394500941-10-13-2023-53-CC-CBEY-CWKRC5-20231013125345

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 394500941
Report Date: 10/13/2023
Date Signed: 10/13/2023 12:53:52 PM

Document Has Been Signed on 10/13/2023 12:53 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 S. CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

FACILITY NAME:	RASOLI, FAHIMA & QADERI, NEGINA		FACILITY NUMBER:	394500941
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY: 8	TOTAL ENROLLED CHILDREN: 0	CENSUS: 0	DATE:	10/13/2023
TYPE OF VISIT:	Prelicensing	ANNOUNCED	TIME BEGAN:	09:15 AM
MET WITH:	Fahima Rasoli & Negina Qaderi		TIME COMPLETED:	01:00 PM

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On 10/13/23, Licensing Program Analyst (LPA) Corina Beckby met with Applicants Fahima Rasoli & Negina Qaderi for the purpose of a pre-licensing inspection. Sharokin Eleyh from the International Rescue Committee was called to interpret. LPA provided the Entrance Checklist to Applicants. Applicants have criminal background clearance verified by LPA accessing Guardian. Applicant’s tentative hours of care are Monday through Friday, from 7:00 AM until 5:00 PM. Applicants do not intend on providing overnight or weekend care.

A health and safety inspection were conducted inside and outside of the FCCH. Applicants accompanied LPA for the entirety of the tour. The FCCH is a 2-story home with a sitting room, kitchen, storage closet, living room, dining area, laundry room, 3 bathrooms, 4 bedrooms, and garage. The OFF-limit areas are the front yard, garage, the right side of the backyard, the shed, the entire house except first floor bedroom and first floor bathroom and backyard. Applicants understands that OFF-limit areas must remain inaccessible to children in care. Applicants understands if they want to make any OFF-limit area an ON-limit area, they must notify Licensing and LPA must do an inspection BEFORE children are allowed in said area.

Functioning smoke and carbon monoxide detectors were observed and tested. A 2A10BC fire extinguisher and first aid were observed. Applicants stated there are no firearms or weapons in the home. Applicants rent and proof of control of property was provided. Landlord did not consent to additional children. Fireplace was observed with tempered glass and will not be used during day care hours.

LPA verified that toxic and hazardous items were inaccessible to children in care. LPA observed cleaners stored in the top cabinet in the laundry room. The outdoor play area was toured. LPA verified that the entirety of the backyard is fenced-in and walked the perimeter to ensure the safety of the fence. There are no bodies of water on the premises.

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SUPERVISORS NAME: Bettina Engelman
LICENSING EVALUATOR NAME: Corina Beckby
LICENSING EVALUATOR SIGNATURE:	DATE: 10/13/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/13/2023

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
SACRAMENTO S. CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

FACILITY NAME: RASOLI, FAHIMA & QADERI, NEGINA	FACILITY NUMBER: 394500941
	VISIT DATE: 10/13/2023

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LPA’s discussed Mandated Reporter Training with Applicants. Health and Safety Code 1596.8662 requires all licensed providers, applicants, directors and employees to complete training as specified on their Mandated Reporter duties and to renew their training every two years. Volunteers are encouraged but not required to take the training. This training requirement may be met by using the Department’s Office of Child Abuse Prevention (OCAP) online training modules. The OCAP modules are free of cost and available at: http://www.mandatedreporterca.com/. The training is currently provided in English and Spanish. Applicants have current Mandated Reporter Training Certificate which will expire on 01/27/25 and 04/13/25. Current Pediatric CPR and First Aid training was verified and expires on 01/06/25. Completion of Preventative Health and Safety training including nutrition and lead exposure was verified before the inspection. Proof of required immunizations for Applicants.

LPA discussed the Safe Sleep Regulations with Applicants 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 Applicants 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. LPA discussed the requirement to check and log infant napping every 15 minutes for infants under 24 months. LPA provided a copy of the LIC 9227, Individual Sleeping Plan, to be completed for infants under 12 months.

Incidental Medical Services (IMS) policy was discussed with Applicants. 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)/ (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm.

Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other important information communication platform.

Continued on 809-C

SUPERVISORS NAME: Bettina Engelman
LICENSING EVALUATOR NAME: Corina Beckby
LICENSING EVALUATOR SIGNATURE:	DATE: 10/13/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/13/2023

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
SACRAMENTO S. CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

FACILITY NAME: RASOLI, FAHIMA & QADERI, NEGINA	FACILITY NUMBER: 394500941
	VISIT DATE: 10/13/2023

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To receive important licensed related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-care-licensing/subscribe and select the Child Care option to receive email communication. Applicants signed up for PIN’s at time of inspection.

Applicants were reminded that all adults 18 and over living in the home, persons who provide care and supervision to children, and staff who have contact with children, 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.

Applicants understand licenses are not transferable, and once licensed, Licensee must live in the home and be present for 80% of the operating hours.

Applicants understand if an unusual incident occurs; Licensing is to be notified via phone call, e-mail or fax within 24 hours and the Unusual Incident Report LIC 624 shall be submitted within 7 days to remain in compliance. A1 understands that if any structural changes are made to the FCCH; Licensing must be notified PRIOR to construction.

Applicants understand annual licensing fees are due on the anniversary of receiving license. The annual fee for a small FCCH is $73.00 per year. A late fee of $36.00 is assessed the day after the anniversary date.

Applicants understand that children’s and staff records are to be maintained according to Title 22 regulations and be accessible to Licensing for up to 3 years. LPA reviewed with Licensee the LIC 311D Forms/Records To Keep In Your Family Child Care Homes, children’s forms/records, facility forms/records, and information to be posted.

Applicants understand that disaster drills must be conducted and documented once every six months.

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SUPERVISORS NAME: Bettina Engelman
LICENSING EVALUATOR NAME: Corina Beckby
LICENSING EVALUATOR SIGNATURE:	DATE: 10/13/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/13/2023

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
SACRAMENTO S. CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

FACILITY NAME: RASOLI, FAHIMA & QADERI, NEGINA	FACILITY NUMBER: 394500941
	VISIT DATE: 10/13/2023

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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 or CARE tools, please send 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/inspection-process.

Applicants were informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain childcare by connecting them to childcare providers and Resource and Referral Agencies (R&Rs) throughout California.

On this date, 10/13/2023, the California Attorney General - Megan’s Law website was searched for information on sex offenders required to register with local law enforcement under California's Megan's Law. No registered sex offenders were found at the facility addresses. Under state law, some registered sex offenders are not subject to public disclosure; therefore, they may not have been included in this search. However, the Department conducts a monthly cross reference of each address on record for all registered sex offenders against all CCLD facility addresses pursuant to information shared by California DOJ.

As of today, 10/13/2023, Fahima Rasoli & Negina Qaderi are approved for a Small Family Child Care Home license for a capacity of 6 children with no more than 3 infants, or 4 infants only. Landlord did not give consent for additional children. Infants are children under the age of 2. An exit interview was conducted, and the report was reviewed with Applicants.

SUPERVISORS NAME: Bettina Engelman
LICENSING EVALUATOR NAME: Corina Beckby
LICENSING EVALUATOR SIGNATURE:	DATE: 10/13/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/13/2023

LIC809 (FAS) - (06/04)

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