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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 304314112
Report Date: 04/25/2024
Date Signed: 04/25/2024 09:41:47 AM

Document Has Been Signed on 04/25/2024 09:41 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
ORANGE CO CHILD CARE, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
FACILITY NAME:AKHAVAN, MAHJABINFACILITY NUMBER:
304314112
ADMINISTRATOR/
DIRECTOR:		AKHAVAN, MAHJABINFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(949) 742-2581
CITY:IRVINESTATE: CAZIP CODE:
92620
CAPACITY: 14TOTAL ENROLLED CHILDREN: 6CENSUS: 2DATE:
04/25/2024
TYPE OF VISIT:POCUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:00 AM
MET WITH:Licensee-Mahjabin AkhavanTIME VISIT/
INSPECTION COMPLETED:
10:00 AM
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Licensing Program Analyst (LPA), Navar conducted a visit for the purpose of a Plan of Correction (POC). LPA observed licensee Mahjabin, Akhaven caring for 2 infants inside the living room area. Licensee was operating within the licensed capacity as specified on license. Facility Day care hours are 8:00 AM - 5:30/5:45PM, Monday through Friday.

A review of the Facility Personnel Report Summary on this date indicates all facility residents, staff, or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions.

On 03/11/2024 LPA conducted a 3-year annual inspection. LPA observed the pool gate bent over during tour. Licensee picked gate back up and latched it with a carabiner lock. Licensee rolled a child’s push toy into the fence and the fence bent over. Licensee stated that she doesn’t know what happened and that she can’t remember. A Type A citation was issued 102417(g)(5)(A) (g) The home shall be free from defects or conditions which might endanger a child. Safety precautions shall include but not limited to: (5) All licensees shall ensure the inaccessibility of pools (in-ground and above-ground), fixed-in-place wading pools, hot tubs, spas, fishponds, and similar bodies of water through a pool cover or by surrounding the pool with a fence. (A)Fences shall be at least five feet high and shall be constructed so that the fence does not obscure the pool from view. The bottom and sides of the fence shall comply with Division 1, Appendix Chapter 4 of the 1994 Uniform Building Code. In addition to meeting all of the aforementioned requirements for fences, gates shall swing away from the pool, self-close and have a self-latching device located no more than six inches from the top of the gate. Pool covers shall be strong enough to completely support the weight of an adult and shall be placed on the pool and locked while the pool is not in use.

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SUPERVISORS NAME: Judy Hanson
LICENSING EVALUATOR NAME: Karen Navar
LICENSING EVALUATOR SIGNATURE: DATE: 04/25/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/25/2024
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
ORANGE CO CHILD CARE, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
FACILITY NAME: AKHAVAN, MAHJABIN
FACILITY NUMBER: 304314112
VISIT DATE: 04/25/2024
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On 4/05/2024 In the areas that were evaluated, the plan of correction was not in compliance and deficiency was observed of the California Code of Regulations, Title 22, Division 12 section 102417(g)(5)(A) (g) (5) All licensees shall ensure the inaccessibility of pools.....a Civil Penalty was issued.

On 4/25/2024 today’s interview and observations with licensee Mahjabin Akhaven. Licensee stated she had fixed the pool and put cement in the wholes where the poles are. LPA observed fence gate latched with a self-latching and self-closing gate latch. Licensee pushed a child’s scoot bike into fence and fence did not bend over or wobble back and forth.

In the areas that were evaluated, NO deficiencies were observed in the California Code of Regulations, Title 22, Division 12 at the time of the visit.



Exit interview conducted and report was reviewed with the licensee Mahjabin, Akhaven. A notice of site visit was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

Appeal Rights were explained. The Licensee was provided a copy of appeal rights (LIC 9058 01/16) and their signature on this form acknowledges receipt of these rights. All appeals must be in writing and received by the Regional Office within 15 business days. First level appeals should be sent to the regional manager to the address listed above.
SUPERVISORS NAME: Judy Hanson
LICENSING EVALUATOR NAME: Karen Navar
LICENSING EVALUATOR SIGNATURE:

DATE: 04/25/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/25/2024
LIC809 (FAS) - (06/04)
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