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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 073406112
Report Date: 04/27/2023
Date Signed: 04/27/2023 11:56:02 AM

Document Has Been Signed on 04/27/2023 11:56 AM - 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, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612
FACILITY NAME:RAZA, NAZREENFACILITY NUMBER:
073406112
ADMINISTRATOR:RAZA, NAZREENFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(925) 477-6361
CITY:ANTIOCHSTATE: CAZIP CODE:
94531
CAPACITY: 14TOTAL ENROLLED CHILDREN: 8CENSUS: 3DATE:
04/27/2023
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
09:40 AM
MET WITH:Nazreen RazaTIME COMPLETED:
12:10 PM
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On 4/27/23 at 9:40 AM Licensing Program Analyst (LPA) Michelle Sutton conducted an unannounced Case Management inspection at Nazreen Raza Family Childcare Home. LPA met with the Licensee Nazreen. Present in the home at the time of the inspection were licensee and 3 preschool children. The licensee requested to license the entire home for the daycare.

LPA inspected the entire home to conduct a health and safety inspection. LPA did not observe any hazardous items or conditions, toxins, bodies of water or medications accessible to children. The licensee has an ample supply of age appropriate toys. The fireplace in the family room is screened. The licensee confirmed that there are no other changes to the on/off limit areas.

The off-limit areas is laundry room and garage. The daycare room in the home entry, family room, kitchen area, 3 bedrooms, 2 bathrooms and backyard are the primary areas of daycare. There are no deficiencies cited during today's inspection. A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with the licensee Nazreen Raza.

SUPERVISORS NAME: Sherelle Johnson
LICENSING EVALUATOR NAME: Michelle Sutton
LICENSING EVALUATOR SIGNATURE: DATE: 04/27/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/27/2023
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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