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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 394500362
Report Date: 08/23/2023
Date Signed: 08/23/2023 12:59:18 PM

Document Has Been Signed on 08/23/2023 12:59 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
SACRAMENTO SOUTH, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME:RAHEEL, BEENISHFACILITY NUMBER:
394500362
ADMINISTRATOR:BEENISH RAHEELFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(510) 299-2717
CITY:MANTECASTATE: CAZIP CODE:
95337
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 10DATE:
08/23/2023
TYPE OF VISIT:POCANNOUNCEDTIME BEGAN:
10:30 AM
MET WITH:Beenish RaheelTIME COMPLETED:
01:15 PM
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On 08/23/2023 at 10:30 AM, Licensing Program Analyst (LPA) Tiffanie Diep met with Licensee Beenish Raheel for the purpose of an unannounced Plan of Correction (POC) inspection. LPA was greeted by Licensee’s assistant (S1) upon arrival as Licensee was not home at the time. LPA observed ten children present in the home with S1 and Licensee’s minor child (C1), who was providing assistance to S1. At 11:30 AM, Licensee returned to the facility.

All individuals subject to a criminal record review have obtained a criminal record clearance. 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 five 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.

During an annual inspection conducted on 06/21/2023, Licensee was issued a Type B citation as personnel records were not maintained for one staff. During today’s visit, LPA verified the required personnel documents for assistant. The deficiency is cleared effective today, August 23, 2023. A POC letter was provided to Licensee.

An exit interview was conducted and report was reviewed with the licensee, Beenish Raheel. A notice of site visit was given to Licensee and must remain posted on, or immediately adjacent to, the interior side of the main door for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

SUPERVISORS NAME: Chayntel Hunter
LICENSING EVALUATOR NAME: Tiffanie Diep
LICENSING EVALUATOR SIGNATURE: DATE: 08/23/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/23/2023
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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