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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376101598
Report Date: 01/16/2024
Date Signed: 01/16/2024 10:14:06 AM

Document Has Been Signed on 01/16/2024 10:14 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:FAIZI, TOBA FAMILY CHILD CAREFACILITY NUMBER:
376101598
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 6TOTAL ENROLLED CHILDREN: 6CENSUS: 3DATE:
01/16/2024
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
08:35 AM
MET WITH:Toba FaiziTIME COMPLETED:
10:25 AM
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On January 16, 2024 at 8:35 a.m. Licensing Program Analyst (LPA) Leilani Curtis conducted an unannounced case management inspection to address the licensee’s request for an increase of capacity. Upon arrival LPA met with Licensee Toba Faizi. Also present was the applicant’s husband Mohammad Fahim Hamidi. Mohammad Hamidi left the facility at approximately 8:45 a.m. and translated for the licensee via telephone. The licensee’s primary language is Dari. There were 3 children present, none of whom are under 24 months. The facility was observed operating within ratio and capacity. The one story, 2 bedroom, 2 bathroom home was toured and inspected to ensure an environment safe for the care and supervision of children. Because the licensee rents/leases the home, proof of landlord notification is required. The LPA observed the Property Owner/Landlord Notification form (LIC9151) that the licensee confirms was provided to the property owner/landlord. The licensee obtained a signed Property Owner/Landlord Consent form (LIC 9149) to care for 14 children. A fire clearance for a capacity of 14 children was received on 01/09/24. The home appears large enough to comfortably accommodate 14 children.

Licensee uses the following areas for child care: kitchen, living room, bedroom #2 and bathroom #2. Off limits areas include: bedroom #1, bathroom #1 and enclosed rear yard. There are no stairs in the home. Licensee will utilize a nearby park for outdoor activities. The licensee understands that she must maintain 100% visual supervision of the children in care while at the park. There are no bodies of water observed during time of visit. The fire extinguisher, smoke and carbon monoxide detector meet requirements and are operational. All poisons, cleaners and hazardous items in the home are inaccessible to children through latches, locks, and/or placed up on high surfaces. Children’s toys and play equipment are available. Applicant states there are NO firearms or other weapons in the home.

SUPERVISORS NAME: Tashima Daniel
LICENSING EVALUATOR NAME: Grace Curtis
LICENSING EVALUATOR SIGNATURE: DATE: 01/16/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/16/2024
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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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, TOBA FAMILY CHILD CARE
FACILITY NUMBER: 376101598
VISIT DATE: 01/16/2024
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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 or exemptions. Pediatric CPR and First Aid certifications expire on 05/21/2025. Licensee has completed the Mandated Child Abuse Reporting-per AB1207. Mandated Reporter certification expires on 9/6/25. LPA reviewed certification and is in compliance. Immunization records per SB792 were reviewed and are in compliance for all personnel that will be providing care and supervision to children. Children records were reviewed for Emergency Information.

There are no new adults living or working in the home over the age of 18 years. 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, except as specified in Health and Safety Code section 1596.871, 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 for a maximum of 5-days or, if the penalty is for a repeat violation, for a maximum of 30-days per person will be assessed if this regulation is violated.

No deficiencies are cited. No corrections are needed; a license for a capacity of 14 children will be issued after final file review.

Exit interview conducted and report was reviewed with Licensee Toba Faizi. Mohammad Fahim Hamidi translated this report into Dari for the licensee.



A notice of site visit was given to the licensee which must remain posted on, or immediately adjacent to, the interior side of the main door for 30 days.
SUPERVISORS NAME: Tashima Daniel
LICENSING EVALUATOR NAME: Grace Curtis
LICENSING EVALUATOR SIGNATURE:

DATE: 01/16/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/16/2024
LIC809 (FAS) - (06/04)
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