376300252-7-20-2023-10-CC-LVAA-CTWPMC-20230720112606

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 376300252
Report Date: 07/20/2023
Date Signed: 07/20/2023 11:26:12 AM

Document Has Been Signed on 07/20/2023 11:26 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
RIVERSIDE SOUTH EAST, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501

FACILITY NAME:	TAHMASEBI FAMILY CHILD CARE		FACILITY NUMBER:	376300252
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY: 8	TOTAL ENROLLED CHILDREN: 8	CENSUS: 4	DATE:	07/20/2023
TYPE OF VISIT:	Case Management - Licensee Initiated	UNANNOUNCED	TIME BEGAN:	10:40 AM
MET WITH:	Nasrin Tahmasebi		TIME COMPLETED:	11:40 AM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	On 07/20/2023, Licensing Program Analyst (LPA) Lorena Valenzuela arrived at the facility to conduct an Case Management - Licensee Initiated inspection due to the licensee applying to increase capacity to a large family childcare home and a review of the application was also included in the inspection. Present during this inspection were: licensee Nasrin Tahmasebi and Yamsan Maghsodi, 4 day care children. The home is single story home with five bedrooms, three bathrooms, with attached garage. Fire Clearance was approved by Riverside County Fire Department on 07/06/2023. At 11:10 am, LPA Valenzuela toured the facility, inside and out with Licensee and the following was observed and/or discussed: • Normal days and hours of operation are: Monday to Friday , 7:00am to 5:00pm • Off-limit areas include: garage, kitchen, all bedrooms except for the child care room and parts of the backyard. • The facility is licensed to have no more than 8 children as a small FCCH and is operating within the licensed capacity and appropriate ratios. There is four children present. The licensee has applied to become a large FCCH. • Appropriate supervision was being provided during this inspection • A working telephone is present, and the current phone number is on file • A fully charged fire extinguisher (2A:10BC) was observed. A smoke detector and carbon monoxide detector were present and tested by the Licensee during this inspection. • Fireplace is properly screened to prevent access by children • All hazardous items are stored inaccessible to children • Toxins are locked and inaccessible to children in care. • Weapons are/are not present/stored according to Title 22. Licensee understands all guns, weapons and ammunition must be key locked separately and made inaccessible per Title 22 Regulations • This is a one story home • Clean, safe and age appropriate toys are provided • Current roster on file • Facility Sketch, Emergency Disaster Plan and Notification of Parent’s Rights poster are posted •

SUPERVISORS NAME: Deborah Mullen
LICENSING EVALUATOR NAME: Lorena Valenzuela
LICENSING EVALUATOR SIGNATURE:	DATE: 07/20/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/20/2023

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
RIVERSIDE SOUTH EAST, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501

FACILITY NAME: TAHMASEBI FAMILY CHILD CARE	FACILITY NUMBER: 376300252
	VISIT DATE: 07/20/2023

NARRATIVE

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Documentation of fire and disaster drills are on file – Last drill was conducted on 05/15/2023
• No bodies of water at this time. Licensee understands all bodies of water including ponds, above ground pools & spas, in-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 product must be emptied immediately after use and stored in an upright position.
• Verification of control of property is on file
• Children’s records are complete
• Employee’s records are complete
• Mandated Reporter Training completed/expired on 10/2022
• Pediatric CPR and First Aid Card expires on 12/17/2024
• Health & Safety Certificate - completed on 11/08/2020
• Resident and/or staff records were reviewed and all adults who require caregiver background checks have received all required clearances and/or exemptions.

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 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.

SUPERVISORS NAME: Deborah Mullen
LICENSING EVALUATOR NAME: Lorena Valenzuela
LICENSING EVALUATOR SIGNATURE:	DATE: 07/20/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/20/2023

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 SOUTH EAST, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501

FACILITY NAME: TAHMASEBI FAMILY CHILD CARE	FACILITY NUMBER: 376300252
	VISIT DATE: 07/20/2023

NARRATIVE

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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, 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 child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.
On-line Licensing forms & regulations for a Child Care Center can be obtained on the Department’s website: www.ccld.ca.gov. Additionally, there is a link to “Receive Important Updates” located on the right side of the page, immediately above Quick Links. One can add their email address and choose which program(s) they wish to receive Provider Information Notices (PIN) for.
The Duty Officer is available to answer questions Monday – Friday; 8:00am to 5:00pm at:
1-844-LET-US-NO (1-844-538-8766) and/or 951-782-4200

During the exit interview, the Licensee Nasrin Tahmasebi, confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.
A notice of site visit was given and must remain posted for 30 days.

There are no deficiencies being cited at this time. Licensee agrees to submit updated facility sketch to include the complete floor plan and will send updated mandated reporter training.

The application for a Large Family Child Care Home will be submitted for approval with a maximum capacity of 12, or 14 with parent notification.

Exit interview conducted and this report along with the appeal rights were reviewed and provided to licensee Nasrin Tahmasebi.

SUPERVISORS NAME: Deborah Mullen
LICENSING EVALUATOR NAME: Lorena Valenzuela
LICENSING EVALUATOR SIGNATURE:	DATE: 07/20/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/20/2023

LIC809 (FAS) - (06/04)

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