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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376300064
Report Date: 12/03/2025
Date Signed: 12/03/2025 02:43:25 PM

Document Has Been Signed on 12/03/2025 02:43 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
RIVERSIDE SE CC RO, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501
FACILITY NAME:MOOSAVI-TABARSHIYADE FAMILY CHILD CAREFACILITY NUMBER:
376300064
ADMINISTRATOR/
DIRECTOR:		MAHSAN M.FACILITY TYPE:
810
ADDRESS:TELEPHONE:
(858) 228-7616
CITY:ESCONDIDOSTATE: CAZIP CODE:
92025
CAPACITY: 14TOTAL ENROLLED CHILDREN: 7CENSUS: 7DATE:
12/03/2025
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:25 PM
MET WITH:Mahsan Moosavi-TabarshiyadeTIME VISIT/
INSPECTION COMPLETED:
02:50 PM
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Licensing Program Analyst (LPA) Keely Messerschmidt conducted an unannounced annual inspection for a large family childcare at the above home on 12/3/2025 at 12:25 PM. LPA met with Licensee Mahsan Moosavi-Tabarshiade, who guided LPA on a tour of the home. There were 7 children present with Assistant when LPA arrived, including 3 infants and 4 preschool-aged children. LPA observed Licensee pull up to home moments after arrival.

The facility operates Monday through Friday from 7:00 AM to 5:00 PM each day. Certain areas are off-limits, including the kitchen, all bedrooms and all bathrooms on right side of entrance hallway, downstairs, backyard and right-side side yard. The facility is licensed as a large Family Child Care Home (FCCH) with a maximum capacity of 14 children and was not operating within the licensed capacity of the license, as assistant was alone with 3 infants and 4 preschool aged children, see LIC809D page.

During the inspection, LPA observed Licensee to be responsive and aware of where the children were at all times. A working cell phone is available, and the current phone number on file is correct. A fully charged fire extinguisher (2A:10BC) was observed, along with a functioning smoke detector and carbon monoxide detector, both of which were tested by the Licensee. The fireplace is properly screened to prevent access by children, and all hazardous items, including toxins, are stored securely and are inaccessible to children. No weapons are present, and the Licensee understands that all firearms, weapons, and ammunition must be locked separately and made inaccessible as per Title 22 Regulations. Stairs are barricaded with a baby gate when children are in care.

The facility provides clean, safe, and age-appropriate toys for children. A current roster is on file, and required postings, including the Facility Sketch, Emergency Disaster Plan, and Notification of Parent’s Rights, are displayed. Fire and disaster drill documentation is maintained, with the last drill conducted on 7/11/25.

NAME OF LICENSING PROGRAM MANAGER: Deborah Mullen
NAME OF LICENSING PROGRAM ANALYST: Keely Messerschmidt
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 12/03/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/03/2025
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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California Health & Human Services Agency
California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:
  • Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.
  • Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)
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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
RIVERSIDE SE CC RO, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501
FACILITY NAME: MOOSAVI-TABARSHIYADE FAMILY CHILD CARE
FACILITY NUMBER: 376300064
VISIT DATE: 12/03/2025
NARRATIVE
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There are not any pools, spas, or other bodies of water. Licensee understands that all bodies of water including ponds, above ground pools, spas, and some fountains must be properly covered or fenced per Title 22 Regulations. The Department must be notified before and after installation of the above types of bodies of water. In addition, all wading pools or similar products must be emptied immediately after use and stored in an upright position.

Both children's and employees' records are complete. Mandated Reporter Training has been completed and is valid until 11/9/26. The Pediatric CPR and First Aid certification expires on 9/6/27. Resident and staff records were reviewed, and all adults requiring caregiver background checks have received the necessary clearances and exemptions.

Licensee Mahsan Moosavi-Tabarshiyaran 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 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. During inspection, LPA observed 2 infants in separate daycare room with the door closed without supervision and 1 play yard to have an additional mattress to prevent child from hitting their head, see LIC809D page.

