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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376101229
Report Date: 12/13/2022
Date Signed: 12/13/2022 10:39:48 AM

Document Has Been Signed on 12/13/2022 10:39 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
CCLD Regional Office, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108
FACILITY NAME:SABER HOSSEINI, MARYAM FAMILY CHILD CAREFACILITY NUMBER:
376101229
ADMINISTRATOR:MARYAM SABER HOSSEINIFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(818) 300-3534
CITY:CARLSBADSTATE: CAZIP CODE:
92011
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 0DATE:
12/13/2022
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Applicant Maryam Saber HosseiniTIME COMPLETED:
10:45 AM
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On 10/29/21 @ 9:30 a.m., LPA Joelle Redding conducted an announced comprehensive visit for the purpose of a pre-licensing inspection. Applicant presented evidence of control of property/lease agreement. LPA confirmed with that all adults living in the home have been fingerprint cleared and associated with the facility and have met all the immunization requirements. Applicant has provided evidence of the completion of the required 16-hr. Health and Safety training to include a Pediatric First Aid/CPR certificate with A-B-Cpr, valid through 7/24 and Mandated Reporter Training valid through 5/24.

A tour of the home was conducted. The home is two stories with three bedrooms, three bathrooms and a one-car garage. Applicant will use the first floor (except for the kitchen) and a portion of the fully fenced back yard for day care. The second story, kitchen and the garage will be off limits and made inaccessible while day care children are present in the home. Applicant has been informed that all items that indicate "keep out of reach of children" are to be made inaccessible and there are no toxics, poisons or other hazardous items noted during this visit. The smoke detector (located on the wall above near the stairs) and carbon monoxide detector (located in the hall by the bathroom) are operational. The fire extinguisher meets Licensing regulation size (2A10BC or larger), is fully charged, easily accessible, and located in the hall closet. There is a sufficient amount of age-appropriate toys, books and games for children, in good condition. There are no bodies of water or firearms/weapons/ammunition on the premises. The back yard is fully fenced with safe, age-appropriate play items.

LPA discussed posting requirements and provided information on required departmental documents for children, regulation highlights, community resource listing, capacity limitations, nutrition programs, supervision, criminal record clearances and transfers, emergency drills, child passenger law, unusual incidents, mandated reporting, immunization cards/use of guide and liability insurance information. Applicant understands that smoking in or around day care areas is prohibited.
SUPERVISORS NAME: Renesha Askew
LICENSING EVALUATOR NAME: Joelle Redding
LICENSING EVALUATOR SIGNATURE: DATE: 12/13/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/13/2022
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
CCLD Regional Office, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108
FACILITY NAME: SABER HOSSEINI, MARYAM FAMILY CHILD CARE
FACILITY NUMBER: 376101229
VISIT DATE: 12/13/2022
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LPA discussed the safe sleep regulations and 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 Applicant 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. Walkers, exersaucers, jumpers, bouncy seats, napping portables and drop sided cribs are not permitted for use. Children will be observed upon entry and throughout the day for signs of illness. An appropriate isolation area has been established for sick children.

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, an updated Plan of Operation that includes 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 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.

Applicant is to be present in the home to ensure children are supervised and reminded that no children are to be left in parked vehicles and car seats are not to use used for sleeping. . Capacity limitations were reviewed. LPA discussed California Megan's Law and the website was provided as follows: www.meganslaw.ca.gov



Applicant is advised to sign up for Quarterly Updates and Provider Information Notices (PINs) for one or more programs on our website: www.ccld.ca.gov. Select “Child Care” then “Quick Links” and Quarterly Updates. Select “Receive Important Updates” then put the email address in and choose which program(s) you would like to subscribe to and select “subscribe.” Upon final file review, this facility will be ready for licensure. A new license will be sent for posting.
SUPERVISORS NAME: Renesha Askew
LICENSING EVALUATOR NAME: Joelle Redding
LICENSING EVALUATOR SIGNATURE:

DATE: 12/13/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/13/2022
LIC809 (FAS) - (06/04)
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