Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 191210523
Report Date: 08/08/2019
Date Signed: 08/12/2019 11:40:25 AM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME:MOZAFARI FAMILY DAY CAREFACILITY NUMBER:
191210523
ADMINISTRATOR:MOZAFARI, ZOHREHFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(818) 344-4740
CITY:ENCINOSTATE: CAZIP CODE:
91316
CAPACITY:12CENSUS: 8DATE:
08/08/2019
TYPE OF VISIT:Annual/RequiredUNANNOUNCEDTIME BEGAN:
12:04 PM
MET WITH:Zohreh MozafariTIME COMPLETED:
03:00 PM
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This is an unannounced annual comprehensive visit conducted by Margarit Sislyan, Licensing Program Analyst (LPA). LPA Sislyan met with Licensee, Zohreh Mozafari and toured the facility on 8/8/19 at 12:30 PM.

LPA observed 8 children were present at the facility during the visit. Licensee and her husband were present.

The home was inspected inside and out for safety, comfort, cleanliness, telephone service, heating and ventilation, inaccessibility to poisons, detergents, cleaning compounds, medicines, and hazardous items that can pose a danger to children. The First Aid kit was observed and complete. Per LIS the facility annual fees are current.
Per licensee, there are no weapons or firearms of any kind in the facility currently. The LPA did not observe any weapons. There is no pool or other bodies of water on the property.

There are age appropriate toys and napping equipment on the premises. The required fire extinguisher (2A 10BC) and smoke detectors are in operable condition. Licensees have current copies of CPR/First Aid; expiration dates are 02/23/19. Licensee has posted as required the License, disaster plan, Parents Rights Poster, Child Seat Safety Law and Earthquake Preparedness Checklist.

The following were discussed: No smoking, no infant walkers, Johnny jumpers, exersaucers and any other item that falls into that category. The LPA also discussed earthquake safety and necessity of drills, required forms for children’s files, facility files and posting requirements and penalty. Fingerprint clearance, transfer process and penalty. The new regulation 102416.3 Alterations to Existing Buildings or Grounds. The Parent Notification AB633 and the licensee discipline practiced by the licensee. Licensee was informed that she is a mandated child abuse reporter with the responsibility of reporting any suspected child abuse to the Child Abuse Hotline at (800) 540-4000.
SUPERVISOR'S NAME: Sharon GreeneTELEPHONE: (424) 302-3048
LICENSING EVALUATOR NAME: Margarit SislyanTELEPHONE: ((42) 430-3049
LICENSING EVALUATOR SIGNATURE:

DATE: 08/08/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/08/2019
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, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: MOZAFARI FAMILY DAY CARE
FACILITY NUMBER: 191210523
VISIT DATE: 08/08/2019
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Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. 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

Senate Bill 792: This bill, commencing September 1, 2016, prohibits a person from being employed or volunteering at a child care facility or family day care if he or she has not been immunized against influenza, pertussis and measles.

New Immunization Requirement: Law enacted by SB 277, beginning January 1, 2016, personal beliefs exemptions will no longer be an option for the vaccines that are currently required for entry into child care or school in California. Personal beliefs exemptions already on file will remain valid until the child reaches the next immunization checkpoint.

Assembly Bill 1207 (Lopez), Chapter 414, Statutes of 2015: Beginning on January 1, 2018, this law 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 directly 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/

LPA discussed the safe sleep guidance for infants.

Exit Interview Conducted
For additional information and forms visit our website at: www.ccld.ca.gov
SUPERVISOR'S NAME: Sharon GreeneTELEPHONE: (424) 302-3048
LICENSING EVALUATOR NAME: Margarit SislyanTELEPHONE: ((42) 430-3049
LICENSING EVALUATOR SIGNATURE:

DATE: 08/08/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/08/2019
LIC809 (FAS) - (06/04)
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