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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434414254
Report Date: 03/04/2024
Date Signed: 03/04/2024 12:46:07 PM


COMPREHENSIVE INSPECTION

Document Has Been Signed on 03/04/2024 12:46 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
SAN JOSE CC RO, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME:SABAHI, SEYEDFACILITY NUMBER:
434414254
ADMINISTRATOR:SABAHI, SEYEDFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(408) 649-3028
CITY:SAN JOSESTATE: CAZIP CODE:
95132
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 0DATE:
03/04/2024
TYPE OF VISIT:Required - 3 YearUNANNOUNCEDTIME BEGAN:
09:15 AM
MET WITH:Seyed SabahiTIME COMPLETED:
11:45 AM
NARRATIVE
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On 3/4/24 Licensing Program Analyst (LPA) Sheena Chin met with Licensee, Seyed Sabahi, for an unannounced annual inspection. LPA explained the nature of today’s inspection to Licensee. There were no children in the facility but the licensee, his mom and his sister. Days and hours of operation are Monday to Friday, 7:00am to 6:00pm. The adults that reside in the home are licensee and his mom. The licensee stated that he rented this house.

Observation
LPA observed that required postings were posted. LPA, along with the licensee toured the inside and outside of the home. Fire extinguisher was not observed. The licensee stated that the facility had fire inspection during covid. Carbon monoxide and smoke detectors are working properly. The off-limit areas inside in the home are the second floor, one bedroom off the stairs, and garage. All disinfectant, cleaning supplies, and other items that could pose a risk to children were observed to be inaccessible. Toys for children were stored in boxes.

LPA observed that the licensee’s mom walked out of her bedroom to the day care area and his sister took care of his mom. The licensee stated that his mom usually stayed in her bedroom until 6pm when kids left and that his sister came to cook food for his mom once a week during weekends. LPA advised licensee that anyone who had contacts with children in care needed to have background and immunization clearances.

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SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Sheena Chin
LICENSING EVALUATOR SIGNATURE: DATE: 03/04/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/04/2024
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
SAN JOSE CC RO, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME: SABAHI, SEYED
FACILITY NUMBER: 434414254
VISIT DATE: 03/04/2024
NARRATIVE
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Records review
The Licensee has current CPR and First Aid certifications expiring 5/ 21 / 2024. The Licensee has the mandated reporter training certificate, expiring on 11/29/2024. LPA advised the licensee that the fire and disaster drills log needed to be done at least once every six months.

Licensee was reminded that all adults 18 and over living or working in the home, 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.

Discussion
Supervision of children was discussed with Licensee, who understood that he must be present in the home during day care hours and ensured that the children were supervised at all times. Licensee understood his capacity options. Licensee stated that he did not transport children via vehicle but he understood that children cannot be left in parked vehicles unattended at any time.

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.

Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02- CCP. 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: https://www.ada.gov/resources/child-care-centers/.

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SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Sheena Chin
LICENSING EVALUATOR SIGNATURE:

DATE: 03/04/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/04/2024
LIC809 (FAS) - (06/04)
Page: 3 of 3
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN JOSE CC RO, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME: SABAHI, SEYED
FACILITY NUMBER: 434414254
VISIT DATE: 03/04/2024
NARRATIVE
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Deficiency
There were no deficiencies cited at this time.

Exit
During the exit interview, the Licensee, Seyed Sabahi, confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.
Notice of site visit was given and must remain posted for 30 days.
Exit interview was conducted and report was reviewed with the Licensee, Seyed Sabahi
SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Sheena Chin
LICENSING EVALUATOR SIGNATURE:

DATE: 03/04/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/04/2024
LIC809 (FAS) - (06/04)
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