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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376101844
Report Date: 07/31/2024
Date Signed: 07/31/2024 02:26:41 PM

Document Has Been Signed on 07/31/2024 02:26 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:NAZARI, ABDUL KHALIL FAMILY CHILD CAREFACILITY NUMBER:
376101844
ADMINISTRATOR/
DIRECTOR:		FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 6TOTAL ENROLLED CHILDREN: 15CENSUS: 3DATE:
07/31/2024
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
11:50 AM
MET WITH:Khalil Nazari AbdulTIME VISIT/
INSPECTION COMPLETED:
02:45 PM
NARRATIVE
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On 7/31/24 at 11:50AM Licensing Program Analyst (LPA) Patrick Ma conducted an unannounced inspection for an Increase Capacity application. Fire clearance was completed on 5/28/24. Upon arrival, LPA met with Licensee Abdul Khalil Nazari and stated purpose of visit. Also, in the home was roommate/helper Bibiamina Nazari and her husband Abdul Jalil Nazari. The one story home was toured and inspected to ensure an environment safe for the care and supervision of children. There were no children in the home when LPA arrived, but 3 showed up at 12:15PM, including 1 under 24 months. Licensee stated he has 15 children enrolled.

Licensee has provided adequate space for the children to eat, sleep and play within the home. Areas used for child care include living room 1-2, kitchen, bedroom 3, and bathroom 2. Off limits areas include bedroom 1-2, bathroom 1, and garage and are inaccessible through use of doorknob covers and lock for garage. The licensee has sufficient toys and equipment available. 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 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. First Aid and CPR certifications expire on 12/2025. Licensee has required immunizations. Licensee completed Mandated Reporter Training on 4/29/24 and is reminded it must be completed every 2 years. Children’s and Staff records were reviewed and found missing required documents. Last fire drill was documented 12/3/23. Rocker was observed in bedroom 3 and licensee stated infant under 12 months have been using it, which is a violation of infant sleep regulations.
SUPERVISORS NAME: Renesha Askew
LICENSING EVALUATOR NAME: Patrick Ma
LICENSING EVALUATOR SIGNATURE: DATE: 07/31/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/31/2024
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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Document Has Been Signed on 07/31/2024 02:26 PM - It Cannot Be Edited


Created By: Patrick Ma On 07/31/2024 at 01:32 PM
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: NAZARI, ABDUL KHALIL FAMILY CHILD CARE
FACILITY NUMBER: 376101844

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/31/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
08/30/2024
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 8/30/24 and file the records.
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Based on records review 3 out of 5 children's files reviewed were missing immunization records which poses/posed a potential health, safety or personal rights risk to children in care.
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Type B
08/09/2024
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 sleep logs were filed at his mother's home who is also a licensed provider. Licensee stated they will submit proof of sleep logs to the Department by 8/9/24 and file the records at the facility.
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Based on records review 2 out of 2 infant files reviewed were missing sleep logs which poses/posed 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:Renesha Askew
LICENSING EVALUATOR NAME:Patrick Ma
LICENSING EVALUATOR SIGNATURE:
DATE: 07/31/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/31/2024


LIC809 (FAS) - (06/04)
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Document Has Been Signed on 07/31/2024 02:26 PM - It Cannot Be Edited


Created By: Patrick Ma On 07/31/2024 at 01:39 PM
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: NAZARI, ABDUL KHALIL FAMILY CHILD CARE
FACILITY NUMBER: 376101844

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/31/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
07/31/2024
Section Cited
CCR
102417(g)(10)(b-c)

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102417(g)(10)(b-c) A baby walker shall not be kept or used on the premises of a child day care facility…A "baby walker" means any article described in paragraph (4) of subdivision (a) of Section 1500.86 of Part 1500 of Title 16 of the Code of Federal Regulations.
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Licensee removed the crib/rocker from licensed area and placed in garage and stated he will not use for infants again. Deficiency corrected during inspection.
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Based on observation and interview, a crib rocker was observed in licensed area bedroom 3 and licensee stated they have placed infants under 12 months in crib rocker for nap which poses/posed a potential health, safety or personal rights risk to children in care.
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Type B
08/30/2024
Section Cited
CCR102416.1

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 102416.1 Personnel records shall be maintained on each employee...
This requirement was not met as evidenced by:
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Licensee stated he will submit missing helper documents to the Department by 8/30/24 and file the records at the facility.
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Based on records review and interview, Helper Bibi Amina Nazari was missing helper records LIC 9108, LIC 9052, and Licensee stated he was unaware the documents were required which poses/posed 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:Renesha Askew
LICENSING EVALUATOR NAME:Patrick Ma
LICENSING EVALUATOR SIGNATURE:
DATE: 07/31/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/31/2024


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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
CCLD Regional Office, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108
FACILITY NAME: NAZARI, ABDUL KHALIL FAMILY CHILD CARE
FACILITY NUMBER: 376101844
VISIT DATE: 07/31/2024
NARRATIVE
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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.

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.

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.

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. 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.

See LIC809D for deficiencies cited.

The following corrections are needed:
• Missing children’s immunization records
• Missing infant sleep logs
• Missing Helper documents
SUPERVISORS NAME: Renesha Askew
LICENSING EVALUATOR NAME: Patrick Ma
LICENSING EVALUATOR SIGNATURE:

DATE: 07/31/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/31/2024
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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
CCLD Regional Office, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108
FACILITY NAME: NAZARI, ABDUL KHALIL FAMILY CHILD CARE
FACILITY NUMBER: 376101844
VISIT DATE: 07/31/2024
NARRATIVE
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Applicant understands that corrections must be submitted to the Department within 30 days or the application may be denied.

After corrections are submitted and reviewed, a license for 14 children may be issued upon final file review. 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 Abdul Khalil Nazari. A notice of site visit was given and must remain posted for 30 days.
SUPERVISORS NAME: Renesha Askew
LICENSING EVALUATOR NAME: Patrick Ma
LICENSING EVALUATOR SIGNATURE:

DATE: 07/31/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/31/2024
LIC809 (FAS) - (06/04)
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