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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376102138
Report Date: 02/28/2025
Date Signed: 02/28/2025 05:01:14 PM

Document Has Been Signed on 02/28/2025 05:01 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:SULTANI, FROZAN FAMILY CHILD CAREFACILITY NUMBER:
376102138
ADMINISTRATOR/
DIRECTOR:		FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 0DATE:
02/28/2025
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
02:00 PM
MET WITH:Frozan SultaniTIME VISIT/
INSPECTION COMPLETED:
05:30 PM
NARRATIVE
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On 02/28/25 at 2 pm, Licensing Program Analyst (LPA) Gerald Poindexter conducted an unannounced inspection for a capacity Increase. This visit is to verify that the licensee, Frozan Sultani, remains in substantial compliance with the health & safety standards as required by regulations governing family childcare homes. LPA met with the licensee, Ms. Sultani. Present at the home was the licensee’s husband Mohammad and their 2 minor children. There were no daycare children present in the home at the time of inspection. Licensee states they currently have 6 children enrolled Monday-Friday, 7 am to 11 pm. Fire clearance report was provided to the Department on 02/011/25. The 2-bedroom, 2-bath, ground-level home was toured and inspected to ensure an environment safe for the care and supervision of children.

Areas used for childcare include the following areas: living room, kitchen, bathroom, and bedroom 2. Bedroom 2 is used to care for/separate sick children. Off-limits areas include: Bedroom 1 and backyard/patio. These areas prevent access through use of doorknob and patio door lock. Applicant does not use backyard/patio for outdoor activities. Applicant states that they 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. The licensee has sufficient toys and equipment available.

The fire extinguisher, smoke detector, and carbon monoxide detector meet requirements and are operational. Licensee states that there are no guns, weapons, or ammunition in the home. Pediatric First Aid and CPR certifications for licensee expire 7/27/25. LPA reminded the applicant that the CPR/First card should be renewed every two years. Licensee has required immunizations. Mandated reporter training was waived due to language barriers. Applicant’s primary language is Dari. LPA observed all required postings were posted. Children’s records were reviewed and found to be incomplete. Staff records were reviewed.

CONTINUED ON PAGE 2

SUPERVISORS NAME: Joelle Redding
LICENSING EVALUATOR NAME: Gerald Poindexter
LICENSING EVALUATOR SIGNATURE: DATE: 02/28/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/28/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.

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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: 02/28/2025
NARRATIVE
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 Licensee does not maintain a current roster of the children. The facility roster was incomplete at time of inspection.

Licensee did not have emergency drills documented. LPA reminded the licensee that emergency drills must be conducted and documented every six months. LPA verified that all adults living or working in the home have been fingerprint cleared and associated. LPA reminded Licensee that all unusual incident reports shall be submitted to Licensing office via email at SDIncidentReports@dss.ca.gov or via fax at (619)767-2203. Duty officer number is (619)767-2248.

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.

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.



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.

The licensee provided proof of control of property. The applicant has not obtained a signed Property Owner/Landlord Consent form (LIC 9149) and states they intended to care for 12 or fewer children. Capacity limitations were reviewed. Licensee

CONTINUED ON PAGE 3
SUPERVISORS NAME: Joelle Redding
LICENSING EVALUATOR NAME: Gerald Poindexter
LICENSING EVALUATOR SIGNATURE:

DATE: 02/28/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/28/2025
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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: 02/28/2025
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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. LPA reviewed helper/assistant/employee requirements with the licensee and provided a copy of the requirements.

See LIC 809D for deficiencies cited

An exit interview was conducted with Licensee,Frozan Sultani. A license for 12 children may be issued upon final file review. Licensee was reminded that annual fees are due on the date they were licensed every year.

SUPERVISORS NAME: Joelle Redding
LICENSING EVALUATOR NAME: Gerald Poindexter
LICENSING EVALUATOR SIGNATURE:

DATE: 02/28/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/28/2025
LIC809 (FAS) - (06/04)
Page: 2 of 6
Document Has Been Signed on 02/28/2025 05:01 PM - It Cannot Be Edited


Created By: Gerald Poindexter On 02/28/2025 at 03:52 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: SULTANI, FROZAN FAMILY CHILD CARE
FACILITY NUMBER: 376102138

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/28/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
03/14/2025
Section Cited
CCR
102419(d)

