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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376101850
Report Date: 04/09/2024
Date Signed: 04/09/2024 12:20:24 PM

Document Has Been Signed on 04/09/2024 12:20 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/
DIRECTOR:		FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 3CENSUS: 1DATE:
04/09/2024
TYPE OF VISIT:PrelicensingANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:00 PM
MET WITH:Applicant, Fenik KhoshnawTIME VISIT/
INSPECTION COMPLETED:
12:40 PM
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On 4/9/24, LPA Saraliz Velando conducted an announced follow-up Prelicensing inspection. The purpose of this inspection was to observe the pool fence correction. LPA met with applicant, Fenik Khoshnaw. The pool gate door swings out and away from pool and self-lock/self-latching. The pool fence also completely surrounds the pool, far enough away from any windows to prevent direct access into the pool area. LPA also observed a 5 ft fence around the pool that also meets Title 22 regulations. Licensee agrees that fencing will remain in place and properly functioning whenever there are licensed children in care.

The correction was made to meet regulations and a license for 8 children may be granted after review.

An exit interview was conducted with applicant, Fenik Khoshnaw. Appeal Rights and a copy of the report were given.
SUPERVISORS NAME: Joelle Redding
LICENSING EVALUATOR NAME: Saraliz Velando
LICENSING EVALUATOR SIGNATURE: DATE: 04/09/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/09/2024
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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