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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 343624958
Report Date: 07/21/2023
Date Signed: 07/21/2023 09:31:51 AM

Document Has Been Signed on 07/21/2023 09:31 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
SACRAMENTO CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME:NOORISTANI, TAMANA & FATIMAFACILITY NUMBER:
343624958
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 0DATE:
07/21/2023
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
08:45 AM
MET WITH:Fatima NooristaniTIME COMPLETED:
09:45 AM
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On July 21st, 2023 Licensing Program Analyst (LPA) Mandie Goodwin met with Licensee Fatima Nooristani for the purpose of an unannounced case management inspection. Licensee's daughter and assistant were in the home and Licensee's daughter provided translation services. All individuals subject to criminal background review have obtained a criminal record clearance. Licensee has requested to increase from a small family childcare to a large family childcare.

A health and safety inspection was conducted in all areas accessible to children. The home is on the bottom unit of a duplex and consists of 3 bedrooms, 2 bathrooms, living room, kitchen, and laundry room. Off-limit areas include laundry room and master bedroom/bath. Applicant acknowledges that child care children must not enter these off limits areas of the home, and their own children under 10 years will count toward the childcare ratio when present during operating hours. A fire clearance was granted on July 13th, 2023 for these areas.

LPA discussed CCR 102416.5 (d) which discusses the required ratios and capacity for a Large Family Child Care. LPA discussed personnel records needed for assistants. LPA discussed required documentation for adult and minor assistants.
Licensee was reminded that all adults 18 and over living in the home, persons who provide care and supervision to children, and staff who have contact with children, 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.

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. (1/2)
SUPERVISORS NAME: Seychelle De Luca
LICENSING EVALUATOR NAME: Mandie Goodwin
LICENSING EVALUATOR SIGNATURE: DATE: 07/21/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/21/2023
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME: NOORISTANI, TAMANA & FATIMA
FACILITY NUMBER: 343624958
VISIT DATE: 07/21/2023
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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.

Licensee was encouraged to visit the Department website at WWW.CCLD.CA.GOV for childcare updates, current forms, legislation and regulation information. This facility evaluation report was reviewed and discussed with the licensee.

In the areas that were evaluated, no deficiencies were observed.

Effective today, July 21st 2023, Licensee’s request for a Large Family Child Care License is approved. Licensee can now provide care for 12 children (when there is an assistant present) with no more than 4 infants or capacity of 14 children when 1 child in T-kindergarten or elementary school and 1 child at least age 6 and a maximum of 3 infants. Infants are children under the age of two years. Licensee understands that when there is no assistant present, ratios of a small capacity must be adhered to.


An exit Interview was conducted with Licensee Fatima Nooristani and a Notice of Site Visit was provided, which should remain posted for 30 days for parental review.
(2/2)
SUPERVISORS NAME: Seychelle De Luca
LICENSING EVALUATOR NAME: Mandie Goodwin
LICENSING EVALUATOR SIGNATURE:

DATE: 07/21/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/21/2023
LIC809 (FAS) - (06/04)
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