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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376101789
Report Date: 01/16/2024
Date Signed: 01/16/2024 12:22:04 PM

Document Has Been Signed on 01/16/2024 12:22 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
CCLD Regional Office, 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: 8CENSUS: 3DATE:
01/16/2024
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
10:35 AM
MET WITH:Raheela FazliTIME COMPLETED:
12:35 PM
NARRATIVE
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On January 16, 2024 at 10:35 a.m. Licensing Program Analyst (LPA) Leilani Curtis conducted an unannounced case management inspection to address the licensee’s request for an increase of capacity. Upon arrival LPA met with Licensee Raheela Fazli. Also present was the applicant’s husband Asadullah Fazli who translated for the licensee. The licensee’s primary language is Pashto. There were 3 children present, one under 24 months. The facility was observed operating within ratio and capacity. The two story, 4 bedroom, 3 bathroom home was toured and inspected to ensure an environment safe for the care and supervision of children. Because the licensee rents/leases the home, proof of landlord notification is required. The LPA observed the Property Owner/Landlord Notification form (LIC9151) that the licensee confirms was provided to the property owner/landlord. The licensee obtained a signed Property Owner/Landlord Consent form (LIC 9149). A fire clearance for a capacity of 14 children was received on 01/09/24. The home appears large enough to comfortably accommodate 14 children. LPA conducted a tour of the home inside and outside per facility sketch. Licensee is using the following areas for daycare: living room, dining area, kitchen, downstairs bathroom, and enclosed rear yard. Off-limits areas include: entire upstairs, laundry room, pantry and garage.

Licensee has provided adequate space for the children to eat, sleep and play within the home. Home is clean, orderly and has adequate ventilation. Children’s toys and play equipment are available and observed free of hazards. Stairs are barricaded via a safety gate. There is a working telephone/email address. All cleaning compounds, detergents, medications, and poisons are made inaccessible through latches, locks, and/or placed up on high surfaces. The fireplace is screened. The fire extinguisher and smoke and carbon monoxide detector are operational. Licensee states there are NO firearms or other weapons in the home. The outdoor play area is fenced and free of hazardous items. LPA observed a locked shed in the rear yard. There are no existing bodies of water present. Children records were reviewed for Emergency Information. Two of the children present do not have facility files available for review. The licensee does not maintain a current children’s roster. Pediatric CPR and First-Aid certificates are valid through August 2025. Licensee is exempt from Mandated Reporter AB1207 training certification due to licensee having limited English proficiency. Immunization records per SB792 were reviewed and are in compliance for all personnel that will be providing care and supervision to children.

SUPERVISORS NAME: Tashima Daniel
LICENSING EVALUATOR NAME: Grace Curtis
LICENSING EVALUATOR SIGNATURE: DATE: 01/16/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/16/2024
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
CCLD Regional Office, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108
FACILITY NAME: FAZLI, RAHEELA FAMILY CHILD CARE
FACILITY NUMBER: 376101789
VISIT DATE: 01/16/2024
NARRATIVE
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There are no new adults living or working in the home over the age of 18 years. All adult residents and helpers have submitted or been cleared for criminal record and child abuse index clearances or exemptions. Licensee 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.

Licensee is reminded that corporal punishment, smoking, walkers, exersaucers, jumpers and bouncy seats shall never be permitted during daycare operation. Licensee is aware that interference with a child’s daily functions, corporal punishment, physical and mental abuse is not allowed. Licensee is reminded to make anything that reads, "Keep Out of Reach of Children" inaccessible to children.

See LIC809D for cited deficiencies.

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.

A license for a capacity of 14 children may be issued once the deficiencies have been corrected.

Exit interview conducted and report was reviewed with Licensee Raheela Fazli. Asadullah Fazli translated this report into Dari for the licensee.

A notice of site visit was given to the licensee which must remain posted on, or immediately adjacent to, the interior side of the main door for 30 days.
SUPERVISORS NAME: Tashima Daniel
LICENSING EVALUATOR NAME: Grace Curtis
LICENSING EVALUATOR SIGNATURE:

DATE: 01/16/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/16/2024
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 01/16/2024 12:22 PM - It Cannot Be Edited


Created By: Grace Curtis On 01/16/2024 at 11:38 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: FAZLI, RAHEELA FAMILY CHILD CARE
FACILITY NUMBER: 376101789

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/16/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
01/19/2024
Section Cited
CCR
102417(g)(8)

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102417 Operation of a Family Child Care Home:(g) The home shall be free from defects or conditions which might endanger a child. Safety precautions shall include but not be limited to:(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 was not met as evidenced by:
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The licensee states that she will send a copy of her current children's roster (LIC9040) to LPA via email by 1/19/24.
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Based on record review and licensee statement, the licensee does not maintain a current children's roster. This poses a potential health, safety or personal rights risk to the children in care.
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Type B
01/19/2024
Section Cited
CCR102421(b)

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102421 Child's Records:(b) The licensee shall maintain, in each child's record, a copy of the emergency information card as required in Section 102417(g)(7). This requirement was not met as evidenced by:
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The licensee states that she will send LPA a copy of the LIC700, ID and Emergency Information for, and all required documents for C1 and C2 to LPA via email by 1/19/24.
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Based on record review and licensee statement, the licensee does not maintain children's records including the LIC700 ID and Emergency Information form for C1 and C2. This poses a potential health, safety or personal rights risk to the 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:Tashima Daniel
LICENSING EVALUATOR NAME:Grace Curtis
LICENSING EVALUATOR SIGNATURE:
DATE: 01/16/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/16/2024


LIC809 (FAS) - (06/04)
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