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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376101844
Report Date: 04/24/2024
Date Signed: 04/24/2024 01:08:10 PM

Document Has Been Signed on 04/24/2024 01:08 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:NAZARI, ABDULKHALIL FAMILY CHILD CAREFACILITY NUMBER:
376101844
ADMINISTRATOR/
DIRECTOR:		FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 0DATE:
04/24/2024
TYPE OF VISIT:PrelicensingANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
11:35 AM
MET WITH:Abdulkhalil NazariTIME VISIT/
INSPECTION COMPLETED:
01:20 PM
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On 4/24/24 at 11:00 AM, Licensing Program Analysts (LPAs) Martha Avila and Keturah Lane, conducted an announced Pre-Licensing inspection for relocation with the applicant. Upon arrival, LPA met with applicant Abdulkhalil Nazari and also present were Bibi Amina Nazari. The home was toured and inspected to ensure an environment safe for the care and supervision of children. The home has 3 bedrooms and 2 bathrooms. The fire extinguisher and smoke detector meet requirements and are operational. However, applicant will obtain an operational carbon monoxide detector and submit a video to LPA. All hazardous items were latched/locked and secured out of reach of children. There are no bodies of water in the home. Applicant states that there are no weapons in the home. CPR and First Aid expire on December 2025. Preventative health practices course was completed on January 15, 2022 which includes lead poison prevention training. Mandated reporter training was completed on March 24, 2022 and expires on March 24, 2024. LPA advised applicant to renew the Mandated Reporter Training as soon as possible. Staff immunization requirements were met. Required documents have been posted. The applicant has toys and equipment available.

Applicant will be using the following rooms for childcare: kitchen, living room, living room #2, bedroom #3, and hallway bathroom. Off limits areas include: bedroom #1, bathroom #1, bedroom #2 and are inaccessible through the use of door knob covers. The garage will also be off limits and is kept inaccessible through the use of a door lock. Applicant will be using the grassy side area which is not fully fenced for outdoor play, as the backyard is off limits. Applicant is reminded that visual supervision is required at all times during outdoor activities.

The applicant provided proof of control of property. Because the applicant rents/leases the home, proof of landlord notification is required. The LPA observed the Property Owner/Landlord Notification form (LIC9151) that the applicant confirms was provided to the property owner/landlord. (Con't on LIC 809)
SUPERVISORS NAME: Renesha Askew
LICENSING EVALUATOR NAME: Martha Avila
LICENSING EVALUATOR SIGNATURE: DATE: 04/24/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/24/2024
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
SAN DIEGO N. CC RO, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108
FACILITY NAME: NAZARI, ABDULKHALIL FAMILY CHILD CARE
FACILITY NUMBER: 376101844
VISIT DATE: 04/24/2024
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The applicant has not obtained a signed Property Owner/Landlord Consent form (LIC9149). Without this consent, the applicant understands that, once licensed, they can operate with a maximum capacity of 6 children. If property owner/landlord consent is obtained in the future, the applicant is advised to submit LIC9149 to the Department so that the license can be updated for maximum capacity 8.

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.

LPA reviewed with applicant the children’s forms/records, facility forms/records, and information to be posted. Entrance Checklist was provided to the applicant. Applicant was reminded of requirements for child abuse and unusual incident reporting. Applicant was also reminded that corporal punishment, smoking, walkers, exersaucers, bouncy seats 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.

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. (Continued on LIC 809C...)
SUPERVISORS NAME: Renesha Askew
LICENSING EVALUATOR NAME: Martha Avila
LICENSING EVALUATOR SIGNATURE:

DATE: 04/24/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/24/2024
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: NAZARI, ABDULKHALIL FAMILY CHILD CARE
FACILITY NUMBER: 376101844
VISIT DATE: 04/24/2024
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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.

On this date, 04/24/2024, 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.

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.

The following corrections are needed prior to the issuance of the license:

1. Obtain a functioning carbon monoxide detector.
2. Install a screw lock to sliding glass door leading to off limits backyard to make it inaccessible.

Once all corrections are made and proof is sent to licensing a license for 6 children may be granted. Applicant understands that proof of corrections must be submitted to Licensing within 30 days or the application may be denied. Applicant agreed to comply with all regulations and laws governing family child-care homes.

Exit interview conducted and report was reviewed with the applicant, Abdulkhalil Nazari.
SUPERVISORS NAME: Renesha Askew
LICENSING EVALUATOR NAME: Martha Avila
LICENSING EVALUATOR SIGNATURE:

DATE: 04/24/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/24/2024
LIC809 (FAS) - (06/04)
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