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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 073406112
Report Date: 05/30/2024
Date Signed: 05/30/2024 10:52:43 AM

Document Has Been Signed on 05/30/2024 10:52 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
OAKLAND CC RO, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612
FACILITY NAME:RAZA, NAZREENFACILITY NUMBER:
073406112
ADMINISTRATOR/
DIRECTOR:		RAZA, NAZREENFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(925) 477-6361
CITY:ANTIOCHSTATE: CAZIP CODE:
94531
CAPACITY: 14TOTAL ENROLLED CHILDREN: 8CENSUS: 4DATE:
05/30/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:00 AM
MET WITH:Nazreen RazaTIME VISIT/
INSPECTION COMPLETED:
11:00 AM
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On 5/30/2024 at 9:00 AM Licensing Program Analyst (LPA) Sikia Blue conducted an unannounced Annual Required inspection at Nazreen Raza Family Childcare Home. LPA met with licensee and explained the purpose of today's inspection. LPA was granted the inspection authority to enter the Home. The family childcare home days and hours of operation are Monday to Friday 6:00 AM to 11:59 PM. Present in the home at time of inspection were Licensee and 4 preschool age children in care. Per licensee there are 8 children enrolled at this time.

Licensee was reminded that all adults 18 and over living or working in the home, 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.

Per licensee, there are no weapons or firearms in the home.

Indoor Space: At 9:15 AM a health and safety tour of inside the home was done. LPA toured the premises with licensee. The home is sanitized and orderly in compliance with Title 22 Regulations at this time. There is a 3 A 40 BC fire extinguisher, smoke and carbon monoxide detector in the home. The home is a single family home consisting of 3 bedrooms, 2 bathrooms, living room, family room, laundry room and garage.

Last drill conducted and documented on 12/2023.

REPORT CONTINUED ON LIC 809C PAGE 2…

SUPERVISORS NAME: Mayla Mendoza
LICENSING EVALUATOR NAME: Sikia Blue
LICENSING EVALUATOR SIGNATURE: DATE: 05/30/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/30/2024
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
OAKLAND CC RO, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612
FACILITY NAME: RAZA, NAZREEN
FACILITY NUMBER: 073406112
VISIT DATE: 05/30/2024
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The OFF-LIMIT: areas are laundry room and garage. These areas are inaccessible to children in care by closed locked doors and visual supervision. IN-USE daycare room in the home entry, family room, kitchen area, 3 bedrooms, 2 bathrooms and backyard is used as the primary areas for day-care. Medicines, cleaning products, sharp objects are stored inaccessible to children in cabinets and draws with latches. LPA reminded licensee that baby walkers, bouncers, jumpers and similar items are not allowed in family childcare homes. Licensee states that there are no pets and no arms and ammunition stored in the home. The fireplace is screened, and the home maintains a working telephone.

Outdoor Space: LPA toured outdoor space at 9:25 AM. LPA inspected the backyard and observed a fully fenced backyard safe for children in care. LPA observed an ample supply of age-appropriate toys, equipment and furniture that appear to be safe and in good condition. LPA DID NOT observe any bodies of water. LPA observed a shed with a lock. LPA discussed with licensee when outside of facility, 100% supervision of children in care is required.

Facility does NOT provide transportation for children, but licensee understands that children cannot be left alone, unattended in parked vehicles.

Children’s records were reviewed to ensure that each child has an Identification and Emergency form. Personnel records were reviewed to ensure all employees’ files and certifications are up to date. Licensee’s Pediatric First Aid and CPR certificate and will expire 05/2025.

On or before March 30, 2018, any person who works in a childcare facility shall complete Mandated Reporter training and renew the training every 2 years. Website provided: https://www.mandatedreporterca.com/training/child-care-providers. Licensee has provided Mandated Reporter certificate and it will expire 4/2025.

REPORT CONTINUED ON LIC 809C PAGE 3…

SUPERVISORS NAME: Mayla Mendoza
LICENSING EVALUATOR NAME: Sikia Blue
LICENSING EVALUATOR SIGNATURE:

DATE: 05/30/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/30/2024
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
OAKLAND CC RO, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612
FACILITY NAME: RAZA, NAZREEN
FACILITY NUMBER: 073406112
VISIT DATE: 05/30/2024
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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

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-and-resources/safe-sleep as an additional resource. LPA also informed licensee 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.

To improve the quality and value of the new inspection process, a survey will be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or tools, please send them by email to [email protected]. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/process

No deficiencies cited today.

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: Mayla Mendoza
LICENSING EVALUATOR NAME: Sikia Blue
LICENSING EVALUATOR SIGNATURE:

DATE: 05/30/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/30/2024
LIC809 (FAS) - (06/04)
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