<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376100076
Report Date: 10/25/2021
Date Signed: 10/25/2021 12:40:04 PM

Document Has Been Signed on 10/25/2021 12:40 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
CCLD Regional Office, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108
FACILITY NAME:FOOLADI, FAHIMEH & RAHIMI, MASOUD FCCFACILITY NUMBER:
376100076
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 7CENSUS: 7DATE:
10/25/2021
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
11:05 AM
MET WITH:Fahimeh Fooladi and Masoud RahimiTIME COMPLETED:
12:45 PM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
On 10/25/2021 at 11:05am, Licensing Program Analyst (LPA) Selina Siao conducted an unannounced case management inspection for the purpose for capacity increase. Licensees has recently submitted a capacity increase application to the department on 10/01/2021 and obtained a prior fire clearance on 04/22/2021. A random inspection was recently conducted on 08/17/2021.
LPA conducted a tour of the day care areas to ensure the home is safe to care for children. Present at the facility were the Licensees Fahimeh Fooladi, Masoud Rahimi and helper Sahar Kashmari with 7 children including licensees new born infant, two day care infants and four toddlers older than two year old. Facility is operating out of ratio today. The home has a fully charged fire extinguisher, smoke and carbon monoxide detector that meet requirements and are operational. No hazardous are accessible to children during today's inspection. Licensee Masoud Rahimi stated that there are no bodies of water or weapons in the home. A review of staff records on this date indicates that all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse clearances.
Licensees has provided adequate space for the children to eat, sleep and play within the home. Areas used for child care include living room, kitchen/dining area, bedroom #1 and hallway bathroom. Licensee has requested to add bedroom #2 as part of the day care area, the room was inspected during today's visit. Off limits areas include master bedroom and bathroom which there is a door knob cover to prevent access. The facility has sufficient toys and equipment available. The home has an enclosed patio area for outdoor activities and visual supervision is required when children are outside. Facility is using the safe sleep log for infants 0-24 months and was advised to keep all children's records and roster for up to 3 years.
SUPERVISORS NAME: Monica Cuddy
LICENSING EVALUATOR NAME: Selina Siao
LICENSING EVALUATOR SIGNATURE: DATE: 10/25/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/25/2021
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 3
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108
FACILITY NAME: FOOLADI, FAHIMEH & RAHIMI, MASOUD FCC
FACILITY NUMBER: 376100076
VISIT DATE: 10/25/2021
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
Licensees 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.

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.

See LIC809D for citation issued:

A large license will be granted effective 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 Masoud Rahimi.
SUPERVISORS NAME: Monica Cuddy
LICENSING EVALUATOR NAME: Selina Siao
LICENSING EVALUATOR SIGNATURE:

DATE: 10/22/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/25/2021
LIC809 (FAS) - (06/04)
Page: 2 of 3
Document Has Been Signed on 10/25/2021 12:40 PM - It Cannot Be Edited


Created By: Selina Siao On 10/25/2021 at 11:57 AM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108

FACILITY NAME: FOOLADI, FAHIMEH & RAHIMI, MASOUD FCC
FACILITY NUMBER: 376100076

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/25/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
10/26/2021
Section Cited
HSC
1597.44

1
2
3
4
5
6
7
A small family day care home may provide care for more than six and up to eight children if all of the following are met: (3) More than six and up to eight children, if At least one child is enrolled in and attending kindergarten or elementary school and a second child is at least six years of age.
1
2
3
4
5
6
7
Licensees stated that they understand that their own children counts towards the capacity until they turn 10 year old. LPA reviewed the capacity chart with licensee Rahimi Mosoud today.
8
9
10
11
12
13
14
(b) No more than two infants are cared for during any time when more than six children are cared for ...... This requirement is not met as LPA observed 3 infants including licensee's new born and 4 toddlers in care today. This poses a potential health and safety risk to children in care.
8
9
10
11
12
13
14
Facility shall submit a written plan of correction to Analyst by 10/26/2021.

1
2
3
4
5
6
7
1
2
3
4
5
6
7

1
2
3
4
5
6
7
1
2
3
4
5
6
7
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Monica Cuddy
LICENSING EVALUATOR NAME:Selina Siao
LICENSING EVALUATOR SIGNATURE:
DATE: 10/25/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/25/2021


LIC809 (FAS) - (06/04)
Page: 3 of 3