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

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376100962
Report Date: 02/14/2022
Date Signed: 02/14/2022 12:17:31 PM

Document Has Been Signed on 02/14/2022 12:17 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:FAIZI, ADILA FAMILY CHILD CAREFACILITY NUMBER:
376100962
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 2DATE:
02/14/2022
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME BEGAN:
09:05 AM
MET WITH:Adila FaiziTIME COMPLETED:
12:25 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 2/14/2022 at 9:05am, Licensing Program Analysts (LPAs), Saraliz Velando and Keturah Lane conducted an announced Pre-Licensing Inspection. LPAs were greeted at the front door by applicant, Adila Faizi also present in the home was Mohammad Faizi (who translated for Licensee in Farsi) and granted entry after identifying themselves and disclosing the purpose of their visit. Also present were Licensee’s five minor children, two of which were under the age of ten years old. The applicant has applied for a capacity of eight (8). The home consists of four (4) bedrooms and two (2) bathrooms. The applicant will be using the following areas for daycare: Living room, bedroom 4, bathroom 1. Off limit areas include: Bedroom 1, Bedroom 2, Bedroom 3, Backyard, Garage and are inaccessible by use of door knob covers. There is an attached garage to the house. Outdoor play area will take place at a community park in the area with constant supervision. Licensee decided to make backyard off limits at this time and understands that she will need to contact Licensing before deciding to use the backyard for child care. An overall inspection of the home was conducted. The inspection included, but was not limited to:

The home has a functioning smoke detector and carbon monoxide alarm. There is a fireplace in the living and has been made inaccessible to children by barricading with a sofa. Storage areas for poisons, detergents, cleaning solutions, medications and items which state keep out of reach of children have been locked and inaccessible to children. There are no bodies of water in the home. Applicant, Adila Faizi, advised there are no firearms or ammunition stored on the premises. The home is kept clean, with heating and ventilation for safety, and comfort. The home provides safe toys, play equipment and materials. All required documents were posted. Licensee requested information regarding capacity increase when eligible. Licensee had a previous license at a different location. Home appears large enough to comfortably accommodate fourteen children.

The new provider packet was reviewed with the applicant including information on children’s records, immunizations, child abuse reporting, car seat laws, Shaken Baby Syndrome, SIDS, Safe Sleep and the effects of lead poisoning. Also included was information on Incidental Medical Services and the YMCA Resource Center. Applicant stated they have enough financial resources to sustain the license. (Continued on LIC809C)
SUPERVISORS NAME: Monica Cuddy
LICENSING EVALUATOR NAME: Saraliz Velando
LICENSING EVALUATOR SIGNATURE: DATE: 02/14/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/14/2022
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 2
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: FAIZI, ADILA FAMILY CHILD CARE
FACILITY NUMBER: 376100962
VISIT DATE: 02/14/2022
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
Applicant was also reminded that corporal punishment, smoking, walkers, exer-saucers, jumpers and bouncy seats shall not be permitted during daycare operation. All equipment that is used should be used only as intended by the manufacturer. Applicant Adila Faizi, states that she is aware that interference with a child’s daily functions, physical or mental abuse and corporal punishment is not permitted. LPA and applicant discussed California Megan’s Law and LPA provided the link www.meganslaw.ca.gov. LPA discussed Safe Sleep regulations with applicant 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 CPSC to be notified of any recalls on their purchased equipment.

LPA discussed the following with the applicant: Maximum capacity for a small family child care home; 4 infants only (infants defined as children under 24 months) or 6 children with no more than 3 infants; or with landlord consent, 8 children with no more than 2 infants – 1 child in kindergarten or elementary school and 1 child at least age 6 including children under the age of 10 who reside in the applicant’s home.

All individuals subject to a criminal record review have obtained a clearance and/or an exemption prior working, residing or volunteering in the home. The applicant was reminded that all adults 18 years and over living or working in the home, including employees or 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 maximum per day/per person will be assessed if there is regulation is violated. The applicant has completed training on preventive health practices including pediatric CPR and First Aid. Staff immunizations were reviewed and are in compliance. There is a working telephone and email address. LPA provided the applicant with the following: Child Care Advocates email address of [email protected]. 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. Applicant agreed to comply with all regulations and laws governing Family Child Care Homes. Additional Technical Assistance was provided and noted on the attached Advisory Note – Technical Assistance (LIC 9102). An exit interview was conducted and the report was reviewed with applicant, Adila Faizi.
SUPERVISORS NAME: Monica Cuddy
LICENSING EVALUATOR NAME: Saraliz Velando
LICENSING EVALUATOR SIGNATURE:

DATE: 02/14/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/14/2022
LIC809 (FAS) - (06/04)
Page: 2 of 2