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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 343624749
Report Date: 03/05/2024
Date Signed: 03/05/2024 02:09:38 PM

Document Has Been Signed on 03/05/2024 02:09 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
SACRAMENTO CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME:SHIRZAD, SILGY AND AHMAD FAISALFACILITY NUMBER:
343624749
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 0DATE:
03/05/2024
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
01:30 PM
MET WITH:Faisal AhmadTIME COMPLETED:
02:30 PM
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On Tuesday, March 5, 2024 at 1:30 PM, Licensing Program Analysts (LPAs) Tanya Washington and Fabian Schwartz met with Licensees Faisal Ahmad and Silgy Shirzad for an unannounced case management inspection to increase capacity to the maximum number of 14 children. There were no day care children in care during the inspection. LPAs reminded Licensees that related children who reside in the home count in ratio/capacity until they turn 10 years old. Everyone residing in the home have obtained the required fingerprint clearance. Facility hours and days of operation are Monday- Friday from 3 PM to 9 PM.

Licensees rent the apartment and have permission from the apartment management to watch up to 14 children (signed consent form LIC9149 is on file). LPAs discussed capacity options with and without an assistant and when the Licensee or the assistant are alone they divert to small license ratio requirements. LPAs reminded Licensees that children must be supervised 100% when playing outside of the apartment.

On February 23, 2024, Sacramento Metropolitan Fire Department granted a fire clearance.

The off limit areas in the home are: entire second floor, laundry room and outdoor patio. Licensees acknowledged that children may never enter the off limit areas of the home. Per licensee, there are no weapons on the premises. Infant safe sleep guidelines were discussed.

There is a pool in the apartment complex which is fenced according to Title 22 Regulations.
Both Licensees have current CPR and First Aid certification.

EFFECTIVE TODAY, 03/05/2024 THE FACILITY IS LICENSED TO SERVE A MAX. CAP OF 12 (WHEN THERE IS AN ASSISTANT PRESENT): WITH NO MORE THAN 4 INFANTS.
OR MAX CAP 14 - NO MORE THAN 3 INFANTS. 1 CHILD IN KINDERGARTEN OR ELEMENTARY SCHOOL AND 1 CHILD AT LEAST AGE 6. Notice of site visit posted and appeal rights were provided.
SUPERVISORS NAME: Amanda Blesi
LICENSING EVALUATOR NAME: Tanya Washington
LICENSING EVALUATOR SIGNATURE: DATE: 03/05/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/05/2024
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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