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) or (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/

NAME OF LICENSING PROGRAM MANAGER: Deborah Mullen
NAME OF LICENSING PROGRAM ANALYST: Keely Messerschmidt
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 12/03/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/03/2025
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
RIVERSIDE SE CC RO, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501
FACILITY NAME: MOOSAVI-TABARSHIYADE FAMILY CHILD CARE
FACILITY NUMBER: 376300064
VISIT DATE: 12/03/2025
NARRATIVE
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Licensee was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

The Duty Officer is available to answer questions Monday – Friday; 8:00am to 5:00pm at: 951-782-4200. All Unusual Incident Reports can be submitted online at UnusualIncidentReportsDO10@dss.ca.gov.



During the exit interview, the Licensee, confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.

To improve the quality and value of the new inspection process, a survey may be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process for CARE tools, please send the email inquiries to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/process.


There are deficiencies being cited on the attached 809-D page.

A notice of site visit was given and must remain posted for 30 days.

An exit interview was conducted, and a copy of this this report was reviewed with and handed to Licensee Mahsan Moosavi-Tabarshiyaran.

Appeal rights were discussed and provided during the exit interview.
NAME OF LICENSING PROGRAM MANAGER: Deborah Mullen
NAME OF LICENSING PROGRAM ANALYST: Keely Messerschmidt
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 12/03/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/03/2025
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 12/03/2025 02:43 PM - It Cannot Be Edited


Created By: Keely Messerschmidt On 12/03/2025 at 02:10 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
, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501

FACILITY NAME: MOOSAVI-TABARSHIYADE FAMILY CHILD CARE
FACILITY NUMBER: 376300064

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/03/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102425(a)(3)
Infant Safe Sleep
(a) There shall be one crib or play yard for each infant who is unable to climb out of the crib or play yard. (3) Mattresses shall be firm and covered with a fitted sheet that is appropriate to the mattress size, fits tightly on the mattress, and overlaps the underside of the mattress so it cannot be dislodged.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation and interview, the licensee did not comply with the section cited above in 1 play yard another mattress was added to prevent child from hitting their head on wall causing sheets to be not fitted which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 12/05/2025
Plan of Correction
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Licensee stated she will remove additional mattress and send proof of completion via email.
Type B
Section Cited
CCR
102425(b)(3)
Infant Safe Sleep
(b) Cribs or play yards shall be free from all loose articles and objects. (3) There shall be no objects hanging above or attached to the side of the crib.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, the licensee did not comply with the section cited above in 1 play yard has a sheet attached to the side and a blanket hanging over the side which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 12/05/2025
Plan of Correction
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Licensee stated she will remove sheet and blanket from side of play yard and send proof of completion via email.
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
Deborah Mullen
NAME OF LICENSING PROGRAM MANAGER:
Keely Messerschmidt
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 12/03/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/03/2025


LIC809 (FAS) - (06/04)
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Document Has Been Signed on 12/03/2025 02:43 PM - It Cannot Be Edited


Created By: Keely Messerschmidt On 12/03/2025 at 02:10 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
, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501

FACILITY NAME: MOOSAVI-TABARSHIYADE FAMILY CHILD CARE
FACILITY NUMBER: 376300064

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/03/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102425(j)(5)
Infant Safe Sleep
The provider shall supervise infants while they are sleeping and adhere to the following requirements: If the infant is sleeping in a separate room from where the provider is stationed, the door to the room the infant is sleeping in shall remain open at all times.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, the licensee did not comply with the section cited above in 2 infants were alone in attached room in their play yards with sliding glass door closed while assistant was in another room with sliding glass door closed with 5 children which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 12/12/2025
Plan of Correction
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Licensee stated she create a plan to ensure the children are not alone and submit proof of completion via email to LPA.
Type B
Section Cited
CCR
102416.5(e)
Staffing Ratio and Capacity
(e) If no assistant provider is present at a Large Family Child Care Home, then the licensee shall comply with the capacity requirements for a Small Family Child Care Home as specified in subsections (b) and (c).

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation and interview, the licensee did not comply with the section cited above in assistant was alone with 7 children, 3 infants and 4 preschool aged children while Licensee stepped away from home which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 12/12/2025
Plan of Correction
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Licensee stated she create a plan to ensure that they are in ratio at all times and submit proof of completion via email to LPA.
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
Deborah Mullen
NAME OF LICENSING PROGRAM MANAGER:
Keely Messerschmidt
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 12/03/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/03/2025


LIC809 (FAS) - (06/04)
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