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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376101850
Report Date: 03/20/2024
Date Signed: 03/20/2024 01:16:03 PM

Document Has Been Signed on 03/20/2024 01:16 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:KHOSHNAW, FENIK FAMILY CHILD CAREFACILITY NUMBER:
376101850
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 3CENSUS: 1DATE:
03/20/2024
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Applicant, Fenik KhoshnawTIME COMPLETED:
01:25 PM
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Licensing Program Analysts (LPAs), Saraliz Velando and Martha Avila conducted an announced Prelicensing Inspection. LPAs were greeted at the front door by applicant, Fenik Khoshnaw. LPA was granted entry after identifying herself and disclosing the purpose of the visit. Applicant will be using the following areas for daycare: Living room, Dining room, Kitchen, Family room, Bathroom 2, and Bedroom 4. The following areas are Off Limits: Bedrooms 1-3, Bathroom 2, Front Yard, Back Yard, and Garage. There is a garage attached to the home that is inaccessible by a doorknob cover. The children are provided a safe, healthful, and comfortable environment, furnishings, and equipment. Business Hours will be Monday- Friday, 6:00am-6:00pm.

LPA tested the carbon monoxide alarm in the dining area, and it was functional. Outside play will take place at a nearby park. There is a fire extinguisher 1A10BC in the kitchen area that does not meet regulations. Licensee stated there are no weapons or ammunition stored at the home and LPA did not observe any. Licensee has a body of water in the backyard that has a fence surrounded by a 4-foot-high mesh fence. The in-ground pool must have a fence that measures at least 5 feet in height. All pool corrections must be completed and submitted to the department before a license can be issued.

There are no wall heaters in the home, however, there is a fireplace in the living room that has been screened to be inaccessible to children. Storage for poisons, detergents, cleaning solutions, medications, will need to be made inaccessible to children in the kitchen and corrections submitted to the department before a license can be issued. The home is kept clean and orderly with heating and ventilation for safety and comfort. Pediatric CPR and First Aid card will expire February 2026. Applicant has a Mandated Reporter Training Certificate that expires March 2026. There is a working telephone and email address.
SUPERVISORS NAME: Joelle Redding
LICENSING EVALUATOR NAME: Saraliz Velando
LICENSING EVALUATOR SIGNATURE: DATE: 03/20/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/20/2024
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: KHOSHNAW, FENIK FAMILY CHILD CARE
FACILITY NUMBER: 376101850
VISIT DATE: 03/20/2024
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Licensee was reminded that all adults 18 and over living or working in the home, 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 discussed the safe sleep regulations with licensee and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed licensee [or facility representative] 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.
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)/ (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: https://www.ada.gov/resources/child-care-centers/. Licensee was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain childcare by connecting them to childcare providers and Resource and Referral Agencies (R&Rs) throughout California. LPA completed the RSO profile in FAS.

The following items will need to be corrected prior to the issuance of the license: Pool fence must be at least 5 feet high. Pool gate must have a self-latching device located no more than 6 inches from the top of the fence. Pool gate must swing away from the pool, self-close, and self-latching. A trash can with a lid in bathroom 2 to make trash inaccessible. Hazardous/sharp items in kitchen must be made inaccessible to children. Fire extinguisher must meet regulations. Once the corrections have been made, and proof has been received in the licensing office, a license for eight (8) children will be granted. Licensee also understands that if corrections are not completed within thirty (30) days, application may be denied. Applicant agrees to comply with all regulations and laws governing Small Family Child Care Homes.

Exit interview conducted and report was reviewed with the applicant, Fenik Khoshnaw.
SUPERVISORS NAME: Joelle Redding
LICENSING EVALUATOR NAME: Saraliz Velando
LICENSING EVALUATOR SIGNATURE:

DATE: 03/20/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/20/2024
LIC809 (FAS) - (06/04)
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