The home is a two-story home with 4 bedrooms, 2 bathrooms, living room, family room, dining room, kitchen, attached garage, front yard and backyard. The stairway is properly fenced and barricaded with a child safety gate. The on-limit areas are family room (main childcare area), living room, dining room (for napping), bedroom on the first floor by the stairs (for napping), and backyard. The off-limit areas are kitchen, office room on the first floor, entire second floor, and garage, which will be inaccessible by closed and/or locked doors and visual supervision. The isolation area is the living room. When a child shows signs of illness, he/she will be separated from other children here.

The inside of the home is observed to be clean and orderly, with central heating and ventilation for safety and comfort. LPA observed there are ample safe and age-appropriate toys, play equipment and materials. There is a fully charged 3A40BC fire extinguisher in living room. There is a working smoke detector in the kitchen. There is a working carbon monoxide detector in the living room. The home is equipped with telephone service and a fully stocked first aid kit. All toxins, cleaning products, and hazardous materials have been made inaccessible to the children. There are no firearms and no pets in the home. There is a fireplace in the living room, which has been made inaccessible to children with a wire cover and coffee table.

There are play yards in the family room, dining room, and on-limit bedroom on the first floor. The play yards have correct size mattresses and fitted sheets. Children bring their own bedding and lunch from home. Licensee provides snacks to children. LPA reminded licensee all beddings and food brought from children’s home are be labeled with the children’s name and stored appropriately. Licensee does not transport children. Page 1 of 3. See LIC 809C.

The licensee completed the Health and Safety training. The licensee’s Pediatric CPR/First Aid certification is current and expires on 12/11/2025. Licensee has completed the Mandated Reporter training for Child Care Providers and expires on 06/23/2025. The licensee is in compliance with the immunization laws. All adults living in the home have obtained a criminal record clearance.

The licensee conducts and documents fire and disaster drills at least once every 6 months and the last conducted drill was on 08/01/2024. All required documents are posted and visible for public review.

LPA reviewed six (6) children’s files and one (1) staff file. There is a current roster available for review. The licensee owns the property. The facility does not have liability insurance, and the Affidavit Regarding Liability Insurance forms (LIC 282) were reviewed.

Licensee was reminded that California Law requires licensees to report unusual incidents or injuries to children in care, to child's parents, and to the Department of Social Services using the Unusual Incident/Injury form (LIC 624B). Any structural changes to the home or additions to the childcare facility must be reported to Community Care Licensing. Incidents must be reported within 24 hours by phone, fax, or email. LPA informed the Licensee that all forms can be downloaded at www.ccld.ca.gov.

Licensee was also reminded that Mandated Reporter Training ("Child Care Providers") is required for all staff and is to be renewed every 2 years by visiting https://mandatedreporterca.com/. Licensee was reminded that EMSA approved Pediatric CPR & First Aid training must be completed every two (2) years.

Licensee was 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, 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.

Page 2 of 3. See LIC 809C.

Licensee was informed of the MyChildCarePlan.org site, 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.

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: 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 platforms. 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.

No deficiencies were issued during today's inspection. One (1) Advisory Note was issued. Please see attached advisory note pages for information on technical violations (TV) issued today. Note that technical violations are not citations but are advisory notes.

Advisory Note (TV): 6 of 6 children's files reviewed by LPA have "blue" immunization record form filled out by licensee. However, there is no documentation or proof of immunization.

A Notice of Site Visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with the licensee, Khadijeh Lashkari. LPA provided licensee a copy of the Appeal Rights.

Page 3 of 3. End of Report.