATE: 12/19/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/19/2024
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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: FAZLY, RAZIA FAMILY CHILD CARE
FACILITY NUMBER: 376101676
VISIT DATE: 12/19/2024
NARRATIVE
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See LIC809D for deficiciencies cited.

The following corrections are needed:
· Provide missing children’s immunization records
· Provide missing infant sleep log
· Conduct Emergency Drill and Update Drill Log
· Complete Facility Roster

Applicant understands that corrections must be submitted to the Department within 30 days, 1/18/25, or the application may be denied. After corrections are submitted and reviewed, a license/capacity increase for 14 children may be issued upon final file review and determination. Licensee was reminded that annual fees are due on the date they were licensee every year.

Exit interview conducted and report was reviewed with the applicant Razia Fazlyi. A notice of site visit was given and must remain posted for 30 days.
SUPERVISORS NAME: Joelle Redding
LICENSING EVALUATOR NAME: Gerald Poindexter
LICENSING EVALUATOR SIGNATURE:

DATE: 12/19/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/19/2024
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 12/19/2024 12:06 PM - It Cannot Be Edited


Created By: Gerald Poindexter On 12/19/2024 at 10:46 AM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108

FACILITY NAME: FAZLY, RAZIA FAMILY CHILD CARE
FACILITY NUMBER: 376101676

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/19/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
01/18/2025
Section Cited
CCR
102418(a)

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102418(a) Immunizations: Prior to admission to a family day care home, children shall be immunized against diseases
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Licensee stated they will submit proof of immunizations to the Department by 1/18/25 and file the records.
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Based on records review 3 of 5 children's files reviewed were missing immunization records which poses a potential health, safety or personal rights risk to children in care.
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Type B
12/29/2024
Section Cited
CCR102425(j)(1-2)

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102425(j)(1-2) INFANT SAFE SLEEP: The provider shall supervise infants while they are sleeping and…check on the infant every 15 minutes…provider shall check and document.
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 Licensee stated they will submit proof of sleep logs to the Department by 12/29/24 and continuously maintain the records at the facility.
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Based on records review 1 out of 1 infant files reviewed was missing sleep logs which poses a potential health, safety or personal rights risk to children in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Joelle Redding
LICENSING EVALUATOR NAME:Gerald Poindexter
LICENSING EVALUATOR SIGNATURE:
DATE: 12/19/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/19/2024


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Document Has Been Signed on 12/19/2024 12:06 PM - It Cannot Be Edited


Created By: Gerald Poindexter On 12/19/2024 at 10:56 AM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108

FACILITY NAME: FAZLY, RAZIA FAMILY CHILD CARE
FACILITY NUMBER: 376101676

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/19/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
01/18/2025
Section Cited
CCR
102417(g)(9)(A)(1)

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102417(g)(9)(A)(1) Operation of a Family Child Care Home: (g) The home shall be free from defects…(9) Each family child care home shall have a written disaster plan of action...(A)Each family child care home shall conduct fire drills and disaster drills at least once every six months. (1)The licensee shall
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LPA provided a sample copy of Emergency drill log to the licensee, who stated they will conduct a fire drill or earthquake drill no later than 1/18/25. The licensee will email a photo of the documentation to LPA via email by POC date. Email: Gerald.Poindexter@dss.ca.gov
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 document the drills, including the date and time of each drill... This requirement is not met as evidenced by:
Based on interview and records review, the licensee has not performed or documented a fire drill every 6 months as required, which poses a potential health, safety or personal rights risk to children in care.
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Type B
01/18/2025
Section Cited
CCR102417(g)(8)

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102417(g)(8) Each family child care home shall have a current roster of children as specified in Health and Safety Code Section 1596.841. This requirement is not met as evidenced by:
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Licensee states will create and submit a complete roster of enrolled children and submit a copy to the Department by 1/28/25.
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Based on record review, the licensee did not comply with the section cited above, as the current roster of children was blank/not completed, which poses a potential health, safety or personal rights risk to persons in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Joelle Redding
LICENSING EVALUATOR NAME:Gerald Poindexter
LICENSING EVALUATOR SIGNATURE:
DATE: 12/19/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/19/2024


LIC809 (FAS) - (06/04)
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