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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376625549
Report Date: 06/21/2023
Date Signed: 06/21/2023 05:29:21 PM

Document Has Been Signed on 06/21/2023 05:29 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
CCLD Regional Office, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108
FACILITY NAME:EDRISAVIFEYAH, MALIHA FAMILY CHILD CAREFACILITY NUMBER:
376625549
ADMINISTRATOR:MALIHA EDRISAVIFEYAHFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(858) 705-9138
CITY:SAN DIEGOSTATE: CAZIP CODE:
92127
CAPACITY: 14TOTAL ENROLLED CHILDREN: 12CENSUS: 10DATE:
06/21/2023
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
03:55 PM
MET WITH:Maliha EdrisavifeyahTIME COMPLETED:
05:35 PM
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On 06/21/2023 at 3:55pm, Licensing Program Analyst (LPA) Selina Siao conducted a plan of correction inspection to ensure that the facility is within compliance with licensing regulations. Upon arrival, helper Sanaz Aflaki opened the door for LPA to enter the home and LPA conducted a tour of the home with licensee Maliha Edrisavifeyah. There are 10 children in care including 3 infants with licensee and another helper Shirin Arya. Facility is operating within the licensed capacity.

Licensee has removed all the day care items in the converted garage as she stated that she is planning to rent out that area. The current area for day care areas includes the day care room, two bedrooms, main bathroom located at the hallway, right side of the backyard that has play equipment and kitchen for non-mobile infants (with playpens) so she could monitor the baby while she is cooking in the kitchen. Off limit areas includes the bathroom #1 (located in bedroom #1), family room, dining room, converted garage room and bathroom and all of upstairs (2 bedrooms, 2 bathrooms and loft area) and also the backyard area located by the dining room.

The following corrections have been made:

Facility is operating within the licensed capacity
Infant is not being swaddled
Facility no longer has prohibited items at the facility (baby walker and bouncer)
All the 10 children's files are available for review
Facility has a current roster
The two infants that are under 12 months has the individual sleeping plan in their files
Sleep log are available for the three infants in care that are under 24 months

Facility is within substantial compliance and all previous citations have been cleared.
SUPERVISORS NAME: Monica Cuddy
LICENSING EVALUATOR NAME: Selina Siao
LICENSING EVALUATOR SIGNATURE: DATE: 06/21/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/21/2023
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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