434417382-10-25-2023-07-CC-AMOS-CWXU85-20231025152058

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 434417382
Report Date: 10/24/2023
Date Signed: 10/25/2023 03:21:04 PM

Document Has Been Signed on 10/25/2023 03:21 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
SAN JOSE CC RO, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME:	SALARI, SOHEILA		FACILITY NUMBER:	434417382
ADMINISTRATOR:	SALARI, SOHEILA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(408) 791-4501
CITY:	SANTA CLARA	STATE: CA	ZIP CODE:	95051
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 14	CENSUS: 0	DATE:	10/24/2023
TYPE OF VISIT:	Prelicensing	ANNOUNCED	TIME BEGAN:	01:55 PM
MET WITH:	Sohelia Salari		TIME COMPLETED:	03:40 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) Anna Morales conducted a Pre-Licensing Inspection and was greeted by Licensee Sohelia Salari and her son Sayyed Shahriar “Sean” Eftekhar. Licensee submitted an application for relocation from 3098 FRESNO STREET, Santa Clara, CA to current location, 2861 Stevenson Street, Santa Clara,CA with a capacity of 8. The Licensee, her husband and her son will be the only adults residing at this location. The hours of operation are Monday - Friday, 7:30am - 6:00pm. The Licensee's CPR and First Aid are current, and expire October 2024. The Licensee has completed Preventative Health Practices Training with Nutrition only. Licensee is scheduled to complete the course with 2020 Lead Poisoning Prevention in November 2023. Licensee will be submitting certificate upon completion to CCL. Applicant will obtain liability insurance upon receiving her license. LPA toured the indoor and outdoor areas of the home during today's inspection. The Licensee has a working telephone in the home. LPA observed sufficient materials, toys, and play equipment for the children in care. The home is orderly, and safe for the day care children. This is a two story home and LPA observed a barricade in front of the stairs. The fire place inside the living room is also barricaded. The off limit areas inside the home are: the entire second floor, the front living/dining room, kitchen and the garage. The off limits outside the home are: the left side of the back yard. LPA observed a fully charged 3A-40BC fire extinguisher, working smoke, and carbon monoxide detectors. LPA did not observe a body of water. The Licensee states that she does not have any weapons in the home. All detergents, cleaning compounds, poisons, medications, and other similar items are out of reach and inaccessible to children.

SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Anna Morales
LICENSING EVALUATOR SIGNATURE:	DATE: 10/24/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/24/2023

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
SAN JOSE CC RO, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME: SALARI, SOHEILA	FACILITY NUMBER: 434417382
	VISIT DATE: 10/24/2023

NARRATIVE

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LPA observed a enclosed playground with age appropriate toys. There are mats underneath the climbing structure and Licensee stated they will place additional mats underneath the playground.

Licensee states that she does not smoke and understands that smoking is prohibited during day care hours. The Licensee states that she does not have any baby walkers/inclined sleepers in the home and understands that baby walkers/inclined sleepers are not allowed in the day care.

The Licensee will be using redirection, and offer alternative activity as forms of discipline. Licensee understands that children's personal rights should not be violated; including no corporal punishment. Discussed isolation of sick children, supervision of children, capacity options, transportation of children, requirements for reporting suspected child abuse, unusual incidents/injuries, heat related illnesses, and requirements for assistant/substitute.

Licensee is encouraged to visit the Department's website at www.cdss.ca.gov (shortcut: www.ccld.ca.gov) to access resources for Providers, Regulations, Online option to pay Annual License fee, Adoption of Laws, etc.

Incidental Medical Services (IMS) policy was discussed with the Licensee and stated that she will not take care of children if they are sick, and does not plan on administering medication to the day care children at this time. 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.

LPA discussed the requirements of AB 633 with the Licensee and understands the AB 633 fact sheet/copy of Acknowledgement of Receipt of Licensing Reports (LIC 9224). LPA discussed "zero tolerance" related regulations with the Licensee and advised the Licensee of the assessment of an immediate $500 per day civil penalty for any violation of a "zero tolerance" related regulation. An ongoing civil penalty of $100 per day continues until the violation(s) is corrected. LPA reminded the Licensee of the applicable civil penalties for those adults who have not received fingerprint clearances, are not associated to the license, and who come in contact with or provide care and supervision to the children.

SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Anna Morales
LICENSING EVALUATOR SIGNATURE:	DATE: 10/24/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/24/2023

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
SAN JOSE CC RO, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME: SALARI, SOHEILA	FACILITY NUMBER: 434417382
	VISIT DATE: 10/24/2023

NARRATIVE

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LPA discussed the safe sleep regulations with licensee and discussed the Child Care Licensing Safe Sleep webpage at
https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-andresources/safe-sleep as an additional resource. LPA also informed licensees 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 informed Licensee that sleep sacks are not allowed to be used on infants.

Licensee has an indoor small dog and Licensee stated that the dog will be kept separated from the children.

No deficiencies are being cited at today's visit.

Exit interview conducted and report was reviewed with the Licensee. Licensee will submit Preventative Health and Safety to include the one hour lead and nutrition upon completion

Licensure pending on final review from Management.

SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Anna Morales
LICENSING EVALUATOR SIGNATURE:	DATE: 10/24/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/24/2023

LIC809 (FAS) - (06/04)

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