073408797-10-5-2023-02-CC-THAR-CWBVZ3-20231005165204

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 073408797
Report Date: 10/05/2023
Date Signed: 10/05/2023 04:52:10 PM

Document Has Been Signed on 10/05/2023 04:52 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, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612

FACILITY NAME:	TABAI, NAHIDALSADAT		FACILITY NUMBER:	073408797
ADMINISTRATOR:	TABAI, NAHIDALSADAT		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(925) 787-7537
CITY:	CONCORD	STATE: CA	ZIP CODE:	94518
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 14	CENSUS: 4	DATE:	10/05/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	02:30 PM
MET WITH:	NAHIDALSADAT TABAI		TIME COMPLETED:	05:00 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	Licensing Program Analyst Tasha Alexander met with licensee for an unannounced 1 YEAR/REQUIRED inspection. Present for the inspection were licensee, her adult daughter/assistant Nastaran Pazouki and 4 children in care, consisting of 3 infants and 1 preschoolers. There is one infant that is under 12 months. LPA toured the facility and backyard for a health and safety inspection. Today the home is observed to be clean and has sufficient heating and ventilation for the safety and comfort of children in care. The home is a single story home. There is a fully charged 2A10BC fire extinguisher and a working smoke alarm /carbon monoxide detector combo. Both were inspected/tested and found to be in working condition. There is a working telephone in the home, no change in phone number. Per licensee there are no fire arms/weapons on the premises. Outdoor play is in the backyard which is fully fenced. LPA observed an ample supply of age appropriate toys and activities, which were in good condition and free of defects. There is a swimming pool located in the backyard that is surrounded by a 5ft mesh fence with a self latching gate that swings away from the pool and meets California State Fire Marshall standard. Today the fence is locked and the swimming pool is empty. All poisons, cleaning solutions and medications are inaccessible to children. Licensee has current CPR and 1st Aid training which expires 8/2024 respectively. The last fire/disaster drill was conducted on 6/9/23. Today licensee is requesting to place an on limits bedroom, on the off limits list. The primary areas for child care are: The kitchen, day care room(dinning room), living room, hall bathroom and backyard. The off limits (children are not allowed) areas are: All 3 bedrooms including the master bathroom, garage and the swimming pool area which is fenced off. Isolation area is the living room. Licensee was reminded that baby walkers, excersaucers, baby bouncers and drop-down cribs are not allowed. LPA did not observe any of the aforementioned items today. Children's files were also reviewed today and found to be complete. Licensee was also informed of the licensing web address ( www.ccld.ca.gov) for downloading child care forms and (www.myccl.com) to register to receive child care updates

SUPERVISORS NAME: Loretta Dyson
LICENSING EVALUATOR NAME: Tasha Hackett-Alexander
LICENSING EVALUATOR SIGNATURE:	DATE: 10/05/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/05/2023

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, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612

FACILITY NAME: TABAI, NAHIDALSADAT	FACILITY NUMBER: 073408797
	VISIT DATE: 10/05/2023

NARRATIVE

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Effective September 1, 2016, a person may not work or volunteer at a child care center or family child care home unless he or she has been vaccinated against pertussis, measles and influenza or has an exemption. Today licensee and daughter both have immunization records in file. both decline the flu vaccine.

Today the newly implemented mandatory mandated reporter training course has also been discussed. Both licensee and daughter/assistant's certificates are up to date-expiration date 10/2024

To improve the quality and value of the new inspection process, a survey may be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or CARE tools, please send email inquiries to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/inspection-process. 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.

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SUPERVISORS NAME: Loretta Dyson
LICENSING EVALUATOR NAME: Tasha Hackett-Alexander
LICENSING EVALUATOR SIGNATURE:	DATE: 10/05/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/05/2023

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, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612

FACILITY NAME: TABAI, NAHIDALSADAT	FACILITY NUMBER: 073408797
	VISIT DATE: 10/05/2023

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LPA briefly discussed the safe sleep regulations with licensee and provided the Child Care Licensing Safe Sleep webpage at .https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-andresources/safe-sleep as an additional resource. LPA also informed licensee [or facility representative] 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 22-02CCP. 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/.

Licensee was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

Licensee confirms that no registered sex offenders reside in the home.

A notice of site visit was given and must remain posted for 30 days.

As a result of today's visit, there are no deficiencies cited.

An exit interview was conducted and this report was reviewed with the licensee, Nahidalsadat Tabai

. Appeal rights were provided.

SUPERVISORS NAME: Loretta Dyson
LICENSING EVALUATOR NAME: Tasha Hackett-Alexander
LICENSING EVALUATOR SIGNATURE:	DATE: 10/05/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/05/2023

LIC809 (FAS) - (06/04)

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