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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376101789
Report Date: 12/19/2023
Date Signed: 12/19/2023 11:43:06 AM

Document Has Been Signed on 12/19/2023 11:43 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
SAN DIEGO NORTH, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108
FACILITY NAME:FAZLI, RAHEELA FAMILY CHILD CAREFACILITY NUMBER:
376101789
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 5CENSUS: 5DATE:
12/19/2023
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Raheela FazliTIME COMPLETED:
12:05 PM
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On December 19, 2023, at 9:30 AM, Licensing Program Analysts (LPA) Sherlynn Banas conducted an announced Pre-Licensing/ Change of Location Inspection to Fazli Raheela (applicant). Upon arrival, LPA met with applicant and Azadullah Fazli (husband). Also present were all their 3 children and 2 siblings from one family. The two stoy house was toured and inspected to ensure an environment safe for the care and supervision of children. 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 is a working phone at the facility. There is a jacuzzi that is empty, covered, and locked. Applicant states that the previous owner owns it and will be picking up the jacuzzi within the week. Applicant states that there are no weapons in the home. Applicant states that they have sufficient financial resources to sustain the license. CPR and First Aid expires in August 2025. Preventative Health practices course was completed on March 2, 2021, which includes lead poison prevention training. Mandated Reporter Training was waived because applicant speaks Phasto. Immunization requirements were met. Required documents have been posted. Applicant rents the home. The applicant has toys available.

Applicant will be using the following rooms for childcare: Living room, dining room, kitchen, bathroom downstairs and backyard are accessible for day care. Off-limits areas include laundry room, all rooms at the second floor. Bedroom # 1, 2, 3, loft and garage are inaccessible using doorknob covers. The second floor was barricaded by a stair with a secured gate to make it inaccessible for children. LPA asked if there is a separate room or place for isolation when one child/children were sick, and she stated that the loft will be used. Garage will also be off limits. Verification of control of property is on file. Property owner/Landlord notification is on file.

Applicant was reminded that all adults 18 and over living in the home, persons who provide care and supervision to 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.
SUPERVISORS NAME: Tashima Daniel
LICENSING EVALUATOR NAME: Sherlynn Banas
LICENSING EVALUATOR SIGNATURE: DATE: 12/18/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/18/2023
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
SAN DIEGO NORTH, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108
FACILITY NAME: FAZLI, RAHEELA FAMILY CHILD CARE
FACILITY NUMBER: 376101789
VISIT DATE: 12/19/2023
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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. The new provider packet was reviewed with the applicant including information on child abuse and unusual incident reporting. LPA provided information regarding 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 applicant discussed Shaken Baby Syndrome and California Megan's Law. LPA provided: www.meganslaw.ca.gov.

LPA discussed the safe sleep regulations with applicant and discussed the Child Care Licensing Safe Sleep information which can be found at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/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.

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.

SUPERVISORS NAME: Tashima Daniel
LICENSING EVALUATOR NAME: Sherlynn Banas
LICENSING EVALUATOR SIGNATURE:

DATE: 12/19/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/19/2023
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
SAN DIEGO NORTH, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108
FACILITY NAME: FAZLI, RAHEELA FAMILY CHILD CARE
FACILITY NUMBER: 376101789
VISIT DATE: 12/19/2023
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Incidental Medical services (IMS) policy was discussed. For IMS information see Evaluator Manual – Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. 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.

No corrections are needed. A license for 8 children may be granted upon final file review. Applicant agreed to comply with all regulations and laws governing family child-care homes.

Exit interview conducted and report was reviewed with the applicant Raheela Fazli and husband, Azadullah Fazli and Appeal Rights was provided.
SUPERVISORS NAME: Tashima Daniel
LICENSING EVALUATOR NAME: Sherlynn Banas
LICENSING EVALUATOR SIGNATURE:

DATE: 12/19/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/19/2023
LIC809 (FAS) - (06/04)
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