434416525-10-14-2022-07-CC-JCRZ-CK7QH4-20221014121030

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 434416525
Report Date: 10/14/2022
Date Signed: 10/14/2022 12:10:40 PM

Document Has Been Signed on 10/14/2022 12:10 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, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME:	KASHIF, RAZIA & ANWAR, MUHAMMAD		FACILITY NUMBER:	434416525
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY: 8	TOTAL ENROLLED CHILDREN: 0	CENSUS: 0	DATE:	10/14/2022
TYPE OF VISIT:	Prelicensing	ANNOUNCED	TIME BEGAN:	08:30 AM
MET WITH:	Razia Kashif & Muhammad Anwar		TIME COMPLETED:	12:15 PM

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	Licensing Program Analyst (LPA) Janette Cruz conducted an announced pre-licensing inspection with Razia Kashif and Muhammad Anwar, Applicants. The purpose of today's inspection: address the Application for a new Small Family Child Care Home license that the Applicant submitted to the Department on July 21, 2022. Application/Record Review: The Applicants, Javaid Kashif (Razia's spouse), Anwar Naziran (Muhammad's spouse) and Razia's minor child (9 year of age) were present in the home during today's inspection. The Applicants state that both their spouses are the adults residing in the home. Razia also has two minor children: (son – age 9 and daughter age 13) residing in the home. Days and hours of operation will be Monday to Friday from 9:00am to 6:00pm Applicants completed the Preventative Health and Safety Training with Lead Training on 07/30/22 ( Muhammad) & 07/10/22 (Kashif) and a copy of the certifications are on file. Applicants have proof of Pediatric CPR and First Aid training with expiration date of 07/2024 on file. Applicants have updated vaccinations (including flu vaccine) and proof of completion of the Mandated Reporter Training for Child Care Workers completed on 08/25/22 are on file. The Applicants own the home and a copy of property tax statement verifying control of property is on file. Applicants state that they intend to have up to 8 children in their day care. All individuals subject to a criminal record review have obtained a criminal record and child abuse index clearances prior to today's inspection. The Applicants agreed to give LPA a tour of the home during today’s inspection. LPA observed the home is a two-story home with six bedrooms, four bathrooms, living room, family room, kitchen, dining area, attached garage, and backyard, LPA observed that the there is a working telephone in the home (cell #916-519-5591). LPA observed the home is clean and orderly, with centralized heating and ventilation for safety & comfort. LPA observed an electric fireplace (family room) and small heater vent (playroom) that need to be barricaded to prevent access by children.

SUPERVISORS NAME: Diana Stephenson
LICENSING EVALUATOR NAME: Janette Cruz
LICENSING EVALUATOR SIGNATURE:	DATE: 10/14/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/14/2022

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
CCLD Regional Office, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME: KASHIF, RAZIA & ANWAR, MUHAMMAD	FACILITY NUMBER: 434416525
	VISIT DATE: 10/14/2022

NARRATIVE

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The off-limit areas inside the home are: entire second floor. Off-limit areas outside the home - a storage shed and left side portion of backyard. There are safe and age- appropriate toys, play equipment, and materials for the children in the home.

LPA observed that the Applicants have designated the family room area where child(ren) can be isolated if exhibiting signs of illness. The home has at least one working smoke and carbon monoxide detector in the home. LPA observed Applicants have one fully charged fire extinguisher (2A10BC) inside the home. Applicants state that there are no firearms or weapons in the home. All cleaning compounds and medications are adequately stored in locked cabinets and inaccessible to children. Applicants were reminded that any poison inside the home must be kept locked. Applicants state that they do not have any baby walkers in the home. Applicants understand that baby walkers are not allowed in the day care. Applicants understand that high chairs are to be used only for eating purposes. Applicants state that no adults smoke and understand that smoking is prohibited in the home.

Kitchen tour: LPA observed the refrigerator and freezer in the home are clean. There are no sharp utensils, cleaning products, lighters/matches, or open bottles of alcohol accessible to children. Applicants understand that any food/drink which is brought by parent(s) of day care child(ren) must be properly labeled with the child(ren) name and properly stored or refrigerated.

Bathroom tour: LPA observed the bathroom toilet and faucet are clean, safe, and operable. All shampoos, soap, medication, mouthwash, perfumes, razors, cleaning products, air fresheners, and nail polish/remover are inaccessible to the children.

Outdoor tour: LPA observed the outdoor backyard area of the home is fenced and secure for the children. LPA observed that the outdoor area is currently being prepared for backyard renovation/construction to complete the children's outdoor play area. There are no bodies of water on the property observed by LPA though Applicants stated that by 11/2022, a small pond for turtles will be added and will be located at the off limit area of the backyard.

Forms of discipline used by Applicants: talking to children and redirecting. The Applicants understand that children's personal rights should not be violated; including no corporal punishment, supervision of children, transportation of children, requirements for
reporting suspected child abuse, unusual incidents/injuries, heat related illnesses, and requirements for assistant/substitute were also discussed with the Applicant during today's inspection.

SUPERVISORS NAME: Diana Stephenson
LICENSING EVALUATOR NAME: Janette Cruz
LICENSING EVALUATOR SIGNATURE:	DATE: 10/14/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/14/2022

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
CCLD Regional Office, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME: KASHIF, RAZIA & ANWAR, MUHAMMAD	FACILITY NUMBER: 434416525
	VISIT DATE: 10/14/2022

NARRATIVE

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LPA reviewed with the Applicants 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.

This facility plans to provide Incidental Medical Services – IMS. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. 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

LPA discussed the requirements of AB 633 with the Applicants. The Applicants understand the AB 633 fact sheet/copy of Acknowledgement of Receipt of Licensing Reports (LIC 9224).

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.

LPA discussed the safe sleep regulations with the 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 conducted an exit interview with Applicants Razia Kashif and Muhammad Anwar, that a small Family Child Care Home license will be approved upon completion of the following:
1. Photos of completed outdoor area renovation of backyard children's play area including but not limited to small turtle pond and children's play yard.
2. Updated outdoor facility sketch
3. Proof of barricaded fireplace(family room) and small heater vent (play room)
4. Proof of available cribs for napping of infants in care
5, Approval of Application by LPA's Manager

SUPERVISORS NAME: Diana Stephenson
LICENSING EVALUATOR NAME: Janette Cruz
LICENSING EVALUATOR SIGNATURE:	DATE: 10/14/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/14/2022

LIC809 (FAS) - (06/04)

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