503906981-8-23-2021-04-CC-LGAN-C66TRT-20210823145804

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 503906981
Report Date: 08/23/2021
Date Signed: 08/23/2021 02:58:11 PM

Document Has Been Signed on 08/23/2021 02:58 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, 1310 E. SHAW AVE,
FRESNO, CA 93710

FACILITY NAME:	ARIANEH, ESTHER FAMILY CHILD CARE		FACILITY NUMBER:	503906981
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY: 8	TOTAL ENROLLED CHILDREN: 0	CENSUS: 8	DATE:	08/23/2021
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	01:45 PM
MET WITH:	Esther Arianeh		TIME COMPLETED:	03:10 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	On 08/23/2021, Licensing Program Analyst (LPA), Luisa Gavoutian, conducted an unannounced Annual Inspection. LPA was greeted by Licensee Esther Arianeh who accompanied LPA on a tour of the home, inside and outside, as shown on the facility sketches (LIC 999A) provided. Present during today’s inspection were eight children. The areas of the home that are accessible to the daycare children are the living room, dining room, nook, family room, kitchen, downstairs bathroom, and backyard. “Off-limits” rooms are made inaccessible by child safety gate. No pets were observed during today's inspection. Licensee stated there are no firearms in this home. Swimming pool is fenced per regulation. The pool gate is self-latching, self-closing and opens away from the swimming pool. No windows or doors have direct access to the pool area. No poisons were observed during the inspection. Detergents, cleaning compounds, medications and other hazardous items are inaccessible to children. Fireplace is inaccessible to children by metal doors and will not be in use during daycare hours. There is a working fire extinguisher, which was purchased within the last year. LPA tested the smoke detector and carbon monoxide indicator, which were both in working condition. The home has adequate heating and ventilation for safety and comfort. Stairs are barricaded when children under age 5 years old are present. Safe toys and play equipment were observed. There are currently no infants in care. LPA discussed Safe Sleep Regulations with Licensee. Licensee understands that when infants are enrolled, there shall be one crib or play yard for each infant in care, cribs and play yards shall be kept free from all loose articles and objects while infants are sleeping, and there shall be no objects hanging above or attached to the crib or play yard. Infants shall not be swaddled while in care. Infants up to 12 months of age shall be placed on their backs for sleeping. (Continued on LIC 809-C)

SUPERVISORS NAME: Alice Juarez
LICENSING EVALUATOR NAME: Luisa Gavoutian
LICENSING EVALUATOR SIGNATURE:	DATE: 08/23/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/23/2021

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, 1310 E. SHAW AVE,
FRESNO, CA 93710

FACILITY NAME: ARIANEH, ESTHER FAMILY CHILD CARE	FACILITY NUMBER: 503906981
	VISIT DATE: 08/23/2021

NARRATIVE

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Licensee shall physically check on sleeping infants every 15 minutes and document any signs of distress which includes but is not limited to flushed skin color, increase in body temperature, restlessness and labored breathing. Infants shall be visually observed through an open door if sleeping in a separate room. Individual Infant Sleeping Plan shall be completed and in file for each infant up to 12 months of age.

Adequate supervision is being provided during this inspection. Children are accorded safe, healthful, and comfortable accommodations, furnishings, and equipment. Licensee maintains an area where ill children can be separated. Licensee is aware that children shall not be left in parked vehicles. Children are supervised when outside in the unfenced play area and there are no hazards to children present. Car seats are used for transportation purposes only and are not used for sleeping children. Capacity as specified on the license is being maintained.

There is a working telephone and cellphone number was verified. LPA reviewed a sample of children’s files, which were all complete with emergency information as required. Licensee maintains documentation of immunizations for influenza, pertussis, and measles for herself. Licensee’s Pediatric CPR/First Aid are current expiring on 10/13/2021. Licensee’s Mandated Reporter training certificate was completed on 02/21/2021. Licensee is aware that any authorized employee of the Department may enter and inspect any place providing personal care and services at any time, with or without advanced notice. Days and hours of operation are Monday – Friday; 6:00 a.m. – 6:00 p.m.

All adults who reside or work in the home have a criminal record clearance or exemption. There are no excluded individuals present at this home. Licensee is aware that upon notice from the Department, any excluded individual must be immediately removed from the home and prevented from returning to the home or having contact with children in care.

This facility does not provide Incidental Medical Services – IMS. Licensee is aware that an IMS plan is required to be submitted to the licensing office if they provide any of these services. Information regarding Americans with Disabilities Act (ADA) can be obtained by contacting US Department of Justice toll free ADA Information line at (800) 514-0301(voice), (800) 514-0383 (TDD) and website link https://www.ada.gov/childqanda.htm.
(Continued on LIC 809-C)

SUPERVISORS NAME: Alice Juarez
LICENSING EVALUATOR NAME: Luisa Gavoutian
LICENSING EVALUATOR SIGNATURE:	DATE: 08/23/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/23/2021

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, 1310 E. SHAW AVE,
FRESNO, CA 93710

FACILITY NAME: ARIANEH, ESTHER FAMILY CHILD CARE	FACILITY NUMBER: 503906981
	VISIT DATE: 08/23/2021

NARRATIVE

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LPA & Licensee discussed the Community Care Licensing (CCL) website (www.ccld.ca.gov) which provides access to Provider Information Notices (PINs), Quarterly Updates, Mandated Reporter Training, Forms, and Regulations. Licensee stated she is receiving PINs and updates through email. LPA discussed infant items permitted in Family Child Care Homes and left a visual handout. LPA provided Licensee with the “Effects of Lead Exposure” brochure in accordance with AB 2370, Chapter 676, Statutes of 2018.

Per Title 22, Division 12, Chapter 3, of the California Code of Regulations, no deficiencies were cited. Licensee was provided a copy of appeal rights.

This report shall be made available to the public upon request. LIC 9213 Notice of Site Visit is provided and required to be posted for 30 days.

SUPERVISORS NAME: Alice Juarez
LICENSING EVALUATOR NAME: Luisa Gavoutian
LICENSING EVALUATOR SIGNATURE:	DATE: 08/23/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/23/2021

LIC809 (FAS) - (06/04)

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