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(d) At the time of acceptance of each child into care, the licensee shall provide the child's parent or authorized representative with a copy of the notice Family Child Care Home Notification of Parent's Rights, LIC 995A (8/06), the Caregiver Background Check Process, LIC 995E (6/05), and the Family child Care Consumer Awareness Information, LIC 9212 (10/05). This requirement is not met as evidenced by:
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LPA reviewed the LIC311D, children’s forms required. Licensee will provide proof of signed and completed LIC995A paperwork for children's files to LPA by 3/14/25. Email to Gerald.Poindexter@dss.ca.gov
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Based on interview, the licensee did not comply with the section cited above. The 6 children in the licensee's care did not have completed paperwork as identified in LIC311D, which poses a potential health, safety or personal rights risk to persons in care.
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Type B
03/14/2025
Section Cited
CCR102417(g)(9)(A)(1)

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Operation of a Family Child Care Home: (g) The home shall be free from defects… A)Each family child care home shall conduct fire drills and disaster drills at least once every six months. (1)The licensee shall document the drills, including the date and time of each drill. This documentation shall be kept at the family child care home. This requirement is not met as evidenced by:
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POC: LPA provided a sample copy of Emergency drill log to the licensee, who stated they will conduct a fire drill or earthquake drill no later than 3/14/25. The licensee will email a photo of the documentation to LPA via email by POC date.
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Based on interview and review of facility records, licensee has not performed or documented a fire drill every 6 months as required. There is no documentation available. This poses a potential safety 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:Joelle Redding
LICENSING EVALUATOR NAME:Gerald Poindexter
LICENSING EVALUATOR SIGNATURE:
DATE: 02/28/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/28/2025


LIC809 (FAS) - (06/04)
Page: 3 of 6
Document Has Been Signed on 02/28/2025 05:01 PM - It Cannot Be Edited


Created By: Gerald Poindexter On 02/28/2025 at 04:00 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: SULTANI, FROZAN FAMILY CHILD CARE
FACILITY NUMBER: 376102138

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/28/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
03/14/2025
Section Cited
CCR
102418(g)(1)

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(g) The licensee shall document each child's immunizations as required by the California Code of Regulations, Title 17, Section 6070, and shall maintain such documentation for as long as the child is enrolled. (1) This requirement includes updating each child's PM 286 (6/95) when the child is due to receive required immunizations after enrollment in the family day care home. This requirement is not met as evidenced by:
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The licensee stated that she will complete the immunization record missing for the child in care that was not on file and submit a copy to the LPA by 3/14/25. Email to Gerald.Poindexter@dss.ca.gov
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Based on record review, the licensee did not comply with the section cited above in the case of 1 of 6 children in care. Not maintaining immunization records for children poses a potential health, safety or personal rights risk to persons in care.
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Type B
03/14/2025
Section Cited
CCR102417(g)(8)

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Children’s Roster: (8) Each family child care home shall have a current roster of children as specified in Health and Safety Code Section 1596.841.This requirement is not met as evidenced by:
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Licensee states trhey will create and submit a complete roster of enrolled children and submit a copy to the Department by 3/14/25.
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Based on record review, the licensee did not comply with the section cited above, as the current roster of children was blank/not completed, which poses a potential health, safety or personal rights risk to persons 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:Joelle Redding
LICENSING EVALUATOR NAME:Gerald Poindexter
LICENSING EVALUATOR SIGNATURE:
DATE: 02/28/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/28/2025


LIC809 (FAS) - (06/04)
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Document Has Been Signed on 02/28/2025 05:01 PM - It Cannot Be Edited


Created By: Gerald Poindexter On 02/28/2025 at 04:10 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: SULTANI, FROZAN FAMILY CHILD CARE
FACILITY NUMBER: 376102138

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/28/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
03/14/2025
Section Cited
CCR
102421(b)

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(b) The licensee shall maintain, in each child's record, a copy of the emergency information card as required
in Section 102417(g)(7). This requirement is not met as evidenced by:
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Licensee says she will obtain all required signed and dated LIC700 forms from parents for each enrolled child by due date of 3/14/25.
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Based on record review, the licensee did not comply with the section cited above, as of 6 of 6 children enrolled did not have completed and signed LIC700 forms available for review. This poses a potential health, safety or personal rights risk to persons 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:Joelle Redding
LICENSING EVALUATOR NAME:Gerald Poindexter
LICENSING EVALUATOR SIGNATURE:
DATE: 02/28/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/28/2025


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