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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376102138
Report Date: 08/12/2024
Date Signed: 08/12/2024 11:20:15 AM

Document Has Been Signed on 08/12/2024 11:20 AM - 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:SULTANI, FROZAN FAMILY CHILD CAREFACILITY NUMBER:
376102138
ADMINISTRATOR/
DIRECTOR:		FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 0DATE:
08/12/2024
TYPE OF VISIT:PrelicensingANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:15 AM
MET WITH:Frozan Sultani TIME VISIT/
INSPECTION COMPLETED:
11:45 AM
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On 8/12/24 at 9:15 am, Licensing Program Analysts (LPA) Gerald Poindexter and Stephanie Mutialu identified themselves and disclosed the nature of the visit before being granted entry. LPAs then conducted an announced pre-licensing inspection. LPAs met with applicant, Frozan Sultani. Also, present: the applicants two minor children. Applicant speaks limited English with primary language being Dari. The two-bedroom, one-bath apartment home was toured and inspected to ensure an environment safe for the care and supervision of children.

The applicant provided proof of control of property. Because the applicant rents the home, proof of landlord notification is required. The LPAs observed the Property Owner/Landlord Notification form (LIC9151) that the applicant confirms was provided to the property owner/landlord. 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 that a new Application for a Family Child Care Home License (LIC 279) must be submitted with a change of capacity fee of $25, to increase the capacity and provide care to 8 children. Applicant states that they have sufficient financial resources to sustain the license.

Applicant will use the following rooms for childcare: living room, kitchen, bathroom, and bedroom 2. Bedroom 2 is used to care for/separate sick children. Off-limits areas include: Bedroom 1 and back patio. These areas prevent access through use of doorknob cover and patio door lock. Applicant does not use back patio for outdoor activities. LPAs reminded applicant that use of back patio or additional room requires notifying Licensing before use. Applicant states they will take the children to a nearby park for outdoor activities and understands that continuous visual supervision is required. There are no stairs in the home. There is no garage. There are no bodies of water in the home.
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SUPERVISORS NAME: Joelle Redding
LICENSING EVALUATOR NAME: Gerald Poindexter
LICENSING EVALUATOR SIGNATURE: DATE: 08/12/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/12/2024
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: SULTANI, FROZAN FAMILY CHILD CARE
FACILITY NUMBER: 376102138
VISIT DATE: 08/12/2024
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There is a working phone at the facility. The fire extinguisher meets 2A10BC requirements. Carbon monoxide detector and smoke detector were tested and are operational. Poisons, cleaning compounds, medications and other hazardous items were latched/locked and secured out of reach of children. Heating and ventilation equipment were reviewed. Living room fireplace is screened and barricaded by entertainment center furniture. Applicant states there are NO firearms and weapons in the home. The applicant has age-appropriate toys and equipment available.

CPR and First Aid expire 7/27/25. Preventative health practices course (with lead poison prevention training) completed 5/2023. Applicant is exempt from Mandated Reporter AB1207 training certification due to having limited English proficiency. Applicant’s primary language is Dari. Staff /resident immunization requirements were met. All required health/safety and facility-related documents were visibly posted.

Applicant 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.

Applicant 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 reviewed the following resources and information with applicant:
· LIC 311D, Forms/Records to Keep in Your Family Child Care Home, children’s forms/records, facility forms/records, and information required to be posted
· New provider packet, including unusual incident reporting procedures
· Rules related to children’s personal rights, child abuse, and prohibiting of corporal punishment
· Rules prohibiting smoking, walkers, exersaucers, jumpers and bouncy seats. Also, allowed/prohibited uses of car seats.
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SUPERVISORS NAME: Joelle Redding
LICENSING EVALUATOR NAME: Gerald Poindexter
LICENSING EVALUATOR SIGNATURE:

DATE: 08/12/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/12/2024
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: SULTANI, FROZAN FAMILY CHILD CARE
FACILITY NUMBER: 376102138
VISIT DATE: 08/12/2024
NARRATIVE
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· Use of all equipment only as intended by the manufacturer
· Shaken Baby Syndrome and SIDS
· California Megan's Law and website: www.meganslaw.ca.gov
· COVID-19 and other communicable diseases guidelines and resources
· Provider Information Notices (PINs), Program Quarterly Update Newsletters, and the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-care-licensing/subscribe.
· YMCA Resource Center information
Additional CDSS contact information and provider resources

LPA discussed the safe sleep regulations with the applicant 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 the 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.

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-and-resources/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.

Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02-CCP. When any IMS is provided, an updated Plan of Operation that includes 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 are available at: https://www.ada.gov/resources/child-care-centers - CONTINUED ON PAGE 4
SUPERVISORS NAME: Joelle Redding
LICENSING EVALUATOR NAME: Gerald Poindexter
LICENSING EVALUATOR SIGNATURE:

DATE: 08/12/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/12/2024
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: SULTANI, FROZAN FAMILY CHILD CARE
FACILITY NUMBER: 376102138
VISIT DATE: 08/12/2024
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The following corrections are needed prior to the issuance of the license:
· Outlet covers for the living room (two outlets), bathroom (one outlet), kitchen (3 outlets) and bedroom 2 (eight outlets)

Once all corrections are made and proof is sent to, reviewed and approved by the Department, a license for eight children may be granted upon the final file review. Applicant understands that proof of corrections must be submitted to Licensing within 30 days, by no later than 9/11/24, or the application may be denied. Applicant understands that they must obtain landlord consent to care for more than six children. Applicant agreed to comply with all regulations and laws governing family child-care homes.

Exit interview conducted and report was reviewed with the applicant, Frozan Sultani. Appeal rights provided.
SUPERVISORS NAME: Joelle Redding
LICENSING EVALUATOR NAME: Gerald Poindexter
LICENSING EVALUATOR SIGNATURE:

DATE: 08/12/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/12/2024
LIC809 (FAS) - (06/04)